Revamp Medical Education

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Medical education is a vital sector that is related with the health of the citizens and the future of the nation. Living a healthy life, both physically and mentally, is the basic right of the people which has been enshrined in the constitution. Nepal has seen a burgeoning of medical institutes in the last decades. But, such rapid surge in the number of medical colleges, with extra bound fees and corruption involved in student admissions, has drawn criticism. The financial motives involved in these private medical colleges have added incurred political interfering, often resulting in disproportionate and unregulated licensing and affiliation to such colleges.

But the real status of public health is often far from the goal envisioned by the state. Disparity prevails between geographical regions, economic status, social class and level of education. However, capacity for financial affordability makes a big difference in terms of ensuring good health care to the people. The World Health Organisation recommends a doctor-patient ratio of 1:1,000; while it is 1:850 in Kathmandu Valley; the rate is 1:150,000 in the rural areas, substantially less than required.  A recent report shows that around 20 per cent of staff positions in the government health facilities are not filled in Nepal. It is for this reason that the state needs to make special intervention and arrange positive discrimination to provide good health care to the people.

 Free basic health services to all citizens, special arrangement for the elderly, disabled and poor and health insurance to all are some of the schemes that are expected from the government. So far as availing good health care is concerned, adequate number of health service institutions play an important role. However, much more depends on the quality of services these facilities provide. Quality aspect of health care is closely related with availability of qualified medical manpower. Only high level of expertise can give desired health services. This is a sensitive sector because a quality health service can save life while a substandard treatment can put life in danger. Maintaining the quality of health service by producing qualified health service providers is inseparable part of medical education. In this regard, policy of the government regarding the opening, operation and management of medical institutions is an important affair that should be handled with utmost consideration. 

Within a few decades back, Nepali students had to go abroad for medical education. Now the situation is different as such institutions are coming up in Nepal. Currently there is the talk of opening a medical university in each province. There is also a school of thought that opening new medical universities and colleges will only encourage commercialisation of the sector. The logic here is first to make medical education affordable and qualitative. Medical colleges are charging students exorbitantly which is an unhealthy tendency that needs to be remedied with appropriate government policy. Colleges that produce doctors and nurses have mushroomed over the decades in Nepal. So have the number of private hospitals, nursing homes and teaching hospitals. Here, a matter of high concern is that these health facilities are overly commercialised. Both getting a medical degree and getting treated in private hospitals is very expensive. People with ordinary income cannot afford treatment in private hospitals. 

Medical education has become a sector where only well off people can expect to earn a degree. In this scenario, there is a possibility that talented but financially poor students may be left out frustrated. Many of the talented students who get an opportunity abroad to study in medical field never return to the country because there is no good opportunity within the country. The nation produces thousands of nurses every year but most of them oft for going abroad for greener pasture. Brain drain of medical manpower is a serious problem for the country. 

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