Picture the student first. She is twenty years old, from a middling town in Andhra or Rajasthan, and she has cleared NEET-UG with a score that would have been considered outstanding a decade ago. It is not outstanding enough now. National Testing Agency data shows the applicant pool has tripled in less than a decade — roughly 8.0 lakh candidates in 2016, a peak of approximately 24.1 lakh in 2024, and still around 22.8 lakh in 2025. The number of MBBS seats, genuinely expanded — from fewer than 52,000 in 2013-14 to approximately 1.23 lakh in 2025-26 across some 808 colleges (up from 780 colleges and 118,137 seats in 2024-25) — cannot absorb that tide. Her score is real. Her ambition is real. The seat is not there.
So her family begins the calculation that roughly 25,000 Indian families make every year, a figure widely cited, including in reporting by University World News. A government college MBBS costs perhaps ₹3 lakh for the entire course. A private college seat — if it can be obtained — can run close to ₹1 crore. A European or Eastern European university, expensive in its own right but cheaper than domestic private medicine, starts to look rational. Prague, Tbilisi, Bishkek: cities most of these families had never contemplated become the sites of their children’s formation.
The Prague File: Questions Without Answers (Yet)
This column has been tracking one such destination: the First Faculty of Medicine at Charles University in Prague, which runs a six-year English-medium General Medicine programme for self-paying international students at approximately €24,250 per academic year. The faculty hosts around 800 international students. No India-specific admission data, progression rates, or graduation outcomes are published on its website (which IndiaWorldEye reviewed on 25 July 2026). That absence is not, by itself, evidence of wrongdoing — European universities are not uniformly required to disaggregate outcomes by nationality — but it means a student signing a six-year financial commitment worth upwards of ₹1.2 crore at current exchange rates is doing so with limited comparative information.
The core question this investigation is probing is straightforward: do international students — and Indian students specifically — face differential academic outcomes at the First Faculty, whether through course design, assessment calibration, or institutional support structures? That question is open. It has not been answered, because the institutions that could answer it have not yet done so.
Between 23 and 26 July 2026, IndiaWorldEye contacted more than two dozen offices and officials, including: the First Faculty itself through its press, communications, and international offices; the Czech Ministry of Education; the Czech Ministry of Foreign Affairs; the Embassy of the Czech Republic in New Delhi; the National Accreditation Bureau of the Czech Republic; the European Commission’s spokespersons for education and justice; relevant European Parliament press offices; the Association of Indian Universities; the Ministry of External Affairs in New Delhi; the Embassy of India in Prague; the National Medical Commission of India; and the National Board of Examinations in Medical Sciences, which conducts the FMGE. No substantive replies have been received. Charles University’s press office was on scheduled leave; the inquiry was redirected to the communications team. Silence during an outreach window proves nothing — institutions have press cycles, summer schedules, and legitimate triage — but this column will continue reporting the status of those responses as they arrive, or do not.
What makes the question worth pursuing is not suspicion of a single institution but the structural reality waiting at the end of that six-year journey. The Foreign Medical Graduate Examination, which nearly every foreign-trained Indian doctor must pass to practise in India, recorded a pass rate of approximately 18.6 percent in its June 2025 sitting — 6,707 candidates clearing out of 36,034 who appeared. That figure, from the National Board of Examinations in Medical Sciences, is not an anomaly: FMGE pass rates have ranged between roughly 10 and 25 percent for years. The aggregate failure burden is enormous. Whether it reflects the quality of preparation abroad, a mismatch between foreign curricula and Indian clinical realities, the examination’s own design, or some combination of all three is a question that deserves disaggregated, institution-level data — data that is largely unavailable.
Foreign graduates reject the implication that they are underqualified. “FMGs are not lacking in knowledge or skills,” argued Dr. Haritha Sri Baskar Jayanthi, a Russia-trained doctor who cleared the FMGE, in a Reclaim the Right to Health policy discussion, locating the problem in the examination’s design rather than in the candidates. Reporting this month on disquiet among foreign medical graduates over what it called an opaque licensing exam, Newslaundry found candidates blindsided by unannounced changes to the test’s format. These are contested claims — which is exactly why disaggregated, published outcome data matters.
A System Under Visible Strain
The domestic backdrop against which these 25,000 annual departures occur shifted seismically this month. Union Education Minister Dharmendra Pradhan resigned on 25 July 2026 amid nationwide student protests over examination-paper leaks and questions about the integrity of competitive examinations administered by the NTA. The protests — reported across Indian and international outlets — represent something more than a political crisis. They represent a legitimacy crisis in the architecture that is supposed to sort 22-plus lakh aspirants into India’s medical colleges fairly.
To be precise about causation: the minister’s departure was not connected to any overseas or Charles University matter. But it would be evasive to treat these as unrelated phenomena. The same structural pressure — too many aspirants, too few trustworthy pathways, too little transparent data — produces both the domestic protest and the overseas exodus. When the examination that is the sole gateway to domestic medicine is perceived as compromised, the 25,000 who leave are not simply making a choice; they are responding to a system signal.
India needs a doctor-to-population ratio that its current system, however genuinely expanded, cannot yet deliver. The National Medical Commission has more than doubled the MBBS seat count in a decade. That is real, creditable policy work. But the demand curve has tripled. The gap is being filled, partly, by young Indians in Prague and Tbilisi and Chengdu, sitting in lecture halls whose assessment standards, student support systems, and differential outcomes remain largely unexamined by the institutions of either country.
What Accountability Would Actually Look Like
This column is not arguing that Charles University or any particular foreign faculty is deliberately disadvantaging Indian students. That is precisely the allegation we are investigating, not asserting. What accountability would look like is relatively modest: published, disaggregated pass and graduation rates by student category; transparent information about what academic support international students receive; and, on the Indian side, FMGE data broken down by country and institution of training, so that a student in Andhra Pradesh making a ₹1.2-crore decision has something approaching informed consent.
The Association of Indian Universities, the NMC’s Ethics and Medical Registration Board (EMRB), and the Ministry of External Affairs have all been contacted. None have replied yet. When they do — or when they demonstrably do not — this column will report it.
The young woman from Andhra deserves better than a system that lets her go abroad underinformed, trains her in a system oriented to European standards, and then sees more than four in five candidates fail the gateway home in a single sitting. Whether the bottleneck is in Prague or in Delhi or in both is the question. We are still asking it.
Outreach to more than two dozen offices and officials remains open. Responses will be reported — and published in full — as received. The investigation continues.
