The Japanese government is seeking to encourage medical tourism to selected hospitals. The main market is wealthy people from abroad, mainly Chinese and Russians. The government owned Development Bank of Japan, estimates, from a base of almost no current medical tourists, 430,000 medical tourists to Japan in 2020. How the bank arrived at this substantial figure and whether it is a prediction or a target to aim at, is not explained.

The government is considering specific measures:
• Creation of a medical service visa system designed to allow foreigners greater flexibility regarding the duration of their stay.
• Establishing an authorization system for medical facilities eligible to accept overseas patients.
• Promoting efforts to develop language-interpreting services at medical institutions.

Japan is a very late entrant to the medical tourism market and hospitals are focusing on health check services as a first step. Japan is a world leader in the use of high-tech examination devices such as magnetic resonance imaging (MRI) and positron emission tomography (PET) systems. Health checks combined with sightseeing tours are the current offering in Nagasaki and Fukushima for people from China, as direct flights are available between the two and Shanghai. Nikko Medical Center in Nikko, has launched a sightseeing medical service department to combine checkups with trips to temples and shrines. Other places are arranging tours based on health checks for diabetics.

Profesor Toshiki Mano of Tama University argues that a medical tourism industry based on health checks is not sustainable in the long term, “Japan is the only country that is trying to capitalize on health checks as a centerpiece of medical tourism. This can work for the present, since only a relatively small number of foreign patients from abroad are currently seeking medical treatment in Japan. However, there’s no telling whether the situation will be the same in 10 years time.”

Mano argues that if Japanese hospitals continue to rely on medical examination tecnology to boost medical tourism, major targets like the Chinese and Russians will not come to Japan once such services become available in their own countries, and at a lower price than offered in Japan. Thinking long-term, he says that the government should work to provide foreigners with treatment for digestive problems, an area in which Japan is particularly advanced and should also make such cutting-edge medical technologies as regenerative medicine the core of medical tourism to this country in the future.

He also points to problems in long delays in government authorization of the domestic use of medical devices and products newly developed abroad, and the growing fear that Japan’s medical system will collapse due to the shortage of doctors. Mano argues of the danger in letting the treatment of foreigners take precedence over Japanese patients.

Others argue that as in Asia, to ensure that Japan’s medical services will have a good reputation overseas, the government should consider not only promotion of medical tourism but also the feasibility of exporting the country’s medical facilities and expertise. Yukihiro Matsuyama at the Canon Institute for Global Studies argues, “The world is shifting away from the age of medical tourism to the direct export of hospitals and university medical departments. If Japanese hospitals and medical schools are not strong enough to branch out overseas, there will be little chance of this country winning the battle with other nations for medical tourism.”

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Bahamas Medical TourismMEDICAL tourism needs Bahamian investors to help the industry grow and keep the wealth that can be made in the country, the chief of the medical pavilion told Tribune Business yesterday.

Dr Conville Brown said the country can benefit greatly from medical tourism, however, it will take Bahamian investors to make it pay off for the Bahamas.

Dr Brown also added that while he is a proponent for medical tourism and opening up the sector to investors, the burgeoning industry will not see significant benefits from large foreign firms that may funnel a large part of its profits out of the country to its investors and for other operational investments.

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“I am for medical tourism and I started to try to set up a facility for medical tourism more than ten years ago,” Dr Brown said. “I think medical tourism can be very good and powerful for the country.”

However, he said Bahamian investment in medical tourism has not been widely accepted as yet and has even been impeded in one way or another.

According to him, large foreign firms who want to bring medical tourism facilitates here to the Bahamas will only provide benefits to the Bahamas by way of hotel room nights and spending.

“We will get the fringe benefits depending on how it is done,” said Dr Brown.


“It can have a positive impact on the medial profession, the economy and the country as a whole and Bahamians can benefit be they professionals as well as employment opportunities.

“If it is implemented in a non-participatory manor, meaning if the typical model is that ‘x’ company comes in and provides service, they will bring their manpower, own the facility and bring their patients, and then they and the proceeds will all leave the country. We will be a domicile with little spin-off benefits except for the occasional hotel room.”

He added that the Bahamas is a perfect location for medical tourism because of its proximity language and parity of the dollar.

“We have very similar standards, and we can deliver the quality,” he said. “This is a model that ought to be encourage because it can be a tremendous benefit to the Bahamas.”

Dr Brown said one year ago the medical pavilion won an award from the EU that was administered by the Caribbean Export Development Agency that allowed them to export medical care and establish a medical tourism model.

“Where we have ended up is we are now in two countries in a substantial way,” he said.

According to him, his company now manages patients in Antigua and brings them to the Bahamas for radiation therapy.

This sort of medical tourism that Bahamians can benefit from and own, said Dr Brown is how the country can benefit in a large way from the instance of medical tourism.

“There are so many spin-offs,” he said. “The only time you will not see any benefits is if we don’t have significant Bahamian ownership and we will have adverse effects.”


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Reverse culture shock, or re-entry shock, affects thousands of returning study abroad students every year. Symptoms include lacking the ability to communicate the significance of time spent abroad, being critical of values, customs, and beliefs that weren’t bothersome before studying abroad, as well as simply missing the lifestyle of a foreign country — full of adventure and new experiences.

“I felt depressed for a couple of weeks when I got back,” said Leslie Gustafson, a senior from Overland Park who studied in Costa Rica for two months this summer. “I didn’t have a job to come back to, so I missed all of the things I had done in Costa Rica, and not really having anything to do for a while made it worse.”

