Shortage of teachers and poor infrastructure compromise the quality of medical education

Nilphamari Medical College does not yet have a permanent campus and medical teaching hospital, although classes started in 2019.

The medical school has only one lecturer for the subjects of forensic medicine and pharmacology and no associate professor or professor for this subject. Three contract technicians from Rangpur Medical College come to Nilphamari two to three days a week to run the medical college laboratory.

A student from Nilphamari Medical College told The Business Standard they were told subject teachers would join after Eid and classes would start.

“As the hospital does not have a medical faculty, we may have to do our internship at the 250-bed Sadar Hospital. Since Sadar Hospital does not provide all types of treatment, we will have a learning deficit,” the student said.

Not only Nilphamari Medical College, several government medical colleges including Jashore, Cox’s Bazar and Noakhali medical colleges do not have hospitals.

Also, most medical colleges do not have standard laboratories while there are many vacant teaching positions. According to the General Directorate of Medical Education, 49.7% of assistant professor positions are vacant in government medical schools.

Out of the 1997 positions, 723 positions are vacant for basic subjects in government medical colleges. Of these, 132 of the 204 approved faculty positions are vacant.

For the position of assistant professors, 156 positions out of 352 are vacant and 94 associate professor positions out of 251 are vacant. In addition, 16 curator posts out of 48, 324 lecturer posts out of 1,135 and one medical adviser post out of seven are currently vacant.

There are 108 medical colleges in Bangladesh, including 38 public and 70 private medical colleges. Half of all medical colleges are in Dhaka Division.

According to a study, 68.4% of prominent citizens believe that the quality of medical education in Bangladesh is on par. They think that if we cannot produce good doctors, it will not be possible to provide quality health care, no matter how good the infrastructure.

To identify and address existing problems in medical education in Bangladesh, scientific recommendations were made through a policy dialogue with 60 people, including eminent doctors, politicians and journalists, from March 11 to July 2. 2021.

Former Minister of Health, Dr. AFM RuhulHaque, in collaboration with the non-governmental organization Eminence Associates for Social Development, conducted the study last year and released the report on March 20, 2022.

The study revealed that there is a shortage of teachers in all medical schools and 46.7% of the participants felt that the teacher recruitment and promotion system should be restructured.

Some 81% of participants were in favor of streamlining health education to bring quality health care within the reach of ordinary people.

The research recommended dividing health education into four categories – clinical health education, health management education, disease prevention education, and medical teacher health education.

Medical training is not up to date

Medical school teachers said existing medical education is not based on the current epidemiological transition and disease pattern.

“Our medical education is curative, not preventive. Today, non-communicable diseases are on the rise, which has led to a 67% increase in out-of-pocket expenses. But prevention of non-communicable diseases is not taught in our curriculum.” Dr Rizwanul Karim, Associate Professor, Community Medicine, Rajshahi Medical College told The Business Standard.

“There is a shortage of teachers and other manpower as the teachers we have are not connected to the modern curriculum. Also, there is a lack of modern laboratories. We produce basically less qualified doctors because they don’t get quality hands-on education,” he said. said.

Dr. Rizwanul Karim recommended increasing the number of places in existing large medical schools instead of creating new medical schools.

Mr Iqbal Arslan, former Dean of the Faculty of Basic and Paraclinical Sciences at Bangabandhu Sheikh Mujib Medical University, told TBS: “We are not producing enough teachers compared to the rate at which medical schools are being created. Students in most new public and private medical schools do not receive patients and therefore lack practical education.The quality of education is also not up to par.

36% of teaching positions are vacant

According to data from the General Directorate of Medical Education, currently 36% of teaching positions in public hospitals of medical faculties are vacant in basic subjects such as anatomy, physiology, biochemistry, pharmacology, community medicine, microbiology, forensic medicine and virology in medical schools.

Professor Dr Rabiul Islam, director of Nilphamari Medical College, told The Business Standard that the shortage of teachers in basic subjects has eased a bit.

Jashore Civil Society Demands Medical University Hospital

Even 11 years after the establishment of Jashore Medical College, it does not have a hospital. Residents have been calling for a 500-bed hospital with the medical school since last October.

Zillur Rahman Vitu, secretary member of the Jashore Medical College Hospital Implementation Committee, told TBS: “Our medical students only learn from books, but they hardly learn from seeing patients, because serious illnesses are not treated at sadar hospital.”

Zillur Rahman said that they formed the Medical College Hospital Implementation Committee with the prominent citizens of the district. This committee organized various programs, including a human chain, a roadblock, a memorandum to the Prime Minister and a massive signature campaign for their demand.

No more crisis in private medical schools

It is mandatory for a Private medicine with 50 beds college to have a modern 250-bed hospital. However, many private medical schools do not have hospitals that meet these prerequisites. Apart from the shortage of teachers, they also lack modern teaching equipment.

A few medical colleges are still admitting students and continuing their activities by filing an order with the High Court after their registration was canceled due to non-compliance with the policy of the Medical and Dental Council of Bangladesh. However, they are now facing complications regarding their students’ internships.

Meanwhile, newly graduated doctors from CARE Medical College’s 2015-2016 session are protesting to demand internship migration.

DrAkmAmirulMorshed, Additional Director General of Medical Education Branch told TBS, that there are questions about the quality of our medical education.

He added that information about the quality of colleges and their shortcomings will soon be uploaded on the website of the Medical Education Branch so that student guardians can make an informed decision.

Out of 70 private medical colleges, 58 colleges provided information on their teacher shortage situation to the management while the remaining 12 did not provide the information requested by the management.

There are 4,626 teachers including 890 professors, 895 associate professors, 799 assistant professors, 73 curators and 1,968 lecturers in 58 private colleges, which need at least 9,000 teachers.

What the authorities are doing to improve the quality of education

DrAkmAmirulMorshed said quality teachers are needed to ensure quality medical education.

“We provide training for teachers. Besides, the medical infrastructure is being developed. The medical curriculum has been revised and a new curriculum will be launched soon,” he said.

“The teacher crisis has escalated due to the lack of promotion for a long time. There will be a meeting on this next week. I hope the promotion problem will be resolved soon and the shortage of teachers will be reduced,” he added.

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