Medical education cost doubled in India amid global decline: Study

While India and China in 2008 had a low cost per student, these numbers shot up 10 years later

Medical education has historically been an expensive affair, but while the cost of medical education has largely been on the decline around the world, it is rising sharply in both India and China, according to a new Lancet study that examined trends in the field.

In 2008, China had the least expensive medical education courses, with its estimated expenditure per graduate standing at a mere $14,000 (around Rs 11.52 lakh by today's exchange rate). India, in 2008, was only behind China, with the estimated cost per graduate standing at $35,000 (around Rs 28.8 lakh today).

For comparison, in 2008, the estimated expenditure per medical student in courses for doctors was a whopping $400,000 (Rs 3.29 crore) in Western Europe and $497,000 (Rs 4.08 crore) in Northern America.

10 years later, however, the numbers tell a whole different story.

Contrasting trends

While there was not much change in North America vis-à-vis the cost of medical education for doctors, the expenditure per student drastically fell in Western Europe, down from $400,000 to $204,000. In Central and Eastern Europe, too, this was the trend, with costs falling from $181,000 and $151,000 in 2008 to $80,000 and $77,000 in 2018 respectively.

The declining cost of medical education for doctors also holds true for other parts of the world: in the high-income Asia Pacific countries, the estimated expenditure per student fell from $381,000 in 2008 to $223,000 in 2018; in central Asian countries, the cost per student declined from $74,000 to $63,000 and similar trends were observed in Latin America and sub-Saharan Africa, where costs fell from $132,000 and $52,000 in 2008 to $77,000 and $32,000 in 2018, respectively.

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In contrast to these trends, the cost of educating doctors in China in 2018 nearly tripled, rising to $41,000 (Rs 33.73 lakh) from the earlier $14,000. Even then, the average cost per student remained considerably lower than that of India, where the expenditure per student ballooned to $70,000 (Rs 57.6 lakh) in 2018.

The study found the aforementioned trends to hold true for medical education for nurses and midwives too, with China and India registering three-fold and two-fold increases in cost per student respectively while the rest of the world saw costs decline.

In 2018, the cost of medical education for midwives and nurses in China stood at $8,000 (Rs 6.58 lakh), up from $3,000 in 2008, while in India, it was $14,000 (Rs 11.52 lakh) in 2018, up from $7,000 earlier.

Workforce imbalances

The study also noted that the annual number of medical graduates and nursing graduates doubled and tripled respectively in the 2008-2018 period, but the distribution of this growth in the medical workforce was uneven across the world.

"Global distribution of the healthcare workforce continued to show imbalances related to skewed numbers of healthcare workers graduating among countries, with high-income countries having more graduates than low-income countries," the study observed.

"Despite having a higher density of healthcare workers and more professionals graduating than low-income countries, high-income countries (and high-income regions within countries) continue to attract and retain professionals from low-income countries and regions," the study said, adding, "This migration of trained health professionals both across and within countries exacerbates imbalances in the ratio of health professionals to population, and increases disparities in access and quality of health care."