Lowering the bar will raise the stakes for millions

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A doctor takes care of a newly-birthed baby at the Hanoi Obstetrics Hospital in Hanoi. As authorities in many provinces and cities are rushing to achieve the regulated ratio of seven doctors to 10,000 people, there are concerns that the quality of medical training is being loosened. / PHOTO: REUTERS

I recently met with some veteran doctors who work at major hospitals in Ho Chi Minh City. They told me that Vo Truong Toan, a private university founded in the Mekong Delta province of Hau Giang in 2008, has set the passing grade for admission at 17 marks out of 30.

Since the Ministry of Education and Training gives as much as three extra grades to the university entrance exam's candidates if they are from disadvantaged areas or their parents have national merit, many students qualified for enrolling in the university, even though they only got 14 marks in for the exam.

It sounded like a joke to me, that 14 is the lowest marks that candidates must achieve this year so they can be eligible for admission to medical universities.

Typically, medical universities in Vietnam, considered the top and most prestigious of all universities, have always required the highest passing grades.

For instance, to enroll in the general medicine faculty at the Hanoi Medical University this year, candidates must get 27.5/30 in the entrance examinations. It was reported hundreds of candidates failed to get admission, even though they scored 27, or almost double that of students who qualified for admission to Vo Truong Toan University.

The HCMC University of Medicine and Pharmacy also set passing grades for its general medicine and pharmacology faculties at 27 and 26, respectively.

I soon learned that this was not a joke.

At a meeting on medical training in the Mekong Delta held by the Can Tho University of Medicine and Pharmacy on August 12, Le Hung Dung, vice chairman of the city's People's Committee, confirmed this information.

He said it was "painful" to see many people need to get just 14 in the entrance exam to enter medical universities, and then become doctors and pharmacists after six years of training.

This was not only unfair, but also threatened to produce a generation of doctors and pharmacists of dubious abilities, Dung said.

Pham Van Linh, head of the Can Tho University of Medicine and Pharmacy, told the meeting that since 2011, 13 new medical training institutions, including 11 private ones, have been established in the Mekong Delta, compared to the addition of 12 between 1975 and 2010.

He said the quality of many new schools is questionable, given that none of the people in charge of managing them have expertise in medicine.

What are reasons behind the decreasing quality of students getting into medical universities and low quality of training they receive?

According to official figures, the Mekong Delta is seeing a serious dearth of human resources in the healthcare sector. Except for Can Tho City and Ca Mau Province that meet the Ministry of Health's regulated rate of seven doctors per 10,000 people, the rate is lower than five to 10,000 in other provinces in the region.

Apparently, as authorities rush to achieve the required ratio of doctors, they are getting lax on the quality of medical training provided. They seem to have forgotten what the consequences of this development can be. 

At the meeting, Tran Thi Thai, vice chairwoman of Dong Thap Province, put it very clearly: "If you fix machines wrongly, you can make up for your mistake. But you cannot do the same thing when treating people wrongly, because the mistake will cost lives."

Anyone can tell what it will be like to be treated by a poorly trained doctor, but the Ministry of Education and Training and the Ministry of Health have licensed the new institutions in such a worrying manner.

This scary situation caused by the rush for doctors is not restricted to the Mekong Delta.

In HCMC, the Pham Ngoc Thach University of Medicine planned to recruit 800 students for its medicine faculty this year, an increase of 200 from last year.

As the city's authorities aimed to achieve the rate of 15 doctors per 10,000 people in 2015, it is very likely that the school will raise its quota to 1,000-1,200 students in the upcoming years.

A former lecturer with the university once told me the school's infrastructure was originally designed for training 150 doctors per course, but the number of students now has reached 800 and will very likely increase further.

With the current manner of training doctors, it will be difficult to find a doctor qualified to treat people and capable of saving people in the future, the lecturer said.

In order to meet the society's demand for doctors, authorities have chosen a simple solution to increase the quantity of medical students, instead of applying more qualitative, strategic and sustainable measures.

Who will pay for this decision?

Surely, it will not be the current authorities who made this choice, because their office term will end before doctors of dubious quality graduate.

It will not be their relatives, either, because when they have health problems, they will very likely turn to central hospitals or international clinics, where well-qualified personnel are likely to diagnose and treat ailments. 

In the end, it is no one but the common man, especially the poor, who will pay dearly for this decision by the authorities when they seek treatment at places their meager incomes can afford.

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