Jen Weghorst, the program director for Spain and Latin America in the Office of Study Abroad, has led re-entry sessions at the University of Kansas for two years through the Office of Study Abroad. However, this year she isn’t sure if one will be offered because of the lack of attendance at these non-mandatory meetings in the past.

She said this would simply be due to the busy schedules that students have when they get back, but the importance of learning how to deal with these feelings cannot be ignored.

One issue students encounter is the lifestyles they come across abroad and differences in outlooks on life compared to what they’re used to at home.

“People in Europe just seem more apt to dealing with hard circumstances, or not ideal situations,” said Paul Tackett, a senior from Wamego who spent four months in Wales, United Kingdom, this past spring. “Whereas coming back to America, if something doesn’t happen according to plan, people get upset quickly and don’t really go with the flow as much.”

Weghorst described these recurring sentiments.

“You can see home in a more critical light,” she said. “Meaning, you more closely examine things that you might have taken for granted before you left whether they be social, cultural or political aspects of life.”

In 2007-2008, 262,400 students studied abroad, according to the latest numbers published by the U.S. Department of Education and the Institute of Educational Sciences. For most of these students the experience changed their lives and had an immensely positive effect on them, but one of the biggest transitions students face is conveying their stories of adventures and the significance of their travels to others.

Weghorst recommends that returning students set up Facebook groups or general discussion groups among other students who have traveled abroad either with them or at other times. This allows students to compare notes on their transitional progress and experiences, and especially on the things they miss.

Educating people on how to transition back into their own social networks when they return has helped past students, and the Office of Study Abroad includes this in pre-departure mandatory meetings with students.

“When you’re talking with friends back home, all they’re doing is listening and asking questions,” said Brian Kelly, a senior from St. Louis who studied abroad in Rome for six months last fall. “But when you talk to somebody who’s done the same thing, you can relate with them and it’s more like a discussion.”

The Office of Study Abroad recommends that students dealing with severe reverse culture shock take advantage of counseling services offered at the Counseling and Psychological Services located in Watkins Health Center.

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( By Nicolas Roesler- The University Daily Kansan)

study abroad health insuranceIn 2000, researchers began an ambitious effort to document the academic outcomes of study abroad across the 35-institution University System of Georgia. Ten years later, they’ve found that students who study abroad have improved academic performance upon returning to their home campus, higher graduation rates, and improved knowledge of cultural practices and context compared to students in control groups. They’ve also found that studying abroad helps, rather than hinders, academic performance of at-risk students. “The skeptics of study abroad have always made the argument that study abroad is a distraction from the business of getting educated, so you can enter the economy and become a contributing member of society,” said Don Rubin, professor emeritus of speech communication and language education at the University of Georgia and research director for GLOSSARI — the Georgia Learning Outcomes of Students Studying Abroad Research Initiative. “I think if there’s one take-home message from this research as a whole it is that study abroad does not undermine educational outcomes, it doesn’t undermine graduation rate, it doesn’t undermine final semester GPA. It’s not a distraction.

“At worst, it can have relatively little impact on some students’ educational careers. And at best it enhances the progress toward degree. It enhances the quality of learning as reflected in things like GPA.”

 The GLOSSARI project is of impressive scope and scale, and not every finding shows a positive impact of study abroad — self-reported knowledge of world geography, for instance, actually decreased across time both for study abroad students and for a control group, and researchers found no significant difference in knowledge of global interdependence between the two sets of students. Rubin and Richard C. Sutton, director of the GLOSSARI project, executive director of international programs at Western Kentucky University, and formerly assistant vice chancellor for international programs at the University System of Georgia, presented these and other findings in a “final report” on the GLOSSARI project at the recent NAFSA: Association of International Educators conference in Kansas City.

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Among their findings:

 •Graduation rates and GPA: Researchers compared graduation rates and grade point averages for 19,109 study abroad students, from across the state system (which includes community colleges, research universities and institutions in between), with a control group of 17,903 students selected to match the institution, semester of study and class standing of the students who’d studied abroad. “What we’ve tried to do in this project is to be very, very careful about who we compare with study abroad students,” said Rubin. “There are all these arguments that say the reason why graduation rates are higher for study abroad students are they are of higher socioeconomic status, or they may be more industrious, or they may be choosing easier majors.”

Study abroad students, in other words, aren’t representative of all students in the Georgia system. So, rather than merely compare the study abroad students’ graduation rates with system-wide rates for first-time, full-time freshmen, who drop out for any number of reasons, the researchers compared study abroad students to a control group of students who had already persisted to the same point in college. They also constructed the control group to closely represent the institutions the study abroad students were coming from (the University of Georgia sends more students abroad than, say, Abraham Baldwin Agricultural College, and the control group was created with a goal of reflecting that). “Our goal,” said Rubin, “was to isolate the effect of study abroad and to make our groups as comparable in every respect except that one group studied abroad and the other did not.”

 They found that the four-year graduation rate was 49.6% for study abroad students, compared to 42.1% for students in the control group (and 24% for students in the University System of Georgia as a whole). Six-year rates were 88.7% for study abroad participants and 83.4% for students in the control group (and 49.3% system-wide). The effect held across various subgroups of students divided by gender, race and SAT score, but was particularly pronounced for certain groups — most dramatically, four-year graduation rates for African-Americans who’d studied abroad were 31% higher than for African-American students in the control group. Four-year graduation rates for other nonwhite students who’d studied abroad were 18% higher than for their peers in the control group. Nationally, nonwhite students remain underrepresented in study abroad — according to the latest data, from the Institute of International Education’s Open Doors survey, 81.8% of Americans studying abroad in 2007-8 were white.

