Thailand’s Emerging Opportunity in a Shifting Global Education Landscape 

As global higher education undergoes its most dramatic upheaval in decades—with traditional destinations losing ground amid geopolitical tensions, financial strain, and dwindling clinical teaching capacity—Asia is rapidly emerging as a rising force, opening new opportunities for countries like Thailand to position themselves as regional hubs for healthcare education. While Western universities face visa restrictions, funding shortfalls, and shortages of clinical educators, institutions across Asia are strengthening their research output, international rankings, and appeal to global students. Against this backdrop, Thailand’s strong healthcare sector, abundant clinical expertise, and growing research capability present a unique window to attract international students—provided key reforms in internationalization, academic hiring, and program development are pursued. 

Five years ago, when I decided to leave my tenured professoriate position in a top-ranking Asian University, many of my colleagues were surprised. Their surprise, turned to sheer disbelief when I mentioned that I did so, in order to take up a visiting professoriate position in Thailand. Five years later and after several high-profile publications and the launch of an international postgraduate program, I think most of them would be able to better understand my decision. At the same time, having now served in an academic position in Thailand, I feel I see more clearly both the potential, as well as the limitations of university education in the Kingdom, in particular in the medical and healthcare professions.  

International University Education: A Global Opportunity and a Major Challenge 

To start with, it’s without doubt a very turbulent time for universities worldwide. A massive global market of more than $400 billion is under reshuffle. Seven million students are projected to leave home next year to seek education and opportunities around the world, while the long-standing order of recipient countries is rapidly changing. The pandemic accelerated several long-term trends in global academia, with most traditional university strongholds emerging weaker in the post-pandemic landscape. Institutions in UK, US, Australia and Canada, having for decades monopolized the aspirations of a global student pool, are finding it increasingly difficult to maintain their share of the global international student market, which is for the first time projected to fall below 50% from 82% in 2021. 

Several reasons have contributed to the challenges faced in each region, with some trends being however common. Geopolitical tensions and visa restrictions have resulted in reducing the appeal for studies in US, UK and Australia, especially for students from China and India. Recent policies in US have reportedly slashed grants, affecting over 7,400 foreign scholars. Tens of thousands of international student visas have reportedly been revoked, although official numbers remain unconfirmed. At the same time, financial strains in many western universities have started to take a toll. UK’s Office for Students reported that 40% of English universities are expected to operate at a financial deficit this year. A recent British Council study found declining numbers of students from Malaysia, Singapore and Thailand enrolling at UK institutions since 2015. Australian universities invested heavily in infrastructure, buildings and hospitality facilities in the years prior to the pandemic, aiming to strengthen their appeal to international students. At the same time, resources allocated to critical staff and academic teachers remained largely stagnant, resulting in many competent academics leaving universities to seek employment in industry or the private market. A full-blown crisis is about to hit many Australian universities, in particular in the periphery. Charles Sturt University, one of the largest regional universities in Australia, is planning to cut staff jobs aiming to save $35 million from its budget. Having recorded a net shortfall of almost $44 million at the end of 2024, CSU vice-chancellor Renée Leon mentioned that the university has lost 90% of its international students since 2019. 

With the budget restrictions a global reality, universities around the world are competing to cover the deficit left by the retreating traditional destinations. The European University Alliance warned that universities across Europe are facing a “new normal” of underfunding and urged institutions to attract more international students. Germany is actively encouraging universities to attract foreign students, as recent study by the German Economic Institute (IW) calculated that international students who began studying in 2022 alone will pay almost $16.8 billion more in taxes and social security contributions than they will receive in benefits. 

Not surprisingly, South-East Asia in being increasingly targeted, as a region that has been traditionally a “net-exporter” of international students. In 2022, Southeast Asia became the third-largest region for outbound student mobility, following China and India, with 350,000 students studying overseas lead by Vietnam. In a sign of the increased focus in the region, last June, the German Embassy in Hanoi funded a “career truck” to tour Vietnam and promote study opportunities in Germany, while a month earlier, French President Emmanuel Macron gave a keynote speech at the University of Science and Technology in Hanoi during a state visit. 

Healthcare Education: A Niche Market with Major Importance 

Healthcare education, the training of doctors, dentists, nurses, and paramedical professions, is a niche market with major impact in the wider society and economy. Healthcare professionals not only contribute significantly to the essential feeling of safety and well-being in a society but can also make a major economic impact by driving a country’s brand in an increasingly globalized market of medical care. A rapidly aging population in most developed economies and the rise of the “silver economy” have made healthcare education an important investment as well as a major asset for any country. 

At the same time, healthcare education is notoriously demanding and expensive, as it extends beyond the lecture halls to complex pre-clinical simulations and supervised practice in hospital environments, relying heavily on clinically competent teachers. The latter, however, are becoming increasingly rare for most western universities. Increasing workload, excessive demands and deteriorating teaching conditions were already problems on the rise, but when amplified by the strain imposed by Covid19, they lead many medical academics to fully or partly leave universities. The drop of income by international students, combined with overall economic malaise has meant that many of these positions remain vacant as of today. Universities across the Western hemisphere appear increasingly unable to attract and maintain the essential numbers of highly skilled and specialized healthcare educators, teachers who need to combine academic credentials with excellence in delivering patient care. 

