AKASH KUMAR MISHRA

Countries across the world spent great amounts of money and resources in advancing their knowledge of health and guaranteeing the wellbeing of their peoples. But in Nepal, there still exists a huge gap between the feasibility and accessibility of healthcare resources. Despite the massive demand, Nepal has been unable to improve the health of its population. Apart from that, the unreasonably high costs of studying MBBS in Nepal and the limited number of medical colleges means that the dream of becoming a doctor, except for the rich, often remains just that, a dream. And for those willing to struggle to achieve their dreams, the only respite comes in the form of medical degrees from foreign lands. About 80 percent of these aspirants end up going to one of the cheaper and more viable options—China.

Going abroad

Studying medicine, or any course for that matter, in a foreign country might not be the first choice for an individual. But in the end, it becomes a compulsion because of our country’s inability to provide opportunities to economically disadvantaged but deserving students. Even after all the hard work put in during the course of study, medical students based outside Nepal are now being deprived of their right to an internship back in their own country. The Nepal Medical Council (NMC) and other governmental authorities, who are well aware of the importance of an internship and intern doctors, are treating Nepali medical students in foreign countries viciously.

Looking at the internship planning of our neighbouring countries, such as India, Pakistan and Bangladesh, we can clearly spot our faults and see where we are lagging. All these countries welcome and provide opportunities to all their students with degrees from foreign countries to gain clinical exposure in their homeland. In Nepal, despite being relatively poor and underdeveloped with a huge need for improvement in the medical field, autocratic bodies such as the NMC have chosen to act deaf and dumb, and have time and again tried to impede students’ privilege to an internship in their home county. Due to the current situation, Nepali doctors are leaving for developed countries in search of a stable future. If the NMC continues to treat these legitimate students as aliens, a day will come when there will remain no doctors to ease the ever increasing doctor-to-patient ratio in Nepal.

 A country’s duty

Every country is responsible for its students. Likewise, it is the responsibility of the Ministry of Health and Population (MoHP), the Ministry of Education and the NMC to train Nepali medical students in foreign countries and provide them exposure and opportunities so that the gap between patients and doctors can be reduced. This can be achieved only if Nepal arranges internship programmes for all Nepali students abroad.

The MoHP and NMC are surely aware that medical students studying in China, Russia, the Philippines and Ukraine have problems understanding the language of these countries. Moreover, a majority of students spend a vast portion of their time studying clinical subjects. For this reason, they have little time to study the language. Here in China, some of the students may be able to speak Mandarin but there still exists much difficulty communicating with patients in the local language and prescribing drugs. Hence, practical exposure, where we have to utilise our expertise and knowledge, goes in vain. Besides, the difficulty of grasping Chinese medical language, which is different from ordinary Chinese, along with the difficulty of correlating this knowledge to operate highly sophisticated and advanced medical technologies and equipment in a Chinese hospital setting leads to even more complexities.

Furthermore, the NMC is not even definite about the issue in its own National Guidelines for Medical Internship Training 2007, issued on May 8, 2007. Clause 3 clearly mentions that during unfavourable circumstances, all Nepali students studying in foreign countries can enjoy the right to an internship in Nepal. However, they have contravened their own guidelines by issuing an inappropriate and unfortunate Act which states that such students should do their internship at the university hospital from where they graduate.

 Justice delayed

If this is what the Act states, why have they allowed students from the 2007 batch and 2008 March session to do internships in Nepal and why have they prevented others from doing so? Furthermore, Clause 5 of the NMC guideline permits Nepali students studying in Nepal to apply for an internship in other countries after pre-informing NMC. If this is all right for students studying in Nepal, and the so-called rule of “internship is part of the curriculum” is not applicable to them and only to students studying abroad, then we can clearly say that the NMC is skating on thin ice. It is not responsible for any outcome and is playing games with our careers and our futures. This kind of irresponsible bearing and unprofessional approach could invite a huge medical crisis in Nepal.

As such, NMC is acting in an irresponsible manner and has seems to have ignored the decision made by an Appellate Court on June 26, 2013, in favour of Nepalese Medical Students’ in Foreign Countries (NMSFC) applicants under NMC Guideline 3 in its hearing, stating that the language problem of special circumstance falls under Clause 3 of above mentioned Guidelines. The Court thus ordered the NMC to dismantle the restriction against NMSFC. Henceforth, it is clear that the guideline is worthless and impractical, as it has been issued just for the personal benefit of NMC members and Nepali medical colleges.

After the Appellate Court’s verdict, we were assured that we students would get the justice we deserve. But now, after a long continuing struggle for our rights, we have come to the conclusion that justice can’t be requested but must be taken by force. If we look to the past, we can clearly see that no matter how genuine the demand, the Nepali people always have had to fight for their rights through protests and demonstrations. And Nepal being a democratic country, we are now left with no option but to launch a huge student protest against the authorities and government agencies. Furthermore, we would like to request all responsible authorities to think over our case and give us the justice we deserve, because justice delayed is justice denied.

Published on: 19 January 2014 | The Kathmandu Post.