Dentists and doctors

2014-04-05

Ekantipur

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Globally, the acronym MD degree refers to Doctor of Medicine. MD graduates are those who have a background of Bachelor of Medicine and Bachelor of Surgery (MBBS)  in their undergraduate course. 

Although the MD degree may be obtained in clinical subjects like medicine or pediatrics, or in some basic medical sciences like anatomy, physiology, microbiology etc., a course in medicine and surgery is always mandatory. 

Interestingly, some Nepali universities are awarding MD degrees to dental graduates who have not been fully exposed to medicine and surgery (except for very short durations), except in their field of expertise—dentistry. The BP Koirala Institute of Medical Sciences (BPKIHS)  has been awarding MD degree to graduates for five to six years, while Kathmandu University (KU) has recently advertised for the course.

These dental graduates have only to learn some basic medical sciences like anatomy, biochemistry, microbiology, pathology, pharmacology and physiology in a bridge course lasting three months. Thereafter, they are eligible to be enrolled for courses in basic medical sciences. Strangely enough, they don’t have to be exposed fully to clinical subjects like medicine, surgery, gynecology or pediatrics for their degree. During their undergraduate course, they receive only some brief introductory education in a few clinical subjects. Thereafter, their curriculum is fully devoted to dentistry and dental surgery. Can we really say that their studies are equivalent to those of MBBS-MD graduates? When they have only been required to study one subject in their three years? This apparent unfairness is the fault of both the Nepal Medical Council (NMC) and the students’ university of study.

It’s even more pathetic that there is scarcity of efficient, fully qualified manpower in dentistry. The number of specialist dentists with MDS degree is few. Still, the concerned universities and NMC are eager to bypass the current problem and look towards increasing the quantity of basic medicine courses available, without fully addressing issues of quality.

More problematic is that MD degrees with a BDS background (I’ll call BDS-MD here) are not recognised by the Indian Medical Council and many other medical councils around the world. India has the largest number of medical colleges (291 colleges offering dental education, with an annual intake of 23,690 graduates) in the world, and they also have scarcity of efficient manpower in basic medical sciences. Still, these countries are not awarding MD degree to BDS like in Nepal, even in the face of this scarcity. After the completion of BDS, it is well-known that an aspirant can either start working or prepare for postgraduate entrance exams. Some postgraduate courses that are available abroad include MDS (Masters of Dental Surgery)  and or a PhD in Dentistry.

Perhaps this is one acceptable solution. After undergoing rigorous research work, a PhD is awarded to MSc graduates of basic medical sciences. Even MBBS students are eligible to study for the PhD degree. This PhD is equivalent to the MD degree (with medical background). The main duty of MD and PhD graduates in basic medical sciences is to undergo research work and to become involved in teaching activities of MBBS students, as well as those studying BDS and BSc nursing. In our context, those BDS-MD graduates will also become involved in teaching activities eventually.  To the best of my knowledge, the BDS-MD degree is not recognised by other medical councils of the world, including our neighbours.

If the NMC and the universities are providing MD degrees in basic medical sciences to BDS graduates simply because they also have the title of Doctor before their name, will they enroll other graduates bearing the same title, like for instance, those who have studied animal husbandry, ayurvedic medicine and homeopathy? Why are the NMC and the universities in Nepal undermining the qualification? Why aren’t they following the same model our neighbours are?

BPKIHS is producing few MSc graduates each year in each subject in some basic medical sciences like anatomy, biochemistry, microbiology and physiology since a decade. Many of these graduates have pursued or are undergoing PhD degrees in renowned universities like Nippon Medical School, Gottingen University, Seoul National University, Kyoto University, All India Institute of Medical Sciences, to name but a few. Why don’t the NMC and the universities plan to start PhD courses in Nepal? If done properly, this system would be recognised by the international community as well, and would solve the problem of manpower scarcity in basic medical sciences. Additionally, there will be more chances to obtain research funding and other support from international organisations. Besides, the universities can also create a good environment for research work in basic medical sciences, so that many MBBS graduates will also be interested to enroll in MD courses in these subjects.

In a new Nepal, we should have new ideas and thinking politically and socially. It doesn’t mean doing something bizarre and absurd—we should be rational enough to follow international norms and values when it comes to the basics of medicine and science.

Dhungel is Associate Professor in the Department of Physiology, Chitwan School of Medical Sciences

(Source: The Kathmandu Post)