16 govt medical colleges struggle with severe shortages, yet more to come

Habiganj 250-bed District Sadar Hospital is located almost at the centre of the city. Habiganj Medical College is housed within this hospital. The government-run college was established in 2016. Even after 10 years, arrangements have not been made for land of its own. The medical college operates from the second, third and eighth floors of the hospital’s eight-storey building.

Habiganj Medical College began its academic activities in 2018 without its own land, buildings or campus. Teaching takes place in five classrooms occupying 3,000 square feet. The college does not have the necessary teachers, practical classrooms or laboratories. Nor does it have accommodation or a hostel for students.

Students at the medical college are disgruntled. One such student, speaking to Prothom Alo on condition of anonymity said, “Every medical college has its own hospital. Our college does not. We have to depend on the Sadar Hospital. But because the hospital has no registrars, there is no one to supervise our work.”

It may be noted that registrars provide students with hands-on training in the hospital wards.

This situation is not limited to just one government medical college. There are 110 medical colleges in the country, of which 37 are government-run. Prothom Alo visited 16 government medical colleges facing shortages or crises involving their own land, infrastructure and teachers, and gathered information on their conditions.

These colleges are relatively new, having been established between 2008 and 2020. Prothom Alo reporters visited the medical colleges between August and September.

The colleges include Pabna, Gopalganj, Jashore, Kushtia, Satkhira, Kishoreganj, Tangail, Jamalpur, Patuakhali, Habiganj, Nilphamari, Netrakona, Naogaon, Magura, Chandpur and Sunamganj medical colleges.

Prothom Alo’s analysis found that the colleges are operating with substantial shortages. Five of the colleges do not have their own land and therefore have no buildings of their own either. All the colleges have teacher shortages with Magura Medical College having 62 per cent of its teaching posts vacant. As accommodation has not been arranged, 67 female students of Patuakhali Medical College are living in an unused building.

Prothom Alo’s investigation found that these medical colleges were established at the behest of individuals. Sheikh Hasina, the former prime minister who was ousted from power in the July mass uprising, had said that a medical college would be established in every district.

The establishment of medical colleges did not stop after her ouster. The interim government led by Professor Muhammad Yunus also approved medical colleges without resolving all the various existing problems. The Bangladesh Nationalist Party (BNP) government is following the same path.

Private medical colleges have to be established in accordance with laws and regulations. They are required to have their own land, their own buildings and their own hospitals. But there are no laws or regulations governing the establishment of government medical colleges.

Medical colleges are being established one after another at the initiative of influential individuals and with the support of the Ministry of Health. Medical colleges are not being established based on assessments of whether there is an actual need for them.

According to sources at the Directorate General of Medical Education (DGME), Netrokona Medical College was established in 2018 at the initiative of Sazzadul Hasan, then secretary at the Prime Minister’s Office, and with the support of the Ministry of Health. Yet the government-run college does not have any land of its own.

The college received administrative and academic approval without decisions being made on where its hospital would be located in Netrokona or how land would be acquired. Eight years after its establishment, the college still has no building of its own, no hospital and no campus. Yet many students have graduated from the college with MBBS degrees and are now practising as physicians.

The medical college is using four buildings built to accommodate physicians on the northern side of Netrokona 250-bed Sadar Hospital as its academic buildings. In reality, the medical college is operating in someone else’s premises. Students are dissatisfied with the situation. They have even held human chains demanding a permanent campus.

Apart from Habiganj and Netrokona, three other medical colleges have no land at all. They are Naogaon, Magura and Nilphamari medical colleges. Classes at these colleges are held at the respective district sadar hospitals. The process of purchasing land for Chandpur Medical College is under way. The college is operating from several rooms at the district Sadar Hospital.

The remaining 10 colleges have land and their own college buildings. These are Pabna, Gopalganj, Jashore, Kushtia, Satkhira, Kishoreganj, Tangail, Jamalpur, Patuakhali and Sunamganj medical colleges. However, Pabna, Jashore and Jamalpur medical colleges still do not have their own hospitals.