 The GLOSSARI Project found that for students who’d studied abroad, their mean cumulative GPA prior to going overseas was 3.24 and the mean cumulative GPA afterward was 3.30. For the control group over the same period, the mean GPA increased from 3.03 to 3.06. Researchers found a particularly pronounced effect of study abroad on academic performance among students who entered college with the lowest SAT scores. Among students who entered college with a combined SAT score of 800 (on the verbal and math sections), those who studied abroad ended up with a GPA of 3.21 compared to 3.14 for those students who stayed stateside. On the other extreme, for those students who entered college with a perfect SAT score of 1600, study abroad had no effect on their GPA, which on average was 3.25 regardless.

 “The conventional wisdom is that students who are at risk should be discouraged from studying abroad altogether,” Rubin said. “But this suggests that study abroad can actually be an intervention to enhance the success for college students who are at-risk. Rather than derailing them, rather than diverting them, it actually focuses them.”

 Intercultural learning outcomes: In another phase of the study, researchers administered a 29-question intercultural learning outcomes instrument to 440 study abroad and 230 non-study abroad participants from 13 Georgia institutions. “There are so many different ways in which students are going overseas and we had to look at a way to assess that across this variety of platforms,” said Sutton.

From pre- to post-test, study abroad participants surpassed non-study abroad participants in measures related to functional knowledge of cultural practices — the ability to say what’s funny in another culture, for instance, or take a train or bus to reach a destination. Study abroad students also grew in their knowledge of cultural context — for example, in their knowledge of how different cultural settings affect one’s own reactions and interactions with others — relative to non-study abroad students.

 Again, on measures related to knowledge of global interdependence and world geography there was no significant difference between the control group and study abroad students. (The general decline in knowledge of world geography — the ability to name four rivers in Europe and three in Asia, or name six countries in Africa — was, unfortunately, a common finding irrespective of time overseas).

 The GLOSSARI project did not consider outcomes related to second-language acquisition during study abroad (although lots of other studies have considered these questions). Researchers did find, however, that time spent speaking a target language was correlated with higher intercultural learning more generally, Rubin said.

 Disciplinary learning outcomes: Another phase of the study considered student learning in courses taught on campus and abroad. Researchers looked at three case studies of courses taught on the home campus and overseas — a Novels of Jane Austen class (taught in Oxford), a French Revolution and Napoleon class (taught in Paris) and an Intercultural Communication class (also taught in Paris). “I was disappointed that despite some vigorous efforts we ended up with only three really good case studies,” said Rubin. “There were a variety of reasons why. We insisted that the majority of the learning objectives had to be the same (in both versions of the course) … another requirement was that they had to be taught by the same teacher.” Researchers also wanted the student assignments to be the same on campus and overseas, as external evaluators looked at student work in gauging student learning.

 Students seemed to acquire more “fact detail” knowledge in courses taught on campus — in the Austen class, for instance, students who took the course on campus cited more examples in their essays. One external rater noted, of the campus-based class, “I saw more answers that demonstrated a deeper understanding, not just of Austen’s body of work, but also of the political and social climate during the time of her writing.” In some ways, Rubin said, this finding is to be expected, as the duration of the study abroad version of the course was shorter and students in that class read fewer of Austen’s books.

 “On the other hand the big-picture kind of learning, the more conceptual learning and the sense of why this is important or why this is still relevant, clearly came across more strongly in the study abroad classes,” Rubin said. For instance, students in the French Revolution class “saw how the events of revolution are interwoven into contemporary France, which is something that students who studied it domestically never achieved. For them it was just a history class.”

 “One of the implications that people who design programs might think about is the value of what’s now being called hybrid learning abroad — classes in which a substantial component is done domestically,” Rubin said.

 The GLOSSARI project was funded in part by a $547,000 U.S. Department of Education grant, which expired June 30. Their data collection work completed, Rubin and Sutton are now making the GLOSSARI database available to other researchers to pursue further questions.

 Outcomes research in study abroad

 “What’s distinctive about the GLOSSARI project is that it’s system-wide,” said Brian Whalen, president and CEO of the Forum on Education Abroad. “No other project really matches it, I don’t think, in terms of the scope and the coherence.”

 But there’s no question that there has been a huge increase in research into study abroad outcomes, as study abroad has grown and as colleges increasingly emphasize the need to assess student learning outcomes more generally. As the latest indication of this, a NAFSA task force recently issued a report on assessing international education — which should, the report argued, “be fully integrated into the broader assessment of U.S. higher education.”

 Whalen, the editor of Frontiers: The Interdisciplinary Journal of Study Abroad, said increased assessment activity is happening on both institutional and faculty-driven levels. “Projects such as the GLOSSARI project, which are very comprehensive and are institutionally-based, are becoming more common as institutions are seeking to establish very good benchmarks for international education,” he said. “Accrediting associations are holding those institutions accountable.”

 “And then you have another wave of research that’s coming out of faculty members in disciplines” — many of whom have led short-term study abroad programs. A recent issue of Frontiers, for instance, included an article by education scholars on the role of study abroad in teacher education, and another article — its first author a molecular and cellular biologist — documented changes in intercultural knowledge and competence as a result of international, undergraduate research experience.

 That same issue also highlighted the findings of the Georgetown Consortium Project, another major, cross-university study that which compared language acquisition — gains in oral proficiency, specifically — and intercultural learning of students who studied abroad and those who studied the target language in U.S. classrooms. As the authors of the latter study write, in outlining the context for their research, research in student learning abroad has “increased dramatically. During the 1970s, 189 research studies were published; that number had increased 675 by the 1990s. During the first decade of the 21st century, the number will almost certainly exceed 1,000.”

