Many young and energetic students eagerly enter the field of Medicine. The Social pressure, the peer imitation, an industryless and constructionless country have all led to an optionless scenario for good students. Everyone still today wants to become a ‘doctor’. Few month back there was an interview of a student who topped the SLC exam and still the aim was too conventional ” Become a doctor and serve the poor”. My opinion is , it is an imposed and crafted dream of parents and society since childhood and I would say it is a Sold Dream. Since childhood, we have been seeing doctors in advertisements and these have created a fantasy in our minds and most chose to go by common way, choose Medicine. And also there is less space for other scopes here besides getting drained abroad.
Medicine , till 10 years back was a respectable and reputed field. The lower payscale for doctors was compensated by High social prestige and liking.
But is it the same today?
Undoubtedly, it isn’t the same. The scope has changed and the scenario. In South Asia, I would say, the working environment is no longer same. We are neither considered God anymore nor we are excused for any deaths occuring in the hospitals. We have all become soft targets here.
Worse situation today is the scope of students after MBBS. What after MBBS?
In Nepal, it is a big trap, where you can enter and neither can you live nor quit. The ratio of PG seats to MBBS seats is too drastic and sooner in future not all students will have blessings to pursue Post graduate course. This is already a known problem in India where undergraduates have now moved to alternative courses like Diploma national board ( DNB), Diploma degrees etc. PG is no more universal for MBBS students.
Every year 1000s of MBBS students pass out of national and foreign medical colleges. The focus of Medical colleges , the governing body and entire system is Money Minting. No one really cares of quality and standards, it’s become a pure business. ‘Pay and get degree’. It doesn’t mean all buy degree, many students are well deserving and have performed best after MBBS. We are talking of the deteriorating system.
The rules are very malleable, the rules are modified as per needs and changes are made without foreseeing any consequences. Sometimes, students are allowed to appear for PG Entrance immediately after MBBS and next year they need year or two of experience. Even the Institute of Medicine has no fixed rules. PG is no more much yeilding in terms of Money and since then it has been ignored and seat have been cut down rampantly throwing students into an abysmal- A trap. Philipinnes and China are options for PG, but the Kathmandu University does not enroll them into academic faculty anymore. So there is a big stagnation in between MBBS and PGs. This has created a level of frustration, uncertainty and anger among MBBS students. Thousands of medical students are now trapped in phase before PG.
Even those who enter PG are at mercy of governing bodies. They have been slapped with years of bond after PG and devoid of their peak time to build their career. All that is best is for ‘Loksewa’ candidates who have the best opportunity in the country. No wonder students are flocking into Loksewa entrance now. NAMS a big institute is totally booked for Loksewa candidates and they have opportunity in every entrance in most colleges. So, one option is to rush into Loksewa.
USMLE had been a very good option for good students, but now many have taken the path in lack of any other opportunity.
After PG, the job in Medical colleges are rarely available. Private hospitals have been stuffed with Consultant doctors. Payscale isn’t any better and many have now started working as Medical officers in absence of opportunities. And the consequence is even lesser opportunity will be available for students to work as MO.
This is a known problem and is going unaddressed. Sooner in future, the entire system will collapse. The government plan is a good doctor patient ratio. That shall be reached soon, but if a Nepali doctor: patient ratio is 1: 250 population, and a patient pays Rs 300-400 NRS per visit, will it meet the daily livelihood for Doctor? It isn’t United states.
Therefore , a huge landslide is approaching this field. The continuous production of MBBS doctors with out a future plan, a big gap in MBBS to PG seats, the ignorance of bodies, the saturation of hospitals and unemployment even after PG and exploitation of doctors by corporates in scenario of increase production: demand ratios have all led to a coming Nightmare in this field. It should no longer be a fantasy of the students in Nepal and whoever wants to pursue Medicine needs to be aware of the scenario, scope and future rather than just fairy tale dream. Only students with secure opportunity in the field can have a better journey in this field.
Huge Investment- Sacrifice- Devotion- Low Output- Harassment- Bad Social Image- Compensations- Media mess
This line summarizes the story of journey from High School to Consultant Doctor.
This article does not radiate pessimism but existing situation in Medical sector on Nepal. We cannot deny reality. Until concerned bodies are serious enough to address the issue and create a plan for brighter tomorrow for intellectual minds of Nepal, the problem is going to get worse each year.
One option is Diploma degrees for Medical students, like DNB courses in India.
Dr Bob, Nepal ( Writer had changed name for Anonymity)