On 31 August, several students of Pabna Medical College told Prothom Alo that although the college was established in 2008, it still does not have its own hospital. The district Sadar Hospital is about eight kilometres from the college. Students have to travel there by bus every day. The road is full of potholes. There is only one bus for 240 students. Travelling to and from the hospital is a painful experience.

Classroom-based teaching and learning, as well as hands-on learning and training, are equally important at medical colleges. Both require an adequate number of teachers. Medical students have to sit for various examinations, both major and minor, on a regular basis. This also requires close supervision by teachers.

When there are too few teachers, students fall short in both their understanding and hands-on learning. Proper supervision also becomes impossible.

It was found that all 16 medical colleges are facing teacher shortages. The situation is most acute at Magura Medical College. The college has 84 teaching posts, but only 32 teachers are working there. Fifty-two teaching posts are vacant. In other words, the college is providing education with 62 per cent of its teaching posts unfilled.

The Directorate General of Medical Education and the Ministry of Health are not overseeing who is teaching in the classrooms, how courses are being completed, who is providing hands-on training or who is conducting examinations.

At Sunamganj Medical College, there are 94 teaching posts, of which only 52 are filled. Forty-five per cent of the posts are vacant. Satkhira Medical College has 103 teaching posts, with 39 per cent vacant. There is no scope to say that the situation is satisfactory at the remaining 13 medical colleges either.

Two female students of Pabna Medical College told Prothom Alo that before enrolling, they had no idea that government medical colleges faced so many problems. There are not even enough teachers to conduct classes. They said their ‘item’ and ‘card’ examinations are completed in a perfunctory manner.

An examination conducted after teaching a small topic, such as a finger or the palm of the hand, is known as an ‘item’ examination. After students are taught many such small topics and after siting for a number of item examinations, they take a ‘card’ examination covering the subject as a whole, such as the entire hand. In medical education, item and card examinations continue throughout the year.

A researcher working at an international research institution, speaking to Prothom Alo on condition of anonymity, said that in reality, item and card examinations are not being conducted properly. “The state has not ensured that students go through this process. This is negligence on the part of the state,” the researcher said.

Eight subjects are considered basic in medical education: anatomy, biochemistry, community medicine, forensic medicine, microbiology, pathology, pharmacology and physiology. These 16 medical colleges are facing a severe shortage of teachers in all eight subjects.

According to information obtained from the DGME, there are 272 posts for professors, associate professors and assistant professors in these 16 medical colleges. Only 100 are currently filled. In other words, 172 posts, or 63 per cent, are vacant in the basic subjects.

The situation is worst at Naogaon Medical College Hospital. There are 14 posts for professors, associate professors and assistant professors in the basic subjects at the college, and all of them are vacant.

The situation is the next worst at Magura Medical College, where 13 of the 14 posts are vacant. At Sunamganj Medical College, 12 of 14 posts are vacant, while at Habiganj Medical College, 11 of 14 posts are vacant. Pabna Medical College, established in 2008 is still facing a shortage of teachers in the basic subjects, with 50 per cent of the posts for teachers in these subjects vacant.

Professor Md Ruhul Quddus, principal of Pabna Medical College, told Prothom Alo that although the college is 18 years old, it still has a shortage of teachers in the eight basic subjects. There has been only one teacher in biochemistry since 2016, and he is the teacher himself. There are no teachers in gynaecology at all.

In medical colleges where there is not even a single teacher in any of the eight subjects, or where seven of the subjects have no teacher at all, who teaches the students? How are tutorials and examinations conducted in these subjects?

In response to these questions, DGME Director General Professor Nazmul Hossain told Prothom Alo that this was a serious problem, but efforts were being made to overcome it.

Some measures have been taken, such as appointing retired teachers on a contractual basis, increasing incentives to 100 per cent of their salaries, and providing a monthly stipend of Tk 20,000 to students who want to study the basic subjects, he said.

In addition, actively considering having the same teacher teach at multiple medical colleges and conducting classes online in these subjects is also under consideration, added the DGME director general.