 The research on study abroad outcomes covers a broad range of topics and uses a variety of instruments in asking questions related to second-language acquisition, or changes in attitudes, beliefs or knowledge as a result of study abroad. Among the many tools being used in study abroad research are the IDI (the Intercultural Development Inventory), the CCAI (the Cross-Cultural Adaptability Inventory), the OPI (the oral proficiency interview), the SOPI (the simulated oral proficiency interview), and the BEVI (the Beliefs, Events and Values Inventory). The Beyond Immediate Impact: Study Abroad for Global Engagement (SAGE) project, based at the University of Minnesota Twin Cities, uses an instrument called the Global Engagement Survey to track long-term outcomes of study abroad on dimensions including civic engagement, knowledge production, philanthropy and social entrepreneurship.  

“There has been some outstanding research that’s already been done in second-language learning overseas, in personal development, intercultural growth, and attitudinal and behavioral changes that occur as a result of study abroad,” said Sutton, the GLOSSARI project director. “But what we felt when we began the GLOSSARI study was that there had been limited efforts and attention paid to learning outcomes and knowledge acquisition and skill acquisition that we felt really needed to be addressed.

 “We saw this very much as a first step, although it turned out to be a very long step.”  

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(By Elizabeth Redden, Inside Higher Ed)

medical tourism insuranceMore than 4.3m medical tourists will visit the UAE this year, with the value of the industry projected to jump by seven percent in comparison to 2009, according to data released by the government.

The UAE is the Middle East’s biggest market for medical tourism.

The local sector will be worth $1.7bn in 2010, with the second half alone seeing 13 percent growth over the same period last year.

Local experts have put these results down to better infrastructure, state-of-the-art medical centres, and modern technology.

A senior official from the Canadian Specialist Hospital in Deira revealed that more than 1,500 patients came from the US to visit the facility every month.

“Treatment rates in the UAE are lower than overseas hospitals, while the country’s hospitals and healthcare centres offer a higher level of diagnostic, curative and rehabilitative services,” said Mohammed Rashid Al Falasi, chairman of the Canadian Specialist Hospital.

“We have hospitals, such as the CSH, offering ultra-high standards of medical services that reflect the development of medicine in the UAE, as well as the world’s simplest and most positive healthcare regulations [in the UAE] when it comes to dealing with patients from all over the world.”

Al Falasi said that around $20.6bn was being spent on providing international healthcare services for UAE nationals and residents, and that concentration on the local sector would create more jobs.

According to data obtained from the UAE Ministry of Health, the volume of medical tourism traffic worldwide is estimated at between 38-40m people over the last three years.

The value of the global industry could rise to as much as $95.1bn by 2015.

(By Ed Attwood Arabian Business)

A fast-growing industry in which Britain is a world beater: what could go wrong? Sadly, rather a lot

DEMAND for higher education is booming around the world. In rich countries like Britain, the number of university students increases every year, and still there are not enough places for all who want one. In fast-growing economies such as China and India, wealthy families can now afford to send their offspring to university but world-class institutions are too few. Whether students cannot find what they want at home or prefer what they see abroad, they are becoming more mobile.

The OECD, a rich-country think-tank, reckons that in 1980 over a million students were enrolled at universities and colleges outside their country of origin. Two decades on, the figure had almost doubled; less than a decade after that, it had tripled.

Britain is a world leader in higher education, second only to America. Long before Oxford had dreaming spires it welcomed its first foreign student for whom records exist: Emo of Friesland, in 1190. Its historic reputation, combined with solid performance in the league tables that purport to show the world’s best universities, has helped Britain attract students not just to its best performers but to other institutions too. On the ranking produced by Shanghai’s Jiao Tong University America has eight universities in the top ten and Britain two (see table).

Another point in Britain’s favour (and America’s) is the strength of English, which has emerged as the lingua franca of business, science and much culture. Pricewise, Britain is broadly competitive with America or Australia. And for over a decade British universities have recruited abroad more actively and successfully than most, both together and separately.

Of the roughly 3m students at a foreign campus in 2007—regrettably, the most recent year for which the OECD has internationally comparable data—20% went to America and 12% to Britain (see chart). This is big business for Britain. With revenues of £25.4 billion ($39.4 billion), higher education is a significant industry. It is comparable in size to printing and publishing, slightly larger than advertising and much bigger than aircraft and space, or pharmaceuticals.

Some £2.9 billion of this money—more than 10% of university income—comes directly from international sources, according to a study by Ursula Kelly and her colleagues at the University of Strathclyde. Foreign students spend another £2.3 billion on accommodation, eating, drinking, entertainment and so on.

But international students are welcome for far more than their impact on Britain’s balance of trade. To start with, they are crucial to the finances of cash-strapped universities. At English universities (Scotland and Wales do things differently) undergraduates from Britain and the rest of the European Union (EU) pay tuition fees of up to £3,290 a year, though that limit is now under review. It costs far more to educate them, so the state helps plug the gap with a grant to universities for teaching them.

That is still not enough, particularly for laboratory-based subjects. Universities subsidise these undergraduates in part by charging foreign students from outside the EU what the market will bear. If foreigners go elsewhere, then either the quality of education available to British students will suffer or they will have to pay more for it.

