According to the World Health Organization (WHO), the world faces a health worker shortage of approximately 20% (~15 million)—a gap likely to widen rapidly under the current education system, driven by chronic diseases and an ageing population. Simultaneously, rapidly changing technologies necessitate reskilling the existing 65 million global health workers. This presents a massive challenge for the world.
Consequently, the global mobility of health care talent is rising. Nations such as the US, Canada, Australia, and several European countries increasingly rely on internationally educated health professionals. This trend is highlighted by the OECD’s International Migration Outlook, which reports significant shares of foreign-trained doctors and nurses in advanced health systems.
This global deficit presents an opportunity for India. Historically, India has prioritised domestic sufficiency, making strides through changes in the National Medical Commission’s structure and policies. Our curriculum, regulations, and training remain distinct and tailored to local needs. The focus has been inward; in fact, global opportunities have often been viewed as a threat—a brain drain. However, this need not be a zero-sum game. It can be a win-win: The domestic market can continue to serve domestic requirements, while we simultaneously create a parallel export-oriented medical education ecosystem as a special economic zone.
This proposed Medical Education Global Centre of Excellence could be a sovereign play insulated from standard Indian regulations. It would allow free-market operations to attract investment, adopt global regulations and accreditations, and recruit health workers/faculty from India and abroad.
We should look closely at the Caribbean model and other such export- oriented models. Other nations, including Poland, have successfully deployed similar models to meet the standards of export markets like the US, UK, Canada, and Scandinavia.
Key lessons include:
- Curriculum alignment: Adopting global curricula (e.g. USMLE), textbooks, and faculty.
- Clinical integration: Tie-ups with global teaching hospitals for clinical rotations (e.g., the 2+2 year model).
- Accreditation: Adopting major global standards.
- Financial recognition: Securing recognition from the major target geographies department of education to ensure student eligibility for loans.
- Investment: Encouraging for-profit colleges with global investors.
India should pursue a Global Centre of Excellence model, export-oriented medical education SEZ zones, distinct from domestic regulations, taxation, and investment rules. These zones would deliver medical, nursing, and allied health care training under internationally aligned curricula, supported by frameworks designed for global accreditation and workforce mobility. Such SEZs would facilitate partnerships between Indian institutions, the global private sector, and leading international universities, providing the flexibility required to align with destination-country licensing requirements.
A targeted incentive framework—including tax holidays, GST/duty exemptions, and export incentives—would attract private investment and lower education costs. By leveraging India’s strong clinician base and visiting global faculty, this model would allow students to complete foundational training in India and transition seamlessly to residency or specialisation abroad. This creates a scalable, export-led ecosystem serving global workforce needs.
To realise this vision, critical challenges must be addressed. Foremost is the deregulation of SEZ curriculums to meet diverse international standards, ensuring graduates are practice-ready and globally mobile. Equally important are frameworks allowing foreign university partnerships, private investment, and genuine educational autonomy. Crucially, these SEZs cannot be isolated clusters near ports like traditional SEZs; they must be designated zones near India’s existing medical hubs. Not preventing existing Indian faculty and patient participation into the SEZ ecosystem is essential. Achieving the right balance at the intersection of domestic and SEZ rules will be key. A pathway to bridge-qualify for Indian practice (NMC registration) if the students choose to stay in India as well as choose other similar pathways to other export markets.
India is uniquely positioned to succeed here. We possess a vast diaspora of global faculty, a massive pool of aspiring medical students, and a reputation as a major investment hub. With the right policies, we can leverage these advantages to create a services factory for the world, mirroring the success of the tech services industry. The domestic healthcare sector and patients could also benefit from the spill-over knowledge and expertise from these SEZs. Our global pool of medical professionals and extended diaspora can be valuable connection to support Heal in India. Heal in India and Heal by India, therefore, can become two sides of the same coin, as health care starts transcending geographic boundaries.
This article is authored by Siddhartha Bhattacharya, secretary general, NATHEALTH and Amrita Agarwal, operating partner, The Convergence Foundation & visiting fellow, Centre for Social and Economic Progress (CSEP), New Delhi.
