This might come as shocking news for a number of USMLE graduate and Doctors who plan to study abroad. Citing the reason that India is facing a huge brain drain among its doctors, as they choose to leave the country to work abroad.

The Health Minister JP Nadda has decided to tackle the issue by not issuing the NORI (No Obligation to Return to India) certificate to doctors under any circumstances, except those over 65 years of age. A NORI certificate is required by a person who has gone to USA on J-1 visa. This visa provision requires J-1 holders to return to their home country for at least two years at the end of their exchange visitor program.

The government is dealing with a two problems here. One, is that in the last 4 years 3,947 permissions were issued to doctors, allowing them to study in the U.S.A meaning they anticipate a similar number to study abroad again, potentially taking away from fee revenue that would otherwise go to colleges in India. Two, the outflow of doctors would lead to an acute shortage in the much more densely populated India where urban and rural health programs are already facing a huge shortage of doctors. This is clearly visible by what Karnataka is attempting to do  But, that doesn’t give the government to act dictatorial and forcibly keep doctors in India while preventing them from securing their future via better courses, research and study opportunities abroad.

The Health Ministry in its defense claims that- better working facilities, pay scales, retirement and employee schemes are already in place and this should be sufficient for doctors. But again the question arises – Why can’t doctors decide where they want to work or study? There is no doubt this kind of draconian rules will adversely affect how doctors view India as a country in terms of being a ‘doctor friendly country’.

It should also be noted that almost 30-40 % engineering and management graduates from premier schools like IITs and IIMs leave country, but the government doesn’t seem to be concerned about that. This move if enforced wholly will ultimately prevent India from having world class Doctors.

Few important points to note:

1. The rule has loopholes!USMLE aspirants up to a few years ago (and apparently even now) were not issued NORI, as seen on the CGI (Consulate General of India) website where it says (w.e. March 5,2014), “Consulate General of India, ATLANTA will not provide No Obligation to Return to India (NORI) Service for Medical Doctors. The Ministry of Health and Family Welfare, New Delhi have issued new Guidelines, according to which, henceforth, No Obligation to Return to India (NORI) would not be issued by Ministry of Health & Family Welfare (MOH&FW) under any circumstance.” 

However for years now  doctors are applying for a H1 visa or going through the Conrad 30 waiver program that allows them to complete their 2 year bond in ‘undeserving parts’ of the U.S

2.Health Ministry serious this time? While a similar ‘serious’ attempt was made in 2012 by then Health Minster Gulam Nabi Azad and the Health Ministry, USMLE aspirants didn’t flinch and the government eventually didn’t follow through on the non-issuance of the certificate, knowing fully well that such a ruling could backfire. This time however, it will remain to be seen if the government implements this strong rule that has wide spread repercussions.

3. Reverse brain-drain: Lots of doctors who go abroad to pursue higher studies or work, do eventually return to India. Case in point being in 2013, when hospitals like Manipal and Sparsh received 8-12 applications from doctors the US, UK, Australia and Singapore; all in their early 30s. They were interviewing at least 1 doctor per week. This is conclusive proof of a ‘reverse brain drain’ contrary to the Health Ministry’s claim.

In conclusion, doctors who go abroad will make a decision to stay on or return to India based on their career goals, the government shouldn’t have to make up rules to force them to stay in India. Instead the Ministry should focus on requirements like- creating a transparent and enforced set of doctor protection laws, enforcing salaries for doctors in government and private teaching hospitals and other pressing issues.

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Join the conversation! 3 Comments

  1. Detrimental decisions for young aspiring medical graduates of India.

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  2. if u r patrotic enough, u ll stay in ur motherland and serve !!!!! don pinpoint n ask what the country, ask wht have you done for ur country before !!!! its a shame on u youngesters if u keep dreaming to run away and settle in foreign nations !!! its similar to leaving ur mom in old folks home, cz u hv ur own family and goals !!!

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  3. Respected Dr D Sahab…why are doctors always victimised?? I suppose …according to YOU people like SATYA NADELLA , SUNDER PICHAI, INDRA NOOYI, AJAYPAL BANGA, RAJEEV SURI, SHANTANU NARAYEN and a lot others are a shame to the nation, are not patriotic enough, and do not love their parents and are eager to settle in foreign nations!!! Please get off your telescopic vision only on doctors!! Why should only doctors be enchained? Why should not a structural engineer along with their archietect, civil, electric brothers and sisters from IIT or NIT be sent to a remote block in Korba and Dantevada to build a Multi speciality hospital with residencial quaters or say a school or say public toilets?? A graduate from various IIM must be put to manage a public treasury and to look after the finances in a block in Madhunani. Under his/her guidance there would be no scams after all they are one of the worlds best managers!!The nation should be able to utilise such big brains as they also used our hard earned reveniews for their education!!
    I tell you… giva a doctor a decent sallary, a basic residence , good infrastructure to do the best for the patients he treats, security, and protection (which are even not available in metros!) he will be more than obliged to work even at the ends of the world!

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