Universities intent on growth in these officially austere times are particularly reliant on foreign students. The government controls closely the supply of undergraduate places to British and EU students, because it must lend money for fees (at subsidised rates) to those who need it, as well as pay universities for taking them. An institution has to apply for permission to expand. If permission is refused, its only way to grow is to recruit students from outside the EU. That is exactly what has been happening. Just 7.1% more students overall were enrolled in higher education in 2008 than in 2004, but non-EU numbers increased by 23.7%.

There are other reasons besides the money-grubbing to seek out foreign students. They are often clever and hard-working. Sir Richard Sykes is a former rector of Imperial College London, which specialises in science, technology and medicine, and draws a third of undergraduates and almost half of postgraduates from outside Britain. “As standards have fallen in the UK, they have been maintained in the Far East,” he says. “Students in Singapore sit the same A-levels I did.” He credits the presence of large numbers of diligent Chinese, in particular, with making their classmates more industrious. “The Chinese work bloody hard and drive up the standards,” he says. “Other students see that, and they have to compete.”

A second reason is that taking a big slug of students from other countries gives universities a more international flavour, enriching the mix and broadening the experience of British students in the process. That, at least, is the theory. In practice large groups of foreign students from a single country tend to stick together rather than blending in. The problem is a familiar one at the London School of Economics (LSE), where half of undergraduates and 80% of postgraduates are from abroad. “The LSE celebrates its diverse student body but there is not multiculturalism, rather it is multi-monoculturism,” observes Peter Zakowiecki, a recent Polish graduate.

A final pair of reasons is that, in the global war for talent, capturing the world’s best and brightest is grist to Britain’s economic mill. These are people who may stay to produce ground-breaking research, or return to run job-creating companies. Even if they don’t, educating them is a projection of “soft power” at a time when Britain finds it increasingly difficult to stump up for the hard version. After the last exam is over, it is hoped, there will be a corner of a foreign factory that is for ever England.

Winds of change

Britain is not alone in thinking along these lines. And, as the market for international education explodes in volume, it is in danger of seeing its market share slip. For the past few years this has remained relatively constant—buoyed partly by the weak pound—but, as the chart shows, the trend over the decade to 2007 was slightly downward. In 2008 British universities had 368,970 foreign students, more than two-thirds of them from outside the EU. Of the total, 47,000 were Chinese and 34,000 Indian (up a promising 32% on the year before, though almost three times as many went to America). The number of foreign students has grown since then, though Britain’s share of the global pool probably has not. And the phenomenon is not confined to particularly elite universities: the former Luton University—now called the University of Bedfordshire—has a student body that is 30% international.

In 1999, when Tony Blair, then prime minister, launched an initiative to attract more foreign students to Britain, only Australia and America were seen as real rivals. Today serious competitors include not only Canada but also—though complacent Anglophones deny it—non-English-speaking countries such as Germany, France and perhaps the Netherlands. Former consumers have turned providers too, including Singapore and Malaysia, which aim to become regional educational hubs, and increasingly China itself.

Though America’s leading institutions have long been focused on enrolling bright students from beyond its borders, most of its colleges have not; unsurprisingly, America lost market share in the years to 2007. Its prominence has had much to with the global dominance of its culture, the allure of its labour market and its lavish bursaries. But that is no longer enough. Many states now employ educational agents to lure foreign students their way. Even top universities are broadening their search.

Australia continues to attract students to its shiny new campuses in comfortable surroundings, boasting state-of-the-art facilities closer to home for many Asian students than Europe or America. The murder of an Indian accountancy graduate, Nitin Garg, in January, and a series of attacks on young Indian men, has dampened the recent enthusiasm from Indian students: their enrolment is 10% lower this year than last. Overall, however, Australia’s international student numbers are 10% higher in 2010, buoyed by a 20% rise in demand from China. This has brought the total number of Chinese students there to 63,000.

Another Old Commonwealth country, Canada, has also been recruiting, though mostly students who would otherwise have gone to America rather than Britain. Its foreign-student numbers doubled in a decade, many of them from China, America, France and India. It appeals as well to students who want an American education but fear that they would be unwelcome south of the border. One American university which has opened a campus in Vancouver reports that it is particularly popular with Iranian students.

Japan too is hoping to increase its share of international students, at present 3-4% of the rich countries’ total and based on a big intake from China. It is taking a leaf from the books of the many European universities (France’s Sciences Po, for one) that now teach in English and other languages in a bid to attract more foreigners.

Against such competition, Britain must look to its relative weaknesses. Cost could be one of them, though on the face of it Britain is not out of line. A student from outside the EU who wants to read physics at Imperial College London, for example, will be asked to pay £20,750 a year, and to set aside a further £14,000 for living costs. Harvard charges £22,000 a year, plus another £12,000 or so for lodging, food and so on. The University of Sydney charges £20,000 per year for undergraduate tuition in physics, and about £12,000 a year to live in halls of residence with meals supplied.

Counting the cost

In Britain, however, most foreign students pay these bills themselves. Just a small proportion get help from their home governments or from scholarship funds established by their compatriots. America’s wealthy universities offer bursaries to anyone in the world who is bright enough to gain entry but too poor to pay. More than 20% of students at Harvard, including many foreigners, receive financial help.

Nor has Britain been helped by the recent tightening of its border controls. A botched reform of the student-visa system to catch bogus applicants has damaged its reputation in many of its key markets, including India, where students languished visa-less last autumn and missed the crucial first few weeks of term, or dropped out altogether. The system is now being rethought. Meanwhile actual and proposed tweaks to the points-based immigration system, giving greater weight to those with money and less to those with PhDs, risk hampering universities in hiring the best academic staff, they say. Institutions compete to attract the best students globally, they argue, and they should be free to do the same for staff.

