Miscellaneous
Management malfeasance
On a recent Thursday morning, a group of students—clad in white aprons, from the now-shuttered Janaki Medical College (JMC)Manish Gautam
The Janakpur-based medical college was shut down nine months ago, and since then its students have been left in limbo. The college had a long troubled history and was plagued by problems that also affect many medical colleges inside the country. In quite a few colleges here, the management team members often lock horns over shares and many engage in prolonged internecine feuds. The students are sometimes not given the basic facilities and stipends that were promised them during admissions. The medical colleges, especially those who can’t meet the basic infrastructure and curriculum requirements, sometimes find themselves waging long court battles that lead to the colleges’ postponing entire academic years. The colleges are oftentimes buffeted by imbroglios related to political appointments at the institution too. And such problems turn institutions such as JMC turn into simmering hotspots of controversy.
At JMC, it all began with disputes regarding shares among the investors of the college—chiefly between Om Prasad Pandey, the college’s chairman, and the other investors. The internal bickering took a nasty turn when Pandey began forming a coterie around him and threatening those who went against him. The quarrel could not be kept confined to the boardroom and soon the faculty members, who had not been paid in months, got wind that things were not all right at the top. Some of them began staging protests against Pandey, while the others decided to quit teaching at the college. JMC, which already was short of staff, had to suspend MBBS classes time and again, and nine months ago shut down operations entirely.
It is the students who have had to bear the brunt of this fiasco. In 2011, when Raj Mehta got admitted to JMC, his family paid Rs 3.5 million as fees to the institution. Just three months later, things started to unravel at the college. Classes were frequently disrupted and the basic science classes—including Anatomy and Physiology, which students need to get through before moving on to more advanced subjects—were not taught at all. Then things got worse, and as the professors started leaving the institution, students such as Mehta found themselves abandoned.
At around the same time that things came to a head at JMC, students at Biratnagar’s Nobel Medical College too were living through similar problems. At Nobel, the trouble was sparked by an ownership dispute between Sunil Sharma, the incumbent chairman of the college, and Dr Gyanendra Giri, a senior cardiologist. And just as at JMC, the students at Nobel were soon seeing a shredded academic calendar year and a wrecked future.
Recently, in July 2014, students from KIST Medical College, Lalitpur, started protests against their college’s management practices. Luckily for the students, the National Human Rights Commission intervened on their behalf and their demands were later fulfilled and classes could resume.
Most such problems that crop up at medical colleges seem to stem from a common ethos held by the institutions’ investors. “Many view the providing of medical education as no different from any other business—that a medical college can easily be run by the average businessman who can come up with the funds to start a college. This has been the biggest fallacy in the sector,” says Dr Jagdish Agrawal, medical educationist at the IoM.
The malaise that has now infected the industry was not prevalent when medical colleges started sprouting up around the country in the mid-90s; the BP Koirala Institute of Health Sciences, in Dharan, and Manipal College of Medical Sciences, in Pokhara, both registered clean sheets, mainly in their early years. Now, the total number of medical colleges offering MBBS courses has reached 23 (two medical colleges affiliated by the KU this year had their licensed revoked under the Prime Minister’s directives in the wake of the fast-unto-death protests by Dr Govinda KC of TUTH) and not all of them are providing quality education.
The sector has over the years drawn many businessmen who wanted to invest in medical education solely because the returns in the sector look exceedingly promising. On average, every student who gets admitted to a private medical college ends up paying at least Rs 3.5 million in fees alone for an MBBS course. The Nepal Medical Council allocates anywhere from 50 to 150 seats per incoming batch to private colleges.
Some of these investors often hand over some of their investment shares to political leaders, who then use their clout to influence the policies of regulatory bodies meant to oversee the sector. Thus many colleges easily get away with offering a lower quality education. The frequent political meddling in the IoM and the politically influenced appointment of the president of the NMC in the past clearly reflects the sector’s unhealthy state of affairs.
Dr Arjun Karki, former Vice-Chancellor of Patan Academy of Health Sciences believes that it is past time the sector cleaned up its act. “Each medical college is accountable to the society it serves,” he says. “The colleges need to ensure that we produce doctors of the highest calibre and that they are not ripped off by the institutions in the first place.”
Nobel and JMC, for example, did not even have enough professors to teach their classes, and their teaching hospitals lacked adequate facilities. Indeed, their teaching hospitals received almost no patients at all and fake patients were placed in their beds when the inspection teams would come calling. The college hired professors from India to bump up their faculty numbers; these professors, known as ‘khade babas’ in medical circles, only had to be present in the labs during supervision. The institutions also created fake student-attendance sheets.
Some experts warn that the only difference between JMC and many other medical schools is that JMC plunged so deeply into such a vicious maelstrom that everyone could soon see that the school was beyond redeemable. Other troubled institutions, warns Dr Karki, could soon end up like JMC too.
That means many more students like Raj Mehta could soon find themselves in a similar predicament. Mehta will probably not get refunded the money he has already ploughed into the MBBS programme, and he hasn’t attended a class in well over two years.
“I am stuck in a quagmire,” he says. “I still cling onto my dream of becoming a doctor, but with every passing day, the dream recedes a little further.”