BUDAPEST -- When a first-year medical student from the United States left his skateboard by the entrance of a 19th-century lecture hall here, Professor Andrea Dorottya Szekely swiftly picked it up and reprimanded its young owner.
"We do things differently here," Dr. Szekely said of Semmelweis University, a 244-year-old institution in Budapest that focuses on the medical and health sciences. Students are expected to stand at attention in classrooms until a bell rings and their professors enter, for example.
Despite having to bridge such cultural gaps at times, an increasing number of foreign students are heading to Eastern Europe for medical, dental or pharmaceutical studies. Though it still hosts far fewer international students than Western Europe does, the region appears to be attracting growing interest.
The number of foreign university students in Hungary rose 21 percent from 2005 to 2011 -- to 16,465 from 13,601 -- according to the Unesco Institute for Statistics, which defines a foreign university student as one who had not previously earned a secondary degree in the country. In Poland, there was an 80 percent increase in the number of foreign students from 2005 to 2010, the latest year for which figures are available. The Czech Republic reported a doubling of foreign students from 2005 to 2011, while Slovakia saw a more than fivefold increase in its foreign student population, according to Unesco.
Many of the foreign students who choose the region do so to study medicine or other health care disciplines. In 2010, the fields of "health and welfare" accounted for 30 percent of foreign student enrollment in Poland, according to a study by the Organization for Economic Cooperation and Development. In Slovakia, 45 percent of foreign students were studying health subjects, while in Poland foreigners made up 15 percent of students in those classes, according to the O.E.C.D. study. In comparison, in countries like Germany, Sweden and Canada, where the competition for spots in medical school is especially intense, 6 to 9 percent of students pursuing those degrees are foreigners, according to that study.
In Hungary, where four universities offer medical and dental programs in English, 42 percent of international students are studying in health-related fields, according to the O.E.C.D.
There are various reasons for the shift, including the growing reputation of degrees from Eastern European universities that teach courses in English. But other factors also come into play, particularly the facts that tuition at these institutions is not as expensive as at top Western schools and that they are not as difficult to get into.
"When I first got here, demand was not that high," said Tomer Portnoy, a New Yorker who finished his final year of medical studies in the spring at Semmelweis. "It was easier to get in."
At Semmelweis, foreign medical students pay less than $20,000 a year in tuition, and students from European Union countries can often get scholarships or student loans. At Charles University, which is in Prague and also offers an English-language medical program, annual tuition is capped at €14,100, or $18,600. Dentistry programs tend to be slightly more expensive because of the cost of materials like fillings and molds in training.
For Europeans, who typically have access to medical schools in their home countries for almost no charge, such fees can seem high. But the costs are comparatively affordable for students from the United States, where even in-state tuition at public universities can exceed $30,000 a year.
Doctors, dentists and pharmacists with degrees from accredited universities in Eastern Europe may practice almost anywhere within the European Union. Semmelweis's medical students generally do their sixth-year rotations in hospitals around Europe, often in the country in which they hope to work later.
Sarah Moslehi, who moved to Budapest from Goteborg, Sweden, to study medicine, compares the fluidity of E.U. borders to those between the U.S. states. "Basically, Europe is now like a huge United States," she said. "You can just study somewhere and then move somewhere else."
Graduates who wish to practice in the United States, however, must pass the U.S. Medical Licensing Examinations. Similar requirements for local certification exist in many other countries, including Canada, India and Israel.
To draw students from outside Hungary, Semmelweis started teaching classes in German in the early 1980s. It began teaching in English later that decade, during the political opening up of Eastern Europe. For the academic year that starts this September, the university has accepted 380 foreign students in its English-language medicine, dentistry and pharmacy programs. Of its 12,719 enrolled students, 1,910 take coursework in English and 911 in German.
Semmelweis has clearly benefited from having a more multicultural campus, according to students and professors, but international students also provide real financial advantages, bringing fees that Hungarians, who study free or nearly so, do not.
Despite the foreign culture, curriculum and language, international students at the university seem to value their time in Budapest.
"It's great to study with people from everywhere," said Charlie Attariani, a Swede who completed a dentistry degree at Semmelweis this year.
Semmelweis is the only Budapest university that teaches medicine and dentistry in English and German, but other prestigious universities around Hungary -- the University of Szeged, the University of Pecs and the University of Debrecen -- also offer such courses in English.
Charles University, in Prague, has a strong reputation among medical students looking toward Eastern Europe, and the Iuliu Hatieganu University of Medicine and Pharmacy, in Cluj-Napoca, Romania, is also attracting an increasing number of would-be doctors, pharmacists and dentists.
Semmelweis's programs have drawn students from Germany, Norway and Sweden, where limited spots in medical schools have made the application process extremely competitive, as well as from Middle Eastern countries including Iran and Israel.
One of the biggest advantages to studying in Hungary is its Old World approach to medical education, students say. In addition to a strong focus on etiquette -- students are required to wear suits when taking exams, for example -- rank and rote memorization, medical students in the country are in contact with patients at an earlier stage of their studies than many of their peers and have more hands-on practice in disciplines like pathology and anatomy.
"Maybe in Sweden and Scandinavia they have the technology, but experience-wise, we've seen a lot more," said Dr. Attariani, the recent dentistry graduate.
For example, first-year dentistry and medicine students in Hungary spend countless hours studying at an anatomy museum in the Anatomy, Histology and Embryology Building, which has mahogany-and-glass cabinets holding jars with body parts, organs and embryos preserved in formaldehyde. After their second year, medical students typically have greater access to human cadavers than their counterparts in Western Europe do. Groups of eight students share a single cadaver for an autopsy, roughly once every two weeks, said Ms. Moslehi, who has just finished her fifth year at Semmelweis. "I would never see this in Sweden," she said.
The Old World pedagogy can also be seen in degree structure and the curriculums. Dentistry students, for example, spend the first two years of their studies with the students of medicine, giving them a broader foundation and, eventually, a Doctor of Dental Medicine degree rather than the Doctor of Dental Surgery degree that is more common in Western schools.
"We teach in a different way," said Dr. Szekely, a Hungarian who leads classes in English as well as in German.
But while the path to the degree may be different, she said, the outcome is the same. "There's just one goal here," she said. "They want to be doctors."
This article originally appeared in The New York Times.