A British peculiarity

Given that students now have, quite literally, a world of choice, how well does the British university experience measure up to the competition? Despite newspaper headlines to the effect that debauched and sodden British students offend the sensibilities of their sober and diligent foreign counterparts, international students seem satisfied with their education. Since English universities started charging tuition fees to British undergraduates in 1998, they have kept an eye on whether their paying customers are satisfied. The National Student Survey asks final-year students to rate the quality of the teaching, the assessment and feedback they got, and their overall satisfaction with their course. Paula Surridge of the Bristol University has analysed the responses and found that international students are generally as satisfied as British ones, and in some cases more so. Moreover, satisfaction for both groups is improving.

Will Archer of i-graduate, which surveys international students enrolled at universities in America, Australia and Britain, concurs. He says his data show that they are mostly happy with what they get in Britain and have grown happier over the past five years, though foreign students in America are more likely to say they feel part of a community.

There is a rub, however, though it has not proved too great an irritant until now. Britain’s universities pride themselves on fostering independent learning. Many offer limited tutorials and even lectures, and attendance at the latter is not usually compulsory. Exams are few and far between. Foreign students often flounder in so unstructured an academic environment. As Sheyrhar Azhar, a Pakistani student who recently graduated from the LSE, puts it, the British style of higher education “helps you grow into adult life very quickly”.

Another oddity is that although Britain pursues international students, it sends relatively few of its own abroad. That is partly because it has good universities of its own at which British students receive a subsidised education. Yet since students have had to pay for their higher education, albeit at knock-down prices, they have begun to seek out what is on offer elsewhere.

Most of those who do study abroad go to America. In 2008 some 8,700 were enrolled at campuses there—a record high—more than a few with financial aid. Institutions that have long targeted pupils at fee-paying schools in Britain are beginning to find state schools fertile ground as well.

Despite this, most British students are still staying put. British universities, however, are not. Many, like their counterparts elsewhere, have established campuses abroad. The University of Nottingham, for example, was the first British university to open a fully-functioning overseas branch, in Malaysia a decade ago; the campus now has 3,500 students. In 2004 the same institution was the first foreign provider to establish a campus in China. The University of Nottingham Ningbo counts more than 30 nationalities among its 4,300 students, though most of them are locals.

Asia, yes, but which bit?

The question is where future growth in the market for international higher education will come from, and what form that education will take. A report by the Economist Intelligence Unit, our sister company, reckons China will no longer be sending ever more students abroad: thanks to its one-child policy the number of young people there peaked in 2007, and improvements in China’s own universities mean more students will stay there. Indeed, those institutions are already starting to vie with American and British ones for foreign students, particularly postgraduates.

India is likely to prove more promising. Despite recent efforts to boost the number and quality of its universities, it lags well behind China. Demand far outstrips supply at its best universities, and India reserves a proportion of places in all public and private universities for different castes to advance those at the bottom of the pecking order. For wealthy Indian students denied a place at one of the country’s best institutions, a good university abroad is a better bet than a mediocre one at home.

The Indian government has introduced legislation to let foreign universities set up campuses there too, though after four years it has yet to be passed. But Britain is keen to be seen not just as a destination for Indian students, or a provider of higher education in India, but also as a partner in boosting the quality of universities across the country. On July 29th, during the trade mission to India led by David Cameron, the prime minister, British university vice-chancellors promised to take part in talks later this year aimed at deepening Britain’s involvement. This week India’s parliament considered allowing foreign partners to help recreate an ancient Buddhist centre of learning, Nalanda, near Patna.

Middlesex University is one British institution that is watching India with interest. It has a campus in Dubai, which recruits locally from the city’s international population. (Many local people too in the Middle East want a Western education but prefer to get it in a Muslim country, a niche that American universities have been especially quick to exploit.) Middlesex opened another overseas campus in Mauritius this year. If it becomes legal to do so, it wants to establish a campus in India too.

One way and another the market for international higher education is being transformed. British universities have done well in it so far, against often better-funded rivals. But to ensure that Britain continues to attract students with the best brains and sufficiently deep pockets to keep its universities world-class, they need to think hard about which markets to tackle, what products to offer and how to forge alumni into a coherent community. As David Greenaway, vice-chancellor of Nottingham University says, “Higher education is only going to become more global. Britain needs to make sure that it maintains quality and doesn’t get caught out by new competition. We must sharpen up.”

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(By Britain, The Economist)

study abroad medical insuranceInterest in study-abroad programs has never been higher among American college students. In 2008 the American Council on Education and the College Board published a report documenting that a large proportion of students plan to study abroad and want their institutions to offer a wide range of international education opportunities.

So why do as few as 1.5 percent of college students travel overseas to study every year?

The answer involves a series of obstacles that prevent enthusiastic students from seeking the opportunities they desire. As the report states, “barriers to student participation are real, including security concerns, high cost, academic demands that accommodate neither study abroad nor other international-learning experiences, and lack of encouragement by faculty and advisers.” Also, many colleges do not foster the international-learning experience. They may talk the talk but don’t walk the walk; they construct many of the barriers that hamper students.

It’s just a matter of time before those institutions find themselves at a huge disadvantage when recruiting undergraduates. A global college education is increasingly becoming a crucial part of being competitive in today’s job market, and students are demanding it more and more. They are talking and blogging about “unfriendly” study-abroad practices and where to stay clear.

So what is a successful study-abroad program? What does a “study-abroad-friendly” university look like?

