Debunking the widespread perception that medical graduates of foreign universities are more capable and better trained than those educated locally, records from the Nepal Medical Council (NMC) show that graduates of local schools fare much better in licencing examinations.  NMC license is mandatory to practice medicine in the country.

Going by the record of seven licensing examinations of the past three years, around 50 percent graduates from foreign countries have passed the test, while over 90 percent of medical graduates from domestic universities have made it through the examination.

In 2012, of the total 682 graduates from Nepal, who appeared the examination in three licensing tests, 640 passed, while only 554 graduates out of 1,118 from abroad made it through the examination. Majority of the graduates from China fail the test. For instance, only 164 students out of 339 graduates from China passed the test last December. Of 591 students, only 252 passed the test in a test held in

April 2011. The pass percent of graduates from China has been consistently low, with the success rate between 35 to 40 percent in the past three years.  

China has become the main destination of medical students for over a decade, followed by Bangladesh and India. Russia, Kyrgyzstan and Philippines are other popular destination.

According to the NMC, 790 students took the eligibility certificate for MBBS and BDS, while 133 doctors took it for post-graduate study abroad in 2010. The NMC has not updated its report of the year 2011 and 2012.

It is interesting to note that sometimes the total number of students from China, who have so far shown the worst performance in the licensing test, are almost equal to the total number of students from Nepal.

“We don’t mean that all the students from China are bad. However, majority of them are not performing well in our examination,” NMC Chairman Dr Damodar Gajurel said.

Many believe that it is the low-cost medical education that makes China a popular destination. A five-and-half-year MBBS course in Nepal costs roughly Rs 4 million, while it costs roughly Rs 2.5 million in China.

Dr Adhikari pointed out that the family has a large role to play in this issue. Parental compulsion to make their children doctors, in spite of lacking academic qualifications, is also prompting the educational migration to China.

“If the child is not intelligent enough to bag seats in Nepal then their destination is China. Medicine is a tough subject and students with poor academics cannot pass it,” Dr Adhikari said, who is also a visiting professor at China Three Gorges University.

Educational Consultancy Association of Nepal, the umbrella organisation of education consultancies, has nine institutes that send students to China for medical studies.

Dr JP Agrawal, medical educationist and a faculty member of the Tribhuvan University Teaching Hospital (TUTH), said that even students with poor grades are fascinated with medical studies just to have a ‘Dr’ before their name and fulfill their parents’ desires.

“Many of the colleges abroad have equipment and facilities more sophisticated than ours. However,

there are very few teachers who can teach in English and they fall short when it comes to explaining the medical context,” claimed Dr Agrawal. “This means that students only understand what is in the text and not its implication practicing.”

Similarly, Dr Arjun Karki, former VC of the Patan Academy of Health Sciences, said that students are not interested in learning the Chinese language and hence, institutions hire teachers from Nepal and India who can teach in English. “We are not sure if these teachers are qualified to teach. It is just that they can speak good English,” said Dr Karki.

Inspections (which the NMC calls a “goodwill visit”) conducted by the NMC at the Weifiang Medical

College in China discovered that “students seemed satisfied with theory classes but mentioned that clinical teachers who speak good English should be deputed during their internship.”

The visit also found that the library contained few medical books in English and even those available were old.

NMC data shows there are students from abroad who have flunked the licencing exam more than 20 times in its 10 year history of conducting tests.

source: The Kathmandu Post, 10 Feb 2013