MBBS graduates are thought of as good authorities on human health. But the recently published exam results by Nepal Medical Council, the sole government entity that tests the competence of MBBS graduates in the country, suggest otherwise. As many as 28 percent of MBBS and Bachelor of Dental Surgery (BDS) graduates who sat for medical license examinations this week have failed their exams, thereby earning the tag of ‘disqualified doctors’. Even more worrying is the fact that NMC has records of graduates who have failed license tests as many as 26 times in a row. While NMC must be appreciated for making MBBS and BDS graduates take rigorous exams before they start their practice, it is also equally important to ensure that the failing 28 percent are not practicing behind the scenes.

Given the rising cases of misdiagnosis and wrong medication, this possibility cannot be ruled out. Often, the patients are made to undergo unnecessary tests and are wrongly diagnosed, leading to untimely deaths in many cases. As MBBS graduates spend huge sums and precious time in earning their medical degrees, they are less likely to stay idle simply because they have failed NMC’s tests. And it’s not just a question of bringing medical doctor in line. A year-long study on the performance of health professionals carried out with the assistance of World Health Organization (WHO) across 22 districts in Nepal shows that approximately 90 percent of medical technicians are unskilled or posses very little knowledge in the required fields. Nonetheless, they are involved in X-raying and blood sugar and blood urea testing, among other routine tests. It is vital that government regulatory bodies, including the NMC, make coordinated efforts to curb such malpractices.

However, all is not gloom, even when it comes to NMC exam results. Of the 199 graduates who failed the tests, the majority (166) are products of foreign universities, most notably from China and Russia. Of the 341 graduates from Nepali universities, only 20 failed. While this is an encouraging sign that graduates from Nepal-based health institutions are far more competent than their counterparts from foreign universities, it also calls for timely government intervention to check the enrolment of Nepali students into foreign universities with a track record of poor performance. Besides, it is no secret that most aspiring medical students in Nepal cannot pursue their desired line of studies owing to unaffordable fees; the government must devise ways to bring medical studies within the reach of middle and low-income Nepalis.

That would be a step in the right direction in the production of competent doctors in Nepal, besides helping stabilize students’ flow to foreign countries for medical studies. Separately, one of the measures to ensure quality of doctors in Nepal would be to make it mandatory for foreign graduates to pass MBBS entrance examinations conducted by home-based universities. All these little efforts could collectively go a long way in improving public health in Nepal and to reassure the general public which increasingly feels the country’s health system is falling into the hands of unprofessional and undereducated doctors.

source: republica,editorial, 26 Dec 2012