Here are my seven signs:

Support from both the administration and the faculty. If the administration supports international education, but there is no buy-in from faculty members, will students study abroad? The answer is yes, but not many. If faculty members support international education, but there is little or no administrative buy-in, will students study abroad? Probably, through a “decentralized” approach, or where there are many barriers, an “exit” approach. Many land-grant institutions, like the University of Illinois at Urbana-Champaign, and other universities, like the University of Michigan at Ann Arbor, adopted the decentralized approach, whereby faculty members pioneered and paved the way for international-learning experiences long before the administration stepped up to support them. The exit approach is the most extreme: Students completely withdraw from the university in order to study abroad.

All in all, things tend to work out better when both administrators and faculty members are on the same page. Administrators have the power of finance, while professors have the power of influence. Where the two converge, there are bona fide results. In an ideal university, professors are globally minded, appreciate international experiences, and have opportunities to engage in the international-education process. Administrators are supportive through both actions and words.

Variety of program options. Nothing frustrates me more than colleges that don’t allow their students to participate in study-abroad programs that are not their own, or make it very difficult for them to do so. They may restrict financial aid, withhold course equivalencies, and/or deny valuable academic credit. Colleges that encourage study abroad offer a portfolio of programs, supported by the academic departments, to meet students’ needs. They also provide a degree of flexibility that allows students to individualize their potential experiences.

Preparation for risk. Colleges with long-term successful study-abroad operations prepare for the inevitable. They develop study-abroad programs carefully and have thorough application processes that involve judicial affairs, health services, disability services, the counseling center, and other key offices on campus. They also have appropriate health insurance, contingency plans, crisis-management protocols, policies, procedures, training, and orientations designed to promote health and safety throughout the international experience. They encourage teamwork and use the campus as a support network. Some successful universities, like Michigan State University, have even named an administrator to oversee the health, safety, and security of travelers.

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Fair value, a fair price. Study-abroad-friendly universities are not always cheap and they’re not always nonprofit, but they are usually open about their financial model and net gains. I read on a student’s blog this year that an American college is going to charge $30,000 tuition to award credit for a $5,000 partner program run by another university. That college should be clearer and more open about its budget. Otherwise, it looks like a 600-percent markup to put its name behind some courses, which they neither develop nor teach.

Eastern Illinois University collaborates with higher-education institutions around the world to maintain quality study-abroad programs for students. We negotiate discounts for students and price programs at cost. While abroad, our students often encounter other students paying three or four times as much for the same academic experience.

Every department has options. Each college needs to connect international-learning experiences to academic needs. The University of Minnesota-Twin Cities, for example, has developed its well-known “study-abroad major advising sheets” to do that. Those sheets help students, academic advisers, professors, and study-abroad professionals match overseas programs with academic programs. They are built from study-abroad course articulations and shift the focus of study abroad from an “extracurricular” activity to a “scholastic” one. And the sheets do more than engage various people in a discussion; they help the college identify programming gaps in academic areas that lack study-abroad opportunities.

Students earn valuable credit. There is no standard for study-abroad credit. An American college may accept academic credit from language schools or institutes overseas based on its own criteria. Successful operations recognize and accommodate the “study” in study abroad. They put mechanisms into place that encourage students to take their courses seriously. Approved courses abroad replace major, minor, and general education requirements in their undergraduate-degree program or fulfill course work or practicum experiences at the graduate level.

A commitment to go green. Middlebury College awards “sustainable study-abroad grants” to assist students with research and projects related to environmentally friendly practices. It also has a Going Green guide, a Green Passport program, a carbon-offset program, and a comprehensive list of sustainable travel resources. We in higher education can’t possibly be promoting global citizenship if we are inconsiderate of how international travel affects the environment. Wise colleges have an awareness, understanding, and concern about the global impact international visitors are having in communities around the world. They do their part in educating students and helping them reduce their possibly harmful footprint.

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 (ByWendy Williamson, The Chronicle of Higher Education)

medical tourism insuranceThe medical tourism industry in Turkey is expected to grow blissfully at a CAGR of around 16% during 2010-2013, according to our new research report “Emerging Medical Tourism in Turkey”. The medical tourism industry holds huge potential and will be mainly driven by improving tourism & medical infrastructure, increasing availability of quality healthcare services and low healthcare costs.

Further, government initiatives, including advertising & promotional programs and investment for setting up affordable hospitals and spas for medical tourists, will drive the industry. Our research indicates that Turkey has emerged as one of the major destinations for medical tourists from Europe, the Middle East and US. Standardized healthcare infrastructure, expert healthcare professionals, low-cost treatments and less waiting time are some of the reasons that attract overseas patients to Turkey.

Besides, we have done an extensive research and prudent analysis of the Turkish medical tourism market in order to understand the factors that will continue to serve as the growth drivers for the industry in the coming years. We have identified that increasing popularity of dental treatment, cosmetic surgery, thermal tourism and infertility treatments spur growth in the market. Various other factors propelling growth in the medical tourism industry have been thoroughly evaluated in the report.

Our comprehensive report “Emerging Medical Tourism in Turkey” provides deep insight into the medical tourism market and evaluates its past, present and future scenario. It discusses the key factors which are making Turkey an attractive medical tourism destination. The report also studies each industry parameters like key market drivers, emerging sectors and government initiatives. Most importantly, the report gives future outlook for all the important aspects of the industry considering the effects of global economic crisis on base drivers, opportunities and challenges faced by the medical tourism industry.

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study abroad insuranceA study program abroad is far different from a family vacation when you were always on hand to take care of the details and ensure your child’ s safety.

On the other hand, some students welcome the opportnity to be completely independent and their parents encourage it.

