EDITORIAL: Undue demands

As medical colleges are related to human life, they must be service-oriented, and the service they provide should be affordable

The Association of Private Medical and Dental Colleges (APMDC) is in agitation over the revised fee structure for MBBS and BDS (Bachelor in Dental Surgery) courses. The association has announced that the private medical colleges would not admit the new batch of students this year even if the fee structure has been revised by the Medical Education Commission (MEC). The MEC on October 18 revised the fee structure after the private medical colleges lodged a complaint that the old fee structure was too little to run their colleges. As per the revised fee structure, a Nepali student who has passed the entrance examination and is pursuing an MBBS course in the Kathmandu Valley is required to pay Rs 4.02 million in installments for a five-and-a-half-year course, up from the previous Rs 3.85 million. A student studying MBBS outside the Kathmandu Valley is required to foot Rs 4.44 million in terms of fee as against Rs 4.24 million in the past. Likewise, a BDS student needs to pay Rs 2.02 million, up from Rs 1.93 million in the last fiscal. The MEC said the fee structure in both the programmes was determined after calculating the inflation rate conducted by Nepal Rastra Bank.

However, the APMDC is unhappy with the fee structure and has said it was not consulted before reaching this conclusion. It has demanded, among others, that the private medical colleges be given 150 seats for MBBS and 75 seats for BDS programmes, respectively. The government has decided to allot 100 seats for MBBS and 50 seats for BDS. The association has also demanded that the MEC come out with a clear policy on the admission of foreign students before the private medical colleges start admitting Nepali students. As per the existing rules, even the foreign students are required to sit for entrance examinations to be conducted by the concerned universities as a common entrance exam have yet to come into practice. Hundreds of students pursuing medical education within the country are awaiting the admission date. There are 12 private medical colleges across the country, and they are required to provide 10 per cent scholarships (approximately 120) to the meritorious students selected by the Ministry of Education.

As the MEC has already decided on the fee structure for this academic year, the APMDC has no option other than to comply with it and start admitting the deserving students in both the streams. Should the association stick to its decision, it will be construed that it has defied the decision taken by the competent authority formed under the law governing medical education. If they argue that the new fee structure will not help recover their cost of investment, the government can provide them some kind of subsidy while purchasing medical equipment required for various faculties. However, a sub-panel of the parliamentary Education and Health Committee has recently found that most private medical colleges were reaping upto 65 per cent profit even from the old fee structure. As the medical colleges are directly related to human life they should be service-oriented, and they must provide health services to the general people at an affordable price. They have a social responsibility. So, they cannot take the government hostage to get their undue demands fulfilled.

No to vandalism

Time and again, hospitals are falling prey to vandalism and manhandling of doctors following the death of a patient. This has just happened in Chitwan Medical College where relatives and family members resorted to the act after a woman died while undergoing a minor nose surgery at the hospital on Sunday. Twelve people were arrested after police had to use force and tear gas shells to bring things under control. There are ways to resolve such issues without having to resort to violent methods. The Nepal Medical Council is the right body to file any complaint should relatives believe that a patient has died due to doctor’s negligence.

One reason why relatives resort to violence is to seek good compensation from a hospital where the patient underwent treatment. And in most cases they have. Times are different and medical treatment is very expensive in the country. So doctors and other medical staff cannot be negligent in their duties. On the other hand, if doctor’s negligence is blamed for every patient who dies, so as to get the hospital to make financial reparation to the victim, this will give rise to a culture of ambulance chasers in the country.