Dr Govinda KC, a senior orthopedic surgeon, held several rounds of hunger strike demanding reforms in the medical education sector.

Regulation of private medical colleges and reining in the arbitrary fees imposed upon the students have been some of the major demands of Dr KC, who has already staged hunger strikes for 19 times. The Medical Education Act, 2019, was promulgated as per the recommendations of a task-force led by Kedar Bhakta Mathema, a former vice-chancellor of Tribhuvan University.

The Act also envisioned the Medical Education Commission to check the malpractices in Nepal’s medical education sector. The commission is chaired by the prime minister and minister for education and minister for health are its co-chairs while the vice-chairperson is the executive head. Despite being a powerful entity, the commission hasn’t been able to check the malpractices in the medical education sector.

The commission in September 2019 fixed Rs4.02 million fee for the MBBS students inside Kathmandu Valley and Rs4.44 million for the rest of the country. There was an increment of around Rs2.2 million in both categories.

The fee, according to the commission, includes every cost except the hostel fee. The students are free to choose whether to stay in the college hostel or in a rented accommodation. However, the medical colleges are demanding students pay thousands of rupees in addition to the fee determined by the commission.

The colleges have set fees as high as Rs240,000 for internship, registration fee of Rs25,000, Rs20,000 annually for internet and examination fee Rs11,000 per year. They are also compelling the students to stay in college hostel paying Rs12,000 monthly on twin sharing basis in addition to Rs7,500 for food.

The students have protested the decision and are refusing to pay the money. As a result, MBBS classes haven’t commenced in a majority of private colleges.

“The colleges are openly cheating us. The regulatory body is a mere spectator,” a student from Kathmandu Medical College (KMC) told the Post seeking anonymity. “We are not going to pay the additional money.”

The students from the KMC; Nobel College, Biratnagar and Manipal College of Medical Sciences, Pokhara, among others, are in a continuous protest against the “arbitrary” fees.

Following the protest, the commission on Tuesday asked the private medical colleges not to charge additional fees in the name of internet, registration and examination. The commission also said students should be allowed to choose whether they want to stay in the college hostel or private accommodation.

However, the colleges have refused to budge. They are in no mood to compromise. Basruddin Ansari, chairperson of the National Medical College, Birgunj who also chairs an umbrella body of private medical colleges, said they are compelled to charge the additional fees as the fee determined by the commission is unscientific.

“The commission hasn’t increased the fee for two years. We cannot operate the colleges with the present fee structure,” he told the Post. “It was the government that asked the medical colleges to set up hostels. Now, the commission is saying students are free to stay wherever they want. This is not acceptable.”

He said the commission is imposing unnecessary limitations on medical colleges, making it difficult for them to sustain. Officials at the commission say the medical colleges must implement their decision.

Dr Dilip Sharma, an executive member of the commission, said the colleges cannot charge additional fees on any pretext. “The colleges are imposing exorbitant fees, which must stop,” he told the Post. “We have already directed them to abide by the commission’s decisions.”

Medical college operators, however, say increasing the tuition fee is the only way out of the present problem. Ansari claims that there was an inflation of around 4.5 percent in the last two fiscal years since the fee was determined in 2019. “There must be a nine percent increment from the 2019 ceiling,” he said.

If inflation adjustments are made as per Ansari’s demand, the fee will go up by around Rs400,000.

The students blame the commission for not taking appropriate steps to check the malpractices.

“The commission must be bold enough to take actions against the colleges that are flouting its directives,” said a student from Manipal College of Medical Sciences, not wanting to be named. “It should at least come forward to implement its fee ceiling.”

Though the Manipal College administration says it is ready to reduce the extra fee slightly, it is not ready to fully abide by the commission’s order.

Following the reluctance of the colleges to implement the fee ceiling, Dr KC on Sunday drew the government’s attention to check the malpractice. He claims that the medical “mafia” is raising millions of rupees illegally from the students.

“There are reports that the college owners close to the government are raising millions of rupees illegally from the students,” KC said in a statement. “We cannot remain spectators to the malpractice.”

Commission officials allege that since medical college owners have close nexus with the political parties, they openly defy their directives. “The medical college owners are leaders of various parties. They have protection from those in power,” said a board member of the commission on the condition of anonymity. “The commission alone can do nothing.”

As claimed by the official, Ansari is a leader of the CPN-UML. He was a mayoral candidate from the party in Birgunj in the 2017 local election. He was a CPN (Maoist Centre) candidate in the second Constituent Assembly elections from Parsa-2. Likewise, Sunil Sharma, who owns the KMC and Nobel Medical College, is close to the Nepali Congress. Khuma Aryal, managing director of Gandaki Medical College, and Suresh Kanodiya, owner of Nepalgunj Medical College, are local Nepali Congress leaders.

Ansari, however, denies that they enjoy political protection. “No party in Nepal favours the private sector. Even the party I am close to doesn’t support us,” he said.