In assessing whether your child should study abroad, here are five questions you should ask:

1. Where is the destination and how long is the program?


By addressing location, you can begin to look at deeper issues like language and cultural difference, security issues, stability of the country, and how much it is likely to cost. If your child hasn’t been away from home very often, you might consider a short winter- or sunmer- progrram. A child who goes to boarding school or to camp every summer might be able to handle a term or a year of study abroad.

2. How safe is the country where the student will study?


Determining the stability of the city and country where your child will study should be a top priority. Prgrams in less developed countries offer some amazing experiences but few guarantees of safety. The U.S. Department of State can be a great resource in your research.

3. Will your child’s university or college give credit for the program you choose?


Many universities or colleges limit credit for study abroad or offer it only for their own partnership programs. Each school has its own set of criteria. These can also affect the cost of a program. Some programs will cost far more than a semester’s tuition at the student’s home school.

4.What goals does the student have for his time abroad?


Before a student travels abroad, he or she should have a list of goals he hopes to achieve during his stay. Learning the language, creating new adventures, and getting to know the locals are some common goals. This often will lead to reflection on some of the experiences likely to be encountered and highlight potential problems or anxieties. In any case, students still should be open to new and unexpected adventure.

5. Is the student willing to fully immerse himself in a new culture?


If the answer to this questioon is no, please don’t consider a program abaroad. If your child isn’t willing to become part of something new, he will have a very miserable time. Home sickness happens even under the best of conditions, so it is important that a student be willing to laccept new customs in every aspect of daily life.. Learning the language in advance is olne way to minimikze this discomfort.

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destination medical tourismWhen Khazanah, Malaysia’s sovereign wealth fund, launched a bid for control of Singapore’s Parkway Holdings healthcare group earlier this year, it triggered a cross-border takeover battle involving companies in three Asian countries.

The tussle demonstrates the high value attached by the rival bidders to Parkway’s extensive hospital network, which the bidders hoped to use to create a leading Asian healthcare provider – and capitalise on the region’s fast-growing medical tourism industry.

Demand for private medical services has been growing in Asia as incomes rise, propelled by soaring economies.

India’s healthcare market alone was worth about $38bn in 2009, and is expected to increase by $62.9bn during the next four years, according to Fortis Healthcare.

The ageing population of the developed world – especially patients without health insurance or facing long queues at over-burdened national healthcare services – is also helping to boost demand for the stock-in-trade of many of Asia’s medical destinations.

These include heart bypasses, hip replacements, and dental work.

India, meanwhile, has emerged as a popular destination for western couples seeking fertility treatment – including surrogate mothers willing to bear their children.

But much of Asia’s medical tourism is still intra-regional, or from the Middle East and Africa, with a flow of patients from countries with less developed healthcare infrastructure towards those with better hospitals.

However, healthcare has not been immune to the global financial crisis. The economic situation has hit demand “because elective surgery is being delayed”, says Paul Keckley, executive director of the Deloitte Centre for Health Solutions.

At Bangkok’s Bumrungrad Hospital, one of the best established medical tourism destinations, profits improved in 2009, but are still 22 per cent down on the pre-crisis peak of 2007.

In the medium term, many providers in the region are looking to the US healthcare market for more growth. A heart bypass operation that might cost $130,000 in the US could cost less than $30,000 in Bangkok, for example.

But so far, such cost savings have mainly appealed to patients without health insurance, with many western insurers still reluctant to pay for what they perceive to be the risks of foreign treatment.

Singapore was an early mover in healthcare tourism, helped by its strategic location in south-east Asia and the rising demand for private hospitals that comes with per capita incomes that are approaching US levels.

Parkway, just one one of several private healthcare providers in the city-state, has also shown that middle class patients from developing countries such as Indonesia can be tempted to make the short flight to Singapore for a standard of healthcare that is difficult or impossible to obtain in their own countries.

For example, it is common to hear Bahasa Indonesia spoken in Parkway’s Mount Elizabeth facility, just off the Orchard Road shopping centre, which was the first hospital in Asia to perform cardiomyoplasty surgery for heart failure successfully with a laser.

Parkway runs three hospitals in Singapore, with a fourth under development, plus one in energy-rich Brunei, six in China and two in India. In addition, it runs 11 in Malaysia, including nine operated by the Pantai group, in which it has a 40 per cent stake, with Khazanah holding the remaining 60 per cent.

Enthused by Singapore’s example, Malaysia’s government has identified private healthcare as one of 11 key sectors for development, alongside more traditional strengths such as energy and tourism.

According to Malaysian health ministry figures, the nascent industry is already showing its value – revenues per patient grew by 12 per cent between the first half of 2008 and the comparable period of last year, reflecting a steady increase in the range and sophistication of treatments.

Najib Razak, the Malaysian prime minister, recently announced a series of initiatives to promote the industry, including tax breaks for new hospitals aimed at medical tourists, simplified visa requirements for patients and incentives for medical specialists to work in the country.

The sector’s prospects are attracting other new entrants, such as Taiwan, South Korea and India.

In Taipei, the Department of Health has set up a special unit to help develop and promote the industry, and the government has set aside and near the international airport to be developed into a medical tourism centre.

The Department of Health estimates that with government support, Taiwan’s nascent medical tourism industry will grow by T$11bn ($342m) and create 3,860 jobs within four years.

The Confederation of Indian Industry estimates foreign medical tourism could also be a $2.4bn business for the country within a few years.

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(Additional reporting by Robin Kwong in Taipei,

© 2017 Compass Benefits Group