India considers allowing expatriate doctors to practise back home

BMJ 2012; 344 doi: (Published 04 May 2012) Cite this as: BMJ 2012;344:e3235
  1. Jane Elliott
  1. 1Delhi

A proposal to lure back from overseas doctors with Indian backgrounds to solve the country’s chronic shortage of trained staff has run into opposition.

India has a desperate need for more medical staff, with rural areas in particular struggling to recruit and retain medical staff.

The country needs another 600 000 doctors, a million more nurses, and 200 000 more dental surgeons.

To fill the shortfall India’s government wants to relax the rules so that doctors with the status of “overseas citizenship of India” (OCI) can also practise there. OCI is the term the government uses for people who come from India but have acquired citizenship of another country (India’s constitution forbids dual citizenship).

Last week India’s health ministry announced that it was making it obligatory for Indian medical graduates who pursue higher studies in the United States to return to India for at least two years after their studies in an effort to stop the medical “brain drain” from India.1

But in an echo of the hostility afforded to some Indians who travel to work in the West, there is some opposition to the plan to reverse the flow.

Anoop Misra, director and head of the department of diabetes and metabolic diseases at the Fortis Group of hospitals, Delhi, said that some are worried that relaxing the regulations could result in a drop in standards. There needed to be rigorous checks and balances for all, he said.

“Doctors from the US, the UK, and a few other developed countries should be competent enough, but trained doctors from some other countries may not come up to proper standards,” he warned.

He added that OCIs could also find themselves vulnerable when it came to treating tropical diseases.

“When we train doctors here, each subject, each exam is modulated to treat tropical diseases and those which are prevalent in India, like malaria, tuberculosis, and kala azar,” said Misra.

UK medical unions are warning their members that they could easily be without any legal protection if they work overseas.

James Armstrong, head of underwriting at the Medical Defence Union, said that OCIs needed to check whether they are insured before undertaking any work overseas.

“The MDU does not provide indemnity for doctors taking on employment overseas,” he said. “However, if a doctor is going overseas for a short period of time to carry out charity work, we may provide indemnity on a discretionary basis.

“Any member considering doing voluntary work is encouraged to discuss whether we can provide discretionary indemnity.”

India’s health minister, Dinesh Trivedi, said that getting some of India’s diaspora to return would greatly improve the provision of healthcare.

“Delivery of quality healthcare services to every nook and cranny of the country is a big challenge for government agencies,” he said. “The doctors of Indian origin are a critical mass, which constitutes about 25% of the global doctors’ pool.”


Cite this as: BMJ 2012;344:e3235