Training abroad, especially in the developed Western hemisphere, is generally seen as a desirable adjunct to qualifications obtained in India. Dr Bernstein, who offers a fellowship in neurosurgery, identifies certain areas of concern. For one, the training may be inappropriate in the country from which the candidate hails. Second, the candidate may be tempted to stay on in the developed West, and this would be a loss for the home country. Finally, the candidate may be abused by his supervisor. How relevant are these concerns in relation to India? To understand this we must first look at some of the characteristics of the Indian medical care system.