Bangladesh is grappling with a doctor-population ratio below World Health Organization (WHO) standards, prompting the establishment of new medical colleges nationwide. While increasing the number of physicians is crucial, it is essential to assess whether this approach aligns with the country’s socioeconomic context and institutional capabilities. Simply focusing on numbers without ensuring adequate infrastructure and system capacity may lead to unintended consequences.
Currently, both government and private medical colleges in Bangladesh offer approximately 11,000 MBBS seats, resulting in around 10,000 new medical graduates annually. The key question is whether the health system can accommodate this growing influx of doctors.
Government doctors are typically recruited through the Bangladesh Civil Service (BCS) process, which can take up to 2.5-3 years for a regular cycle and around 1.5 years for a special cycle. With about 5,000 doctors recruited over three years, nearly 30,000 new doctors would have received registration during the same period, leaving around 25,000 outside the government healthcare system.
Private healthcare facilities in Bangladesh mainly offer routine surgical services and rely heavily on specialist physicians from the public sector. This reliance limits employment opportunities for newly graduated MBBS doctors, leading to a significant decrease in physicians’ remuneration.
The imbalance between the supply of doctors and the demand for healthcare services has driven down physicians’ pay rates, with many young doctors working long shifts for minimal compensation at private hospitals. The undervaluation of these skilled professionals highlights a concerning neglect of talent by both the state and society.
The establishment of numerous medical colleges across the country has been influenced by political interests and local lobbying. While leaders believe that new medical colleges will enhance healthcare services, these institutions primarily focus on education rather than providing direct healthcare. To address this mismatch, upgrading district hospitals with proper resources and staffing could be a more practical solution to improve healthcare access for local communities.
The government must implement stringent policies to address the challenges in medical education. Admissions should be halted for medical colleges lacking essential infrastructure and faculty. Students from institutions with deficiencies should be transferred to better-equipped colleges to ensure the quality of their education and future professional competence.
Medical colleges should not admit students until they meet all necessary requirements, including proper infrastructure, qualified faculty, and modern facilities. Medical education demands high standards from the outset to produce competent physicians who can safeguard human lives. Without halting the expansion of inadequately planned medical colleges, Bangladesh’s healthcare system may face long-term decline.
Dr. Syed Abdul Hamid, a professor at Dhaka University’s Institute of Health Economics, emphasizes the need for sustainable, high-quality policies in medical education to prioritize excellence over mere expansion.