Siddharta Yadav: Politicizing medical education

Yesterday, I witnessed a doctor being beaten up at the Tribhuvan University Teaching Hospital of Nepal. The doctor was exiting the hospital grounds when a group of people stopped him. Few words were exchanged and suddenly, one of the persons from the group repeatedly punched and kicked the doctor. The doctor shouted for help. The police rushed in. They stopped the assailant and asked him to leave. No arrest was made.

The sequence of events that led to this incident is complex and involves a lot of politics. Doctors and medical students at the Tribhuvan University Teaching Hospital, one of the largest tertiary care centres in Nepal, were on a strike for 18 days. They were protesting against the dean of the institute for his alleged involvement in selling in advance the question papers of the examination to select doctors into post-graduate medical education.
The doctors were demanding that the dean resign on moral grounds or he be suspended to allow a fair investigation on the issue. The doctors are backed by many different political and professional organizations in their demands. So far the dean has dismissed these claims and has refused to resign. Like the doctors, the dean is not alone either. He is backed by a different group of political organizations. Yesterday’s incident was a part of this display of political force when a member of a political group opposing the protest beat up a doctor involved in the protest.

Politics has always been prevalent in government academic institutions in Nepal such as this one. It is a known fact that appointments to important positions such as the dean, hospital director, campus chief, or even the vice-chancellors of government-run universities and institutions are based on an individual’s connection to major political parties within the country rather than on his academic contributions. Moreover, even promotions from one level to another, such as from an associate professor to a professor, is said to be largely dependent on an individual’s political approach.

This has led to a strong polarization amongst all levels of employee and students of the government universities towards different political parties within the country. When I was a medical student at the Tribhuvan University Teaching Hospital, we had sister organizations of major political parties amongst the professors, faculty doctors, resident doctors, nurses, other staffs and even medical students. I still remember the clashes amongst rival student organizations, usually during elections. It was nothing out of the ordinary when few students would get hurt every now and then due to such clashes.
Many medical students and doctors believe that their political organizations are essential to get things done for the benefit of students and doctors. This is indeed true to some extent. In Nepal you do not get heard until you demonstrate power and force. Political organizations are very good at this. Whether it is to negotiate the salary of doctors, working hours or get books for the library, political organizations of doctors and medical students are very effective in getting their demands met by all possible means including strike.

However, more often than not, these machineries have been used against each other. When one organization coordinates a strike, the other opposes it. When one has its demands met, the other pushes for fresh demands. This has only created chaos within the academic system.
With politics in prime, the biggest loser is academics. For any lecturer or associate professor, it might be beneficial to spend an hour with a politician than spending the same time with students. After all, for him to become a professor or the dean or the hospital director, it will not matter whether he took classes or not or whether he attended the hospital OPDs and rounds or not.

What will matter is whether he knows any “big” politician of a major political party or not. The hardworking academicians have been pushed to the corner while the politically motivated doctors and teachers who shunned academic activities and never bothered to show up for lectures, OPDs or rounds have been handed over the leadership of academic institutions. An irony really! This has only further lead to widespread corruption, low priority to academics and incidents like doctors resorting to strikes and getting beaten up.

Things have only been getting worse in the past few years. Perhaps the instability in the environment of academic institutions reflects the political instability within the country. However, this should not be an excuse to foster political idealism while compromising academic activities. I think we have now reached a breakpoint where we need to stop all this nonsense and let an academic institution be strictly “academic.” For once, let’s just focus on teaching students and taking care of patients at university hospitals and keep partisan politics in medical education to a minimum.

Competing interests: I served as the elected vice-president of the Nepal Medical Students’ Society (NMSS) from August 2007 until July 2008.

Siddhartha Yadav is a former BMJ Clegg scholar.

  • RP Sharma

    Siddhartha has really nicely brought up this grave issue of politicization in government medical institution in Nepal. The devastating consequences of such politics would be directly on the professionalism and ethics of noble medical practice. In long run, it will mire the whole health system of the country.

  • mohan bhusal

    Thanks Dr siddhartha for bringing this issue in an international arena.Politics has always been a hindrance to flourishing the academic environment especially in government colleges of our country, where nearly one third of the academic session is lost in strikes and vandalism.Regarding the medical college the scenario was not that pathetic but for the last 1-2 years they have also adapted the same heinous way which is ethically not permissible.Even the emergency session was halted for two days which seems quite serious.The consequence of that 19 day strike has created so much chaos in our institution that Exams of undergraduates and post graduates are postponed. Thousands of patient had to seek health services in the costly private clinic and all the academic activities came to a complete halt.
    Though the strike was for a good cause i.e to make the exam system fair and scientific,to eliminate the political appointment in such prestigious posts but the hilarious thing is that some of the heads of the organizations like (FDA, pradhyapak sang) also politicized for their vested interes.Different student unions also tried to politicize accordingly. Government also turned deaf till 18 days, which later turned up just forming a probe committee.Had that been done earlier the issue would have resolved soon. Due to delay in addressing this issue thousands had to suffer so i think everyone is wrong in one way or the other.The system has been so established in our country that without agitation of 10-15 days even minor issue is not going to be addressed.So i think the main culprit is the government itself and we all have to be honest from our side to make a better academic environment .political appointment should be strongly discouraged.We as an intellects should come up with new ways of making a protest and the concerned body shouldn’t turn deaf ear towards such genuine issue…

  • JamesWright

    When politicization is connected no doubt that this will be clashes and will not nurtured with improvements, debates arises when talked about. Politics must be detached with it so that it will have it’s good direction.

    Academic internal medicine programs must be prioritized and given a good structure.