Medical education in Bangladesh is totally controlled by the government. A unique undergraduate curriculum is run throughout the country under both public and private sectors. Currently in Bangladesh, there are fifty-four private medical colleges. Each year, around 5,800 students are admitted to private medical colleges.
Priti Chakrabarty, Chairman of Universal Medical said this in an interview with the Bangladesh.
Following is the excerpts of the interview.
Bangladesh Post: First of all, please brief us on the present level of standard of medical science education in private sector in the country?
Priti Chakrabarty: Through privatization, the role of government will be reduced and the private institutions will make major contributions to meet people’s medical needs. An environment will be created where reliance on private sector increased thus reducing dependence on the government.
Private medical schools can be totally or partially autonomous. There are manifold reasons for sudden increase in private medical schools. On one hand, the demand for places at medical schools is greater than seats. In addition, government is unable to meet medical needs of society due to economic constraints as well as limited infrastructure. More medical schools, whether private or public, can meet the need for ever-expanding population. There is a strong relationship between the number of medical schools and physician density. More medical schools in low density areas will certainly increase the physician density. A healthy competition between private and public medical institutions will benefit prospective job candidates.
The monopoly in medical education by the government-run institutions will be substantially reduced. With privatization, medical education will remain free from political influence. Many newly-established private colleges are not accredited by any national body. Absence of their accreditation will put qualification of the graduates in questions and those may not be nationally and internationally recognised.
Establishment of more medical colleges will result in oversupply and inappropriate distribution of new doctors. This will create lack of job opportunities for fresh graduates. Stringent monitoring and enforcement of international standards by the government and health agencies is a must to avert this. The curriculum should be scrutinised carefully and the colleges should be kept up-to-date with advances in science, medical education and health. Continuous curriculum evaluation is a must.
The ‘ideal’ teacher-student ratio should be maintained. Faculty development programmes should be made mandatory. Quality, rather than quantity, should be the priority
Bangladesh Post: Please tell us about the hurdles and challenges faced by success entrepreneurs in medical institutions.
Priti Chakraborty: Private medical colleges around the globe are more expensive than public ones. Medical education has become costlier over the time. The quality of students entering education programmes in some private institutions is more often dependent on their capacity rather than their merit. Hence the quality of doctors coming out of these institutions is compromised to some extent. Private medical colleges are facing problems like poor staffing, poor quality of training and high student-teacher ratios in some colleges. Their staff lack proper training and many of the faculty work on a part-time basis or appointed only for the purpose of accreditation.
Government support always helps improve quality of education.
Bangladesh Post: As an expert in healthcare sector, what are your recommendations in removing those hurdles?
Priti Chakraborty: Private institutions should shoulder the responsibility for their products — medical graduates, research results or models of health service delivery. Bangladesh Post: As a healthcare operator, how would you evaluate budgetary allocation for health sector in the recently-placed national budget?
Priti Chakraborty: Health budget does not ensure affordable, quality healthcare. The health budget for the next fiscal year is much lower than the World Health Organization’s recommended level (15 percent of total budget). Only five percent budget has been allocated for health sector. For the last 10 years, the budgetary allocation for health has been around five percent. If the government wants private sector to take responsibility for health sector, there should have a regulatory mechanism. A big portion of the budget is used for infrastructure development and purchase of equipment. Many government-approved private medical colleges are still underutilised. If the government makes these facilities fully operational through public-private partnership, the poor and the extreme poor of the society can have access to health services at low cost.
A recent report says that every year we have 10,000 fresh MBBS doctors, and in the near future, many of them will not get job. When government healthcare centers remain underutilized, many doctors are still unemployed. These issues should be addressed. There is a growing tendency among people to go abroad for treatment. If better treatments can be provided here, then people’s health expenditure will surely come down. The government has a lot to do in fixing prices of medicines. Currently, it only fixes prices of essential drugs. But prices of other drugs are mostly controlled by the traders. The government will withdraw tax on raw materials of some medicines. This will only benefit pharmaceutical companies, not the consumers. Medicines are exported to foreign markets but the local people are not getting same quality drugs here. The budget has failed to address these issues.
