How Red Tape Is Killing Off Future Doctors in Crimea
WHY YOU SHOULD CARE
Because there are many issues with living in an annexed country, and this is one that’s been quietly overlooked.
With balloons strung up and cans of confetti ready to be sprayed, Abhishek Saini checked his computer one final time before his friends arrived to celebrate his graduation from medical school. It had been a long journey for the 25-year-old, who left his hometown of Ludhiana in India’s northern state of Punjab to join the Crimea State Medical University in Simferopol in 2008, back when the peninsula was still an unquestioned part of Ukraine.
But as Saini discovered in an email just before his poorly timed party in September, his dream of working in the U.S. or Europe as a doctor was unexpectedly put on hold because his degree, which bears a Russian government stamp, isn’t recognized by the U.S. or the European Union — both of which still consider Crimea to be a part of Ukraine. “I’m a qualified doctor, but suddenly much of the world doesn’t want me,” says Saini.
It’s been one year since Russia annexed Crimea, and while life has calmed down for many people with ties to the region, it’s another story for Saini and more than 500 medical students and grads from India. They, plus nearly 1,500 others from Crimea and different developing countries (mainly Africa) have found their job-related aspirations trapped in the geopolitical crossfire between Moscow and the West.
Part of the reason this problem is impacting so many Indian students in particular stems from a decadelong pull to Crimea’s medical colleges; the schools have attracted thousands of bookworms from India with significantly lower tuition fees, says Hardeep Singh, managing director of BobTrade Education Group, an education consultancy based in Kharkiv in eastern Ukraine. How much lower? Private Indian medical schools charge upward of $10,000 a year, compared with about $3,000 in Crimea.
These colleges are affiliated with the Crimea State Medical University, which in turn gets listed in the International Medical Education Directory, a global public database of med schools recognized by their own countries. It’s also the official directory that the U.S., Canada, the U.K. and many other major European nations use as a primary tool to screen foreign medical grads for licenses to practice, according to reps OZY spoke with from each government’s medical regulator. So what’s the problem here? It turns out Crimea State Medical University was registered in the IMED as a recognized institution under Ukraine — not in Russia, the country now technically handing out degrees.
Crimean grads would have to seek work in countries where they can take tests that would clear them for practice.
Crimea isn’t the first region that’s found itself in this position, of course. In some cases, annexations — like India’s swallowing of Goa in 1961 or China’s grab of Tibet in 1951 — were eventually accepted internationally. But in many others, including Golan Heights (occupied by Israel) or West Papua (which Indonesia took over), annexed regions still don’t boast globally recognized universities. Even East Timor, which has been independent since 2002 following 27 years of Indonesian annexation, still has no medical school in the IMED.
So while the issue in Crimea may seem like a simple bureaucratic oversight, it isn’t clear how it may play out for new doctors there. It’s also triggered a second roadblock for some doctors waiting to work in developed markets. Those seeking a license from the British regulator known as the General Medical Council, for instance, are required to make sure at least half of their courses were each “undertaken in the country that awarded the qualification,” says Andrew Edgeworth, a council spokesman. This requirement — which Saini and many others obviously can’t meet now — is at times relaxed, but boils down to an “individual, case-by-case basis,” Edgeworth says. Meanwhile, countries like Germany have “no policy [on] how to proceed,” says Dr. Alexander Jäkel, a policy adviser at Bundesärztekammer, the German Medical Association.
To be sure, the Crimean medical school is trying to get registered in the IMED under Russia. In a statement, it says, “We are aware of the problems our students have faced … and are trying to help.” And future doctors-in-training, like fourth-year student Rajesh Nigam, are counting on that help. Nigam’s father, a farmer from the western Indian state of Maharashtra, sold a tract of land to fund his son’s education in Crimea as a pathway to a career in the U.S. “I hope the university figures something out,” Nigam says.
The other alternative? Crimean grads would have to seek work in countries where they can take tests that would clear them for practice, including India, China or — yes — even Russia. Saini, in fact, is already pursuing that option.