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Covid-19: China reopens borders to medical students, but problems remain

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o2280 (Published 21 September 2022) Cite this as: BMJ 2022;378:o2280
  1. Kamala Thiagarajan
  1. Madurai

Medical students from India who have been studying in China have been heartened by the decision to allow them to return to resume their studies in person, although they admit that many obstacles remain including exorbitant air fares and “zero covid” policies.

The Chinese government updated its visa policies for international students on 22 August, allowing them to return. China’s borders were sealed off to international travellers in January 2020, shortly after covid-19 struck.

More than 23 000 Indian students and 28 000 Pakistani students are thought to be affected by pandemic quarantines and unable to return to China even after two years.

The decision by the Chinese government to start issuing visas to international students comes after months of unrest for Indian medical students in particular. In May protests were held in Delhi, with medical students urging the government either to help them return to China or to arrange for their practical training in medical schools in India. The Supreme Court intervened and directed the Indian Medical Commission to help arrange for the students’ practical training in India.

On 8 September Ji Rong, counsellor at the Department of Asian Affairs in China’s Ministry of Foreign Affairs, tweeted: “Warmest congrats to #Indian #students! Your patience proves worthwhile. I can really share your excitement and happiness. Welcome back to #China.”

Quarantines

However, despite the official announcements, many students say that they cannot return until their universities issue formal permission in the form of “certificates of returning to campus.”

Mridul Salaria, a medical student in China’s Jiangsu province who returned to her home town of Pathankot, Punjab, in January 2020 on a vacation, has been attending online classes for over two and half years. She told The BMJ that she was waiting for her university to grant permission for her to return before she could apply for a visa.

Haris Rehman, from Peshawar, Pakistan, was admitted to Chengdu University of TCM, China, in September 2020 and is concerned about the rising costs of air fares, as direct flights to China have not resumed after the pandemic. “A flight ticket to China costs around 5 lakhs [500 000 Pakistani rupees; £1835; €2100; $2080], which is unaffordable. There are so very few and ridiculously expensive flights,” he said.

China’s zero covid policies also mean that international arrivals must provide negative PCR tests taken 12-48 hours before boarding a flight, which means that travellers must stay in transit countries for at least three days before they can fly into China, increasing costs for students.

Added to this are the long quarantines. In late June the quarantine period for international arrivals was reduced from 21 days to 10 days—with seven of those days spent at a government run quarantine facility. However, many universities still require an additional, two week quarantine when students arrive.

On 8 September the Indian embassy in Beijing advised prospective students to be cautious when considering applying to medical colleges in China.1 It said that, while graduates from Chinese medical schools needed to clear the FMGE (foreign medical graduate exam) in India to be eligible for clinical practice, they had a poor record of doing so. A performance assessment by the Indian embassy showed that from 2015 to 2021 only 6387 of 40 417 Indian students (16%) who sat the FMGE after graduating from Chinese medical colleges passed the exam.2

Despite the mounting difficulties, Salaria said that she was looking forward to going back and resuming her studies.

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