Reforms In Medical Education

Uttam Maharjan

With the signing of the nine-point agreement between the government and Dr. Govinda KC, a ray of hope has emerged that medical education will see reforms. The government has agreed to incorporate Dr. KC’s demands into the National Medical Education Bill and the proposal encapsulating Dr. KC’s demands is being deliberated upon in Parliament.
The government did not easily accept Dr. KC’s demands. Dr. KC had to stage his 15th fast-on-to-death strike for a grueling 27 days. He first went into fast on to death in Jumla, an outlying and backward place in Karnali Province, where medical facilities are shockingly inadequate and where the treatment of Dr. KC himself was not possible when he was on hunger strike. As such, the government forcibly airlifted him to Kathmandu apparently to turn the scales in its favour. But things did not turn out the way the government wanted.

While Dr. KC was on hunger strike, he was able to garner loads of support but there were some elements that tried to portray him in a bad light. Even now, some parliamentarians have criticised Dr. KC so much so that they make no bones about calling him a killer. In fact, medical strikes in some hospitals during the hunger strike of Dr. KC affected some patients. However, Dr. KC deserves kudos for forcing the government to consider his demands that are directed towards eliminating anomalies and anomie seen in medical education.
Now, all eyes are on the implementation of Dr. KC’s demands. Dr. KC has now staged his hunger strike fifteen times. He first resorted to his hunger strike way back in 2012, demanding non-interference of the government in medical education. He has since upped the ante. This time, his main demands included a 10-year moratorium on the establishment of medical colleges in the Kathmandu Valley, restriction on the affiliation of a single university to five medical colleges at most and necessity for a hospital with at least 300 beds to have run for three or more years to run a medical college.
If Dr. KC’s demands, which are more or less in line with the report of the Mathema panel, are incorporated into the national medical education bill, it will affect some medical colleges in operation or in the process of being established. It has come out into the open that such colleges have blessings from political leaders. It is alleged that Durga Prasai, a the executive directors of B&C Hospital in Jhapa, wined and dined Prime Minister KP Sharma Oli and CPN (CPN) Co-chair Pushpa Kamal Dahal at his residence the other day and in return they removed some provisions from the national education medical ordinance and a replacement bill favouring their colleagues or cronies like Durga Prasai was tabled in Parliament.
In the past, every time Dr. KC was on hunger strike, the then government would convince him to break his strike by assuring him that his demands would be fulfilled. Agreements were also signed at the time. But most of the agreements are still unexecuted. This time also, there is a nine-point agreement, whose contents are being discussed in Parliament. As the successive governments played Dr. KC false by falsely assuring him that his demands would be met, this time the government should do what it has pledged to do. Whether Dr. KC will stage his sixteenth fast-onto-death strike is incumbent on whether his demands will be fulfilled.
Dr. KC is undaunted in nature. He does not fear death. His chief concerns are how to make medical education affordable even to poor students, and how the quality of medical education can be enhanced and overall improvements can be brought about in medical education. He has a bonanza of disinterest and altruism and seeing reforms in medical education is his mission in life.
Medical education is a sensitive field; it is directly related to public health. It is unfortunate that such a sensitive field of study has landed in the hands of some individuals, whose main thrust is making a profit even at the cost of quality education. In fact, the quality of education imparted by private medical colleges leaves much to be desired vis-à-vis government-run medical colleges. Commercialisation of medical education is a bane that must be extirpated at any cost. That is why at present there are voices in favour of nationalising private medical colleges.
Further, entrepreneurs prefer setting up medical colleges in the Kathmandu Valley rather than outside the Valley from a profit motive. This has concentrated medical education in the Valley. The plight of Janaki Medical College in Janakpur points out the fact that medical colleges in the Valley are preferred. That is why Dr. KC has put forth a 10-year moratorium on the opening of medical colleges in the Kathmandu Valley. However, medical colleges need to be established in the Valley in keeping with the changing times and as per requirements.
Reforms in medical education are exigent. As things stand, only the rich can afford such education. In the first place, the fee structure of medical colleges needs to be scientifically reviewed. Without proper adjustment of the fee structure, the poor cannot afford it. So even if Dr. KC’s other demands are met by the government, this very core demand will remain unfulfilled if no attention is paid toward revising the fee structure. Likewise, the quality of medical education needs to be enhanced. Diversification of medical colleges is equally important. The government is also planning to open at least one medical college in all the seven provinces, which should materialise soon.

Keep Word
In the final analysis, the government should keep its word and should not take it as its defeat while fulfilling the demands of Dr. KC. The government should also create an environment so that Dr. KC does not have to put his life on the line again by staging another round of fast on to death. After all, reforms in medical education are to the advantage of the country as a whole.


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