After the Awami League government was ousted amid the mass uprising on 5 August 2024, an interim government led by Professor Muhammad Yunus took charge. Reforming various sectors, or taking initiatives to reform them, was the main task of that government. However, like many other sectors, the interim government could not carry out any reforms in medical education either.

The interim government did not arrange land for medical colleges that had no land of their own and were operating on others’ premises. It did not take initiatives to appoint teachers to colleges facing severe teacher shortages; instead, it was in the process of approving new government medical colleges.

During the interim government’s tenure, a government medical college was approved in Munshiganj, the district of Home Affairs and Agriculture Adviser Jahangir Alam Chowdhury. Documents show that Public Works Adviser Adilur Rahman Khan had recommended the establishment of this medical college. However, the initiative to establish the college has now come to a complete halt.

During the interim government’s tenure, approval was also given for the Bangladesh Navy to establish a medical college. The college is located in the hospital gate area on the airport road in Chattogram.

Besides, initial work began on establishing a medical college in Narsingdi. Officials from the Ministry of Health and the Directorate General of Health Services had visited the area and gave opinion in favour of establishing the medical college.

Although work to establish Narsingdi Medical College began during the interim government’s tenure, the college received administrative approval from the ministry after the BNP government took office. However, land for the college has yet to be finalised. For now, work of Narsingdi Medical College is expected to begin at the 100-bed Narsingdi District Hospital, according to ministry sources.

Generally, a hospital with at least 250 beds is required to establish a medical college. However, Narsingdi has no such hospital. Even the existing 100-bed hospital does not have adequate staff. Work is underway to upgrade the hospital to 250 beds.

Soon after the BNP government was formed, Thakurgaon Medical College was approved. The development project proposal (DPP) for the college is nearing finalisation. The college will be located beside the Thakurgaon-Dinajpur highway, about five kilometres from Thakurgaon town. There is an initiative to enrol students at Thakurgaon and Narsingdi medical colleges in the 2026–27 academic year.

Regardless of whether land, a hospital or teachers are available, the BNP government wants to establish more government medical colleges. According to Health Ministry sources, the process of establishing two medical colleges in Bhola and Joypurhat has begun. Ministry officials have already visited the two districts.

DGME Director General Professor Nazmul Hossain told Prothom Alo, “We have received applications from a total of 12 districts.”

Referring to the formation of a seven-member committee headed by the state minister of health to assess proposals for establishing new medical colleges, he said, “With the support of the World Health Organization, work is underway to assess the demand or need for workforce in 25 areas of medical education up to 2041.”

“The report will be available by October. Based on the report, the seven-member committee will then decide on the medical colleges. However, after Thakurgaon and Narsingdi, the government is not approving any new government medical colleges for the time being,” he added.

The country’s first medical college, Dhaka Medical College, was established in 1946. Before independence, there were seven medical colleges, all of them government-run. Since independence, another 103 government and private medical colleges have been established.

Of the 110 medical colleges, 37 are government-run and seven are under the armed forces—one Armed Forces Medical College, five Army Medical Colleges and one Navy Medical College. There are also 66 private medical colleges.

Most of these 110 medical colleges face infrastructure crisis, a lack of the required number of teachers and shortages of educational materials. Experts believe that many medical colleges should not even have remained operational if there were no compromise with irregularities and corruption.

Abu Jamil Faisel graduated with an MBBS degree from Mymensingh Medical College in 1976. After graduating, he joined government service. He later left government service to work in the private sector and was involved in research for a long time. This public health expert told Prothom Alo that most medical colleges were established for political reasons.

Even after many years since their establishment, many have failed to become full-fledged medical colleges. These colleges cannot provide medical education while maintaining proper standards, nor can they produce quality physicians. It is true that there is deep public discontent over the standard of healthcare in the country. These colleges are behind this discontent, he said.

[The report was prepared with information provided by staff correspondents in Kushtia, Tangail, Habiganj and Sunamganj; the Jashore office; and correspondents in Satkhira, Gopalganj, Kishoreganj, Patuakhali, Jamalpur, Chandpur, Netrakona, Magura, Nilphamari, Pabna and Naogaon.]