If you graduated from high school in 1990 and wanted to be a doctor, you either had to compete for one of 20 available seats in Tribhuvan University’s Teaching Hospital, or try to finagle your way into the handful of seats available from embassies of India, Pakistan, and Bangladesh. No more than 30 students in a year could become doctors.
Then the middle class parents discovered that they could send their kids to Bangladesh and pay about 8 to 10 lakhs, and their child would return a doctor in five years. Soon you could do the same by sending your kids to Russia or China. This was a gold mine for many who wanted to be doctors, but had no way of becoming one in Nepal.
Only when students started leaving to these countries in large numbers did the entrepreneurs of Nepal, the Medical Council, the bureaucrats and the politicians, realize that by allowing medical schools in the country, Nepalis could save a lot of money, and also make a lot. It was then that permits to open medical colleges started being distributed.
As students graduating in 1996, I and many of my friends viewed these medical institutions as second grade. No one could be sure whether they would survive for four years. Some even feared that these institutions might take your money and never give you your degree. We were wrong. These institutions have produced quality graduates, virtually all of whom pass their Nepal Medical Licensing Exam. Many are world class doctors. There is no good reason to believe, for example, that Nepali graduates from Manipal in Pokhara, or Chitwan Medical College in Bharatpur, are not up to the mark, compared to the graduates of Teaching Hospital in Maharagunj.
These new private medical colleges have opened up opportunities for the rich as well as the poor. If your parents cannot afford the 30 to 40 lakhs that these colleges require for admission, you still have a better chance of becoming a doctor than in 1990. You can compete for the 20 percent of seats that these private colleges need to allocate for government quotas—which adds up to more than 100 seats and continues to increase as new medical colleges open.
Even the fees that these institutions charge is lower compared to what parents paid in 1990. Assuming that it took 9 lakhs in 1990, and assuming an inflation of 9 percent, that money is now equivalent to about 65 lakhs! You can become a doctor at half the cost and you don’t even have to go to Bangladesh.
Not only do the students and parents, but the rest of the society also benefits fro this situation. We now have more doctors. Also, these institutions provide job opportunities to many, and have improved the economy of where they reside. In short, what has happened is truly remarkable progress.
What happened in the Medical College Industry is now happening in Engineering and Business Schools, and policymakers need to view these changes with the lens that they viewed medical colleges 20 years ago. There are many in Nepal who can become good engineers and managers, if the government doesn’t block them from being one. Parents are willing to pay, the students have the intelligence, preparation and the ambition, and the entrepreneurs have identified the market. The government should make it easier for this transaction to occur. It should give more licenses to open colleges, not restrict them! It should waive taxes for these colleges. In return, a model similar to the medical college can be applied. That is, the government selects smart students who do not have the means to pay for private education, and mandate the private colleges accept them at a fraction of the cost they charge regular students.
Sadly the current narrative has been that private colleges are exploiting uninformed parents and students—taking their money, and not giving them quality education. This argument implicitly assumes that parents and students are either stupid, or that the private colleges are successfully hiding some information from the students. The indication is that if the students knew the secret that private colleges have kept from them, they would not pay as much, or not attend their college. Both these assumptions don’t make sense—especially for colleges that have graduated at least one cohort of graduates.
Let us keep in mind that what makes for a great teaching intuition are not buildings, infrastructure, or the acres of land it sits on, not even its teachers, but its students, and the management that provides the environment for learning.
There is no shortage of hard working, ambitious students in a poor and populous country like Nepal where the only escape from poverty is a good education. But there is a shortage of institutions with good management. We need to learn from past success, and allow the private sector to fill this void. Good teachers and good infrastructures are secondary, and are just a matter of time
Source: Republica National daily published in Jan 27, 2013