442
Uncontrolled Business: The Case of Blacklisting Kyrgyzstani Medical HEIs by Pakistani Medical Council (PMC)
Ainazik Omurzakova1*, Ermek Doszhanov2, Taalaibek K. Ismanov1, Gulzat T. Kulalieva1
1International University of Kyrgyzstan, Bishkek, Kyrgyz Republic
2American University in Central Asia, Bishkek, Kyrgyz Republic
ABSTRACT
Medical education for export in Kyrgyzstan has many challenges in the way of achieving international standards. Existing archaic state regulative norms have huge discrepancy with modern global standards in the field. In addition, the uncontrolled growth of number of HEIs newly entered the market aggravates the situation. Along with this, countries which students usually choose Kyrgyzstan as a direction for medical training, have weak policies and establish low barriers for recognition of qualifications from the places their students choose to study in. A recent case of blacklisting Kyrgyzstani medical HEIs by Pakistani Medical Council (PMC) can be analyzed as a typical example of the shortcomings listed above. It has disclosed different problems and aspects of the phenomena of medical education for export in Kyrgyzstan: compliance of Kyrgyzstani medical education with international standards, shortage of standardized control from Kyrgyzstani and Pakistani authorities, the role of agents is not anyhow standardized or licensed.
Keywords
Medical education in Kyrgyzstan; Kyrgyz Republic; Law; education for export; Pakistani medical students; PMC
Introduction Aims.
Since the time of receiving independence the Kyrgyz Republic declaratively pays attention to development of its system of education. Emerging market relations have changed the face of the country and the psychology of its citizens, who are starting to think by new socio-economic categories. Kyrgyzstani HEIs should adapt themselves to new conditions in terms of globalization of education, with all its challenges and imperatives.
During the past decades development of the system of education led to such negative phenomena, as organization of HEIs, which were not matching modern standards of higher education[1].
Public healthcare is one of the factors of sustainable development of the country. For that purpose, there should be introduced an effective system of healthcare, medical education [2].
Unfortunately, there are some negative trends in the system of higher medical education.
Currently there are 20 medical HEIs and faculties in Kyrgyzstan. Also there is a program of revocation of license started to increase the quality of education. Particularly, the license of the medical faculty of the University of Science and Business is revoked; the license of the medical faculty of KNU is suspended.
Many youngsters from Pakistan and India choose to study medicine, due to the status of a medical worker in these countries [3]. Another reason of high demand in receiving medical
443
education among Pakistani students is the lack of qualified medical workers and increase of career opportunities due to different factors, including brain drain to developed western countries [4].
Due to the high demand, expensiveness of contracts, and other limitations, medical education in Pakistan is non-achievable to many Pakistani citizens, and it makes them look for other opportunities outside the country to pursue the path of physicians. Relatively rich families try to send their children to Eastern Europe and Russia, and lower-class families choose between such exotic countries, as Kyrgyzstan and Tajikistan. According to Dietrich Reetz [5], the price of study at Kyrgyzstani medical HEIs is on average five times cheaper in comparison to study in Pakistan.
Main Analysis
The Pakistan Medical Commission (PMC) has included all Kyrgyzstani medical HEIs into the black list of universities, meaning all Kyrgyzstani HEI graduates were not allowed to pass the Pakistani National Licensing Exam (NLE), or prolong the license. The problem is salient: easy path to enter the market caused to a sharp increase of HEIs specializing in medical training for Pakistani students. There is no standardized control in both Pakistani and Kyrgyzstani sides. It has led to the situation when thousands of graduates and students have big concern about suspension of their majors [6].
The main reasons to include all Kyrgyzstani medical HEIs to the black list, according to the Minutes, are:
1. The statement, that many students from Pakistan are being lured into the colleges by agents. Agents provide guaranteed entry to the colleges without any prerequisite criteria;
2. Dozens private medical colleges have been opened since 2013 in the territory of Kyrgyzstan Mainly these HEIs are focused on provision of medical education for export, with one of biggest markets in Pakistan. Most of these newly opened HEIs do not have enough or any clinical bases and qualified teaching staff.
As an intermediary decision, upon the request of the Ambassador of the Kyrgyz Republic in Pakistan, PMC removed 4 (four) “Public” medical HEIs from the black list, and placed those to the Green one. Along with this, PMC set up other rules and criteria for further recognition procedures.
According to the Embassy of Pakistan in Kyrgyz Republic, there are 8495 students admitted in Kyrgyz medical HEIs in 2019[6]. However, this number does not correspond to the data received from the Ministry of Education and science of Kyrgyz Republic (MESKR) (see Table 1).
Table 1.Number of local and foreign medical students according to data provided by MESKR, including number of Pakistani students and graduates (as for the year 2020)
No. Name of HEI
Total
Number of students
Number of foreign students
Students from Pakistan
Graduation of Pakistani students
1 KSMA 7271 2154 234 Yes 2016-2017 (31)
2 OshSU 2897 2882 16 Yes 2016-2017 (75)
3 JASU 2154 1513 234 Yes 2015-2016 (5)
4 AsMI 3914 3914 1212 Yes 2015-2016 (49)
5 IHSM 3493 3493 147 Yes 2015-2016 (242)
6 Ala-Too 265 202 105 No (2017)
444
7 SRMSI 98 98 93 No (2018)
8 IMU 2099 1911 1747 Yes 2019-2020 (10)
9 EIMU 508 508 492 No (2019)
10 ADAM 1015 656 629 No (2018)
11 Salymbekov 410 410 410 No (2019)
12 Avicenna 98 98 98 No (2017)
13 RMU 125 125 A No (2020)
14 KNU 17270 N 39 No (2020)
15 KRSU 2092 883 1 No
16 IUK N N N
17 ABC A 60 No (2020)
18 IUSB N N N
19 OshIMU 200 200 A No (2020)
20 TOTAL 19047 (19107)
8495=44.5%
from 19107, 5842=30.6%
from 19107
5517 (5842) 68.7% from 8495
412
N – No data, A – data of columns 4 and 5 is combined and calculated to derive TOTAL. In TOTAL raw – the data without calculation of A, and with calculation of A in parentheses with percentage to PMC number of admitted students. In the column 6: if Yes – first year of graduation (since 2015) and number of graduated Pakistani students in parentheses; if No- year of first admission in parentheses. There is no clear data from the IUK since the standardized MESKR questionnaire is filled in by them incorrectly. IUSB is the absolutely new HEI as for 2020. They have not conducted admission yet.
There are no mandatory standards of state/international accreditation of medical HEIs in Kyrgyzstan. Accreditation-passing has a status of recommendation. However, many medical HEIs have started accreditation-process during last 3 (three) years. Kyrgyzstani medical HEIs pass through state accreditation (5 HEIs), IAAR accreditation (4 HEIs), AAEPO (3 HEIs), EdNet (2 HEIs), and state accreditation by a state authority of another country (1 HEI). Some HEIs do not provide names of bodies and entities by which they were accredited.
Main regulating acts to perform medical training are:
1. The Law of Kyrgyz Republic “On Education” [7];
2. State license from the Ministry of Education and Science of Kyrgyz Republic [8].
Important: in the report provided to the MESKR many HEIs state that their Charters are approved by different ministries (MESKR, Ministry of Healthcare). However