About health insurance for all, there is no guidance on which process people will get this. The government is saying the poor and ultra-poor will get health insurance of Tk 50,000 per year. But where will they get this service from? The public sector is already overcrowded. So, it is clear that people will have to get this service from the private sector. The private sector doesn’t have the capacity to provide healthcare at rural level. So, there is little scope for people to have insurance coverage. Improving healthcare is crucial if we want to achieve the SDGs by 2030. In order to achieve SDG goal 3, maternal mortality rate has to be reduced to 70 in every 100,000 births.
Bangladesh Post: Universal Medical College & Hospital Ltd formerly Aysha Memorial Specialized Hospital has been established to serve people by providing best healthcare.
Priti Chakraborty: In 2004, Universal Medical College Hospital turned into a multidisciplinary healthcare service providing tertiary hospital to create healthier healthcare. After a decade, it has become one of the most recognized and renowned referral hospitals in Bangladesh. Hi-tech healthcare facilities are part of the institution’s main objective for providing patients with the highest level of service and personalized care at affordable costs. Our future plan is to incorporate all super specialty disciplines under one roof. I love to see people are going back with smiling faces. ‘Smile for all’ is our slogan & we all are working for making our dreams true.
Bangladesh Post: As a private sector hospital, how far you are able to provide multidisciplinary healthcare?
Priti Chakraborty: We are trying to provide patients with multidisciplinary healthcare. We provide Adult ICU with Bed Side Dialysis, NICU & PICU, State of the Art Cath Lab, Ortho & Trauma Center, HDU & RCU, Hemodialysis Unit, and Fever Clinic among others. We provide both Diagnostics & Hospital facilities to our patients. We have already started the construction for a 500 bedded quaternary care hospital which’ll have every single facility any world class hospital needs to have.
Bangladesh Post: As a renowned referral hospital in Bangladesh, what successes your hospital has been able to achieve so far?
Priti Chakraborty: Being a renowned referral hospital itself is a success in its own right. This means others have faith in us to treat critical patients. Over the years we have successfully treated some very perilous cases with high success rate. For example, Master Easin, 5 years old male child was admitted to UMCH from Trishal, Mymensing on August 19, 2017 with complaints of inhalation of tamarind seeds with very critical condition diagnosed as foreign body inhalation with respiratory failure and Hypoxic ischemic encephalopathy. Trial of removal of seeds first failed in Mymensingh Medical College, and later in Chest Hospital at Mohakhali in Dhaka. Parents tried to admit him to other hospitals but all refused. Finally he was accepted in PICU of UMCH and he was immediately intubated with MV support followed by removal seeds successfully by our expert team on the same day in our hospital. His condition was improved within few days and he was discharged to home after 10 days with normal condition without any sequel. We have also been awarded with several acknowledgements & accolades for our superior service. We have been awarded as the Best Critical Care Hospital by Mirror Magazine on 2012. Recently Asia One URS awarded us as the fastest growing healthcare provider in Bangladesh.S
Bangladesh Post: We know that in the period of the last decade, tremendous development has taken place in the country’s health sector, still it is felt that the lower and middle income segment of people are deprived of healthcare services, how would you evaluate?
Priti Chakraborty: The gap between rich and poor is bigger than in Bangladesh than any other country, and most people are unconcerned about health care. Most of the people from any income sector tend to see a doctor when they’re facing severe health issues, while people in other countries go to doctors regularly. They see it as a part of their regular routine. People from Lower & Middle income segment thinks seeing a doctor is a burden. This is because of this mentality they’re deprived of healthcare services. If they’ve went to see a doctor in the very beginning of an issue than there would not be much bigger problem then. But they decide to see a doctor when the issue has become quite uncontrollable, thus the treatment becomes much expensive and going out of reach of their pocket. Also there aren’t sufficient beds & personnel in govt. hospitals and the treatment in private hospitals is much costlier as we don’t often get any subsidy from government, depriving the lower & middle income segment people of healthcare services in process.
Bangladesh Post: Achieving faith of patients is still a question in our country, why?
Priti Chakraborty: This is really sad we have still failed to achieve patients’s faith. We can’t overcome this in a short time. Though general perception is our doctors are careless & corrupt, in truth this happens because of their non-communicative nature. Many doctors are still uncaring to queries of the patients. They have to stop this. They need to answer each & every query of patients in a caring manner.
Ahammad Parvej Khan