Only 39 percent of medical doctors—MBBS and BDS graduates—have cleared the licensing test of the Nepal Medical Council. This has raised concerns about the academic standards of future doctors.

Of 1,077 doctors—894 MBBS graduates and 183 BDS graduates—who sat the exam, only 421 secured pass marks in licensing tests held on Wednesday and Thursday.

The council, the national regulatory body for medical doctors and dentists, does not allow doctors to practice medicine without clearing its licensing test.

“Those who could not secure a pass mark cannot examine patients or prescribe medicines,” said Dr Satish Kumar Deo, the council’s registrar. “They have to sit another licensing test and clear it to get the license.”

The council conducts the licensing test every four months for graduate and postgraduate medical students.

Of the 894 MBBS (Bachelor of medicine and bachelor of surgery) graduates, who sat in the council’s test, 389 (43 percent) cleared the exam. While a total of 183 BDS graduates sat the test, only only 35 (19 percent) qualified to start practice.

Officials say it is not unusual for a large number of medical graduates to fail the licensing test, but the failure rate among dental graduates this time is alarming.

“I have to check if such a huge number of students failed to secure pass marks in the past or not,” said Deo. “The number of students who failed repeatedly in previous tests could be higher this time, hence the higher failure numbers.”

To qualify as a medical practitioner, a doctor must score at least 50 percent in the licensing exam. Experts say the quality of medical education is being compromised because underachievers who should not be practising medicine continue to enter the profession.

They say that universities and colleges must pay closer attention to the performance of the doctors they produce.

An official at the council said that in the two previous tests, the pass percentages of doctors were unusually high, and a complaint was lodged about it.

“I don’t know what is the real cause, but everything should be seen in a chart or trend,” an official at the council said, asking not to be named, as he is not authorised to speak to the media. “If the number of students repeatedly failing the licensing test is high, then the failure rate will naturally be high.”

Licensing tests for medical doctors are a routine procedure in every country. Nepal’s licensing test focuses only on doctors’ knowledge. Some countries also conduct skill tests. Council officials said they had also planned to conduct skill tests in the past, but could not do so due to the lack of skill labs.

Currently, only the National Academy of Medical Sciences, Tribhuvan University’s Institute of Medicine, and Kathmandu University’s Dhulikhel Hospital have skill labs.

The council had previously planned to set up skill labs with support from various agencies, including the World Health Organisation, but the plan did not materialise.

The World Health Organisation said inaccurate diagnosis, medical errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities and practices, and healthcare providers who lack adequate training and expertise are present in all countries.

The UN health body says low-quality health care is increasing the burden of illness and health costs globally.