Furthermore, under the pressure of metrics and research output, many universities tend to increase the proportion of basic sciences in the curricula and among staff. It is without doubt that academics in basic sciences are essential to medical education and all healthcare curricula. As they are free of any commitment to patient care, they can focus their time on teaching and research, producing typically higher volume and impact of scientific publications, something that the university can use to pump its metrics and raise its position in the rankings. At the same time, a shrinking pool of excellent clinical teachers can only spell trouble for institutions whose primary objective always was and still remains the training of competent doctors. 

As a result, both quality and quantity of clinical training the students receive at present in universities of the western world is reported to be decreasing. Academics from many parts of the world complain for reduced bedside teaching and mentorship, shift from hands-on, patient centered-learning to overreliance on diagnostic technologies, while medical and nursing students need to compete for fewer clinical hospital placement spots. Staff shortages of clinically competent academics increase burnout rates and resignations, further deteriorating effective supervision and mentorship to students. Operating under immense financial pressure, some institutions seem to prioritize revenue-generating activities over teaching, leading to a devaluing of clinician-educators. 

This couldn’t happen in a worst time, as the entire medicine is currently shifting to a new paradigm catalyzed by big data and digital technologies. Precision Medicine is spreading in all medical domains, with digital technologies introducing new powerful potential for healthcare professionals, from proteomics to 3D imaging and AI-powered surgical robotics. 

Asia, a Rising Star in Global Education? 

As global universities intensify the competition for international students, the appeal of universities in Asia is rising fast driven by major improvements in the quality of higher education across the region. English speaking universities such as the National University of Singapore and the University of Hong Kong have been the major hosts of international students in the region, their position however being increasingly challenged by rising regional champions. In 2024, 23 East Asian universities made it into the QS World University Rankings of the world’s top 100 universities, a 35% increase compared to 2015. HKU expects non-local students to comprise 50% of its undergraduate population next academic year, while Japan now hosts more Vietnamese students than any English-speaking country. 

It is evident that international students can bring benefits to the host institutions, the wider society and the country well beyond the financial contribution to the economy. As such students experience the local culture and establish life-long connections to the host institutions, they become active ambassadors of the country they studied in and major facilitators of its “soft power”. They contribute to research and development and when reaching a critical mass, they help the universities attract and maintain talent creating centers of excellence. Furthermore, as many of them choose to remain in the universities and pursue further degrees after graduation, they can significantly contribute to the overall economy with innovation and advanced specialist skills, especially in fast growing industries such as STEM and Medicine. It is therefore no surprise that the ratio of international students is one of the key metrics in most university rankings, well reflecting the intensive global competition to attract them. 

In short, it is evident that traditional recipients of international students in healthcare are currently being squeezed between slow tectonic shifts and acute geopolitical and financial challenges. At the same time, there is a rapid rise of ambitious Asian universities, with significant potential to evolve as regional and possibly global players in the healthcare education. With quality healthcare services being paramount to any advanced society, but also a potential catalyst for economic growth and prosperity for the entire country, opportunities such as these cannot be overlooked. The natural question emerging however is whether Thailand can benefit from the current global trends and if we could envision Thai universities as regional and global hubs for international students in the near future. To that end, the potential is great, but not without obstacles and limitations. 

Chulalongkorn University, Thailand’s Opportunity: A Personal Journey 

It was late 2019 when I left the University of Hong Kong and joined Chulalongkorn as a visiting professor, supported by a special fund of the University. By that time, I was counting almost 20 years in academia and had served in high profile positions in Sweden, Switzerland, Australia and Hong Kong. My profile would have been mostly described as a mid-career clinician/academic, with high credentials in clinical research and significant service in top 10 ranked institutions. Back then, I knew little of Chulalongkorn University and even less of the overall academic landscape in Thailand. Still, having had a close collaboration for a couple of years with a research team at Chulalongkorn, I was aware of the great potential for research and development within some very “futuristic” areas of surgery such as navigation and robotics. This team and the respective Department of Oral and Maxillofacial Surgery had all the ingredients needed for a breakthrough: many bright young minds, highly experienced senior clinicians, a well-organized clinical facility, good patient flow and the will to work hard to distinguish themselves at international standards. It was a very fertile ground for further high impact clinical research, while at the same time I felt my profile as perfectly supplementing the array of skills of the team, thus I decided to formally join the team initially as a “sabbatical”. I joined Chulalongkorn and started working full-on with teaching, research and patient care, through the support of the “Top Professor” scheme (a grant of the University aiming to attract international academics for periods of 1-2 years) and a Smart-Talent visa. 

My initial contract was then followed by a second and a third and to make a long story short, 5 years later, I find myself more engaged than even in the University. In the meantime, we conducted some groundbreaking clinical trials, we collectively published more than 40 scientific papers and hosted a global consensus workshop in computer assisted surgery. The Faculty of Dentistry rose meteorically to be ranked 59th in the world, far above traditional “global heavyweights” in USA and Europe. We launched a center of excellence and an international English-speaking clinical Master of Science Program, graduated several cohorts of specialists, Masters and PhD candidates, while also thanks greatly to this work I recently found myself ranked among the 2% top scientists. Having worked in many top positions in academia worldwide, it is with no hint of exaggeration when I say that very few faculties globally -if at all- could match this level of achievement in such a short time frame. 

Thailand as a Global Education Hub? 

I’m sure there could be similar stories in the overall higher education landscape in Thailand, albeit they would still constitute the exception rather than the rule. It is also true that Chulalongkorn does not represent the average university, but rather an extrovert, highly aspiring institution with significant resources. Nevertheless, looking closer in my own domain, healthcare education, one can find many strengths but also limitations at present in Thailand. 

To start with, Thailand offers a mature and well-developed healthcare services sector, currently emerging as a regional hub including the growth of medical tourism. Despite a rather extrovert healthcare sector, the university education with few exceptions is not tuned towards attracting international students. Still, it is to me obvious that the healthcare education in Thailand has at present great potential to quickly raise its international appeal, with its status as an education hub matching or surpassing this of healthcare. 

Clinical excellence remains highly valued in Thai universities, contrary to the trend in the western world. As a result, Thai universities still maintain a large pool of clinically competent and highly specialized doctors, many of whom with highly recognized overseas specialist credentials. There is an abundance of patients seeking care under university clinics, thus the student opportunities for high level training to actual hospital settings are in Thailand much better than most of the peer institutes I have served in 3 continents. On top of that, some clinical facilities reach or exceed global standards, boasting access to devices and technologies that few institutions worldwide can offer to trainees. It is no exaggeration to say that Thailand has an abundance of high value human capital in healthcare sciences, both in the sense of highly trained medical professionals but also aspiring students and trainees, willing to invest significant time and effort to develop high skills. In a global landscape where, academic teachers are in short supply, this is a rare comparative advantage. Increasing research impact conducted in Thai universities can further strengthen the “brand” of the institutions and appeal to an international audience. The safe and welcoming reputation of the Kingdom and the relative low cost of living could be also important factors appealing to an international student population, who seek professional competence but will also value a place where student life is affordable but also vibrant and meaningful. 

At the same time, university healthcare education is lagging behind in internationalization. With less than a handful of international programs in healthcare, the sector appears relatively introvert. Attracting foreign talent in the academic ranks is very difficult, with the complexity of the academic appointment, tenure and promotion system acting as a deterrent. Further licensing restrictions add up to the limitations of foreign trained professionals. Research training can be further optimized and streamlined, as currently much time is being wasted in formalities. Navigating a complex bureaucracy and immigration rules is difficult for foreign students without specialized help, while language barriers add to the overall complexity. 

Nevertheless, the potential remains as few success stories like ours can clearly indicate. With proper planning and few targeted interventions, Thai universities could greatly increase their share of the international student market, with major benefits for the institutions and the wider society. 

It is clear that such a change will not happen overnight, neither it can include the majority of universities at least at start. Instead, an effort should be directed towards identifying first a group of “national champions”, units, clinics, disciplines, departments and universities that are close to reaching the critical ingredients for a global impact. Fostering growth of such national centers of excellence, would be the first critical step towards raising the profile of the whole industry. Targeted support could help these centers to attract a critical mass of international high-profile academics. Rather than short visits, universities should target medium to long-term full-time appointments, aiming to support the local centers in developing the capacity to produce education and research of international standards. Strengthening the “brand” and international reputation of such centers will be an essential prerequisite to get distinguished in a globalized market of education. Simplifying the bureaucracy related to teaching and research will be a next needed step, aiming to increase efficiency and align closer with international best practice. Thereafter, facilitating the development of international programs in English will be the final important target. This will require attracting some international academics but also fostering local talent to the international teaching norms and standards and collaboration with regional and international institutions. 

Even a handful of such champions achieving international recognition will profoundly impact Thailand’s brand as an education hub. This may be a slow process, but once started, it will accelerate and self-reinforce. 

Developing a knowledge economy is vital for Thailand’s future prosperity. Universities are key to this transformation, and internationalization is a critical component. Healthcare education, with its significant advantages, stands out as an area ripe for growth. With focused efforts and investment, Thailand can become a major stronghold for global healthcare education in the near future. 

About the Author 

Dr. Nikos Mattheos is a visiting professor at the Department of Oral and Maxillofacial Surgery at Chulalongkorn University, Bangkok. He is also Honorary Professor at the University of Hong Kong and affiliated with the Faculty of Dental Medicine, Karolinska Institute, Sweden. He is the academic director of the Chulalongkorn University Implant and Esthetic Dentistry (CUIE) International Master’s Program. He is a global expert in implantology and also healthcare education, in particular with the use of new technologies and his research is disseminated through more than 170 publications in international peer reviewed journals and he has received numerous international awards and academic positions in top-ranked universities. He lives in Bangkok since 2020 and he travels frequently in the region and globally for scientific and educational events. 

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