There has recently been a major quandary with admission test into Medical Colleges resulting in massive disappointment and untold distress for many brilliant minds destined for distinguished health professional career in the country. The dreams of these sprouting spirits wishing to dedicate their career for the suffering humanity have been shattered.
There has obviously been reactive response to such a calamity, protest and street agitation, emotions giving way to violence, brutality and destructive exploits.
This, no doubt in my mind, is the reflection of the entire health profession and Bangladesh hospital health care's beginning of a free fall into chaotic, undesired demotion by 2030 when according to the Commission on Global Surgery, nations unprepared for improving their health care systems will have tremendous economic loss and that of life. This is in the face of a projection of Bangladesh becoming a full member of the middle income countries by 2030 and on its way to becoming a full-fledged developed nation thereafter.
The profession must voice its displeasure at the existing admission process into medical colleges that ought to be honest, fair, transparent and virtuous and not be knavish and deleterious as alleged to have been the case this year. Any controversy, particularly with evidenced allegation of corruption, would most definitely be detrimental to the very concept of the profession. The admission process should have been halted, transparent inquiry launched and results cancelled a long way back if the allegations proved to be true and fresh admission process started as soon as the corrupt misadventure was exposed. It is indeed sickening to observe that despite evidence the authorities decided to implement the result. Is there no accountability and the fraudulent, perfidious and profiteering practice is allowed unabated? It is really hard to believe that an educationally privileged, intellectually endowed, socially confederated, politically connected community, like the medical profession, does hardly wave a finger in protest against such attack against the profession. Maybe, time is rapidly disappearing for us to rectify ways of our conduct as members of such a resourceful community.
Are we aware that in Bangladesh there are almost 20,000 recently qualified medical graduates who have no regular job and are not on any training programme? Next year, there will be another 9,000 joining the queue and in 2017, probably another 10,000 and similar number every year then after. In any civilised country of the world medical graduation is not enough for practising as a physician independently. Minimum 5 to 10 years structured training is mandatory before any medical graduate can prescribe without being supervised.
The medical profession has arrived at its apocalypse with the hospital healthcare in Bangladesh facing Armageddon. Though this does not apply to primary healthcare which is the shinny example of our success and the head of the government has proudly been receiving the awards for 'Bangladesh Miracle', it is sad that the reality in hospital healthcare is so different. Only the unemployed doctors with family to look after and without possibility of any job prospect in the near future is enduring the pinch, they have indeed been pushed out of the frying pan into the open fire.
And the situation in health exists despite the fact that the incumbent Prime Minister has the vision of a prosperous and healthy Bangladesh. Her father, in clause-2 sub-clause-18 of the 1972 Constitution, guaranteed health and nutrition for the people of Bangladesh.
Astonishingly, there appears to have hardly been any concern expressed and there is definitely no co-ordinated discussion or consolidated approach to resolving this impending national crisis. There is hardly any endeavour in ensuring high standards of post-graduate medical education in Bangladesh. The profession is thus the hotbed of genuine but intricately poised outrageously tempestuous infuriation. How is our society going to bring about the desired outcome in their most noble of professions?
The greater society must support the medical profession to open discussion; lawful, constitutional, persuasive and structured dialogue with relevant authority emphasising on policy resulting in good governance and greater good for the citizens. The medical profession's aim ought not to be confrontational, but it is imperative for the profession to gather objective and accurate information on existing situation in healthcare in the country through audit and research, make direct contact with its members on the ground who are suffering and explore all the avenues of negotiated policy formulation with the present and future authorities.
The medical profession need to work together to reverse this potentially cataclysmic catastrophe. Only the unemployed thousands of doctors now can feel in their bones and we have no more time to spare as we have arrived at the fringe of the profession's ruination and must somehow influence new policy on post-graduate medical training to create adequate number of proper training posts in General Practice and Hospital Speciality with established reciprocal referral system that will require massive investment into capacity building in training opportunities both in country and outside, in public, private, public-private partnership, indigenous and with external collaboration. The medical profession in Bangladesh should be seeking dialogue with the highest authorities of the land. In a rapidly evolving situation, such as medical admission debacle every member of the profession and the population in general ideally must announce their intention on involvement in the reform and planning and implementation of policy process related to the health of the nation.
Prof Raqibul M Anwar --- a Consultant Surgeon specialising in Conventional and Laparoscopic Colorectal Surgery at The Royal London Hospital, a College Tutor, Examiner, Convener of Examinations and Special Envoy of the Royal College of Surgeons of England and a retired Colonel in the Royal Army Medical Corps, United Kingdom Armed Forces --- is President and CEO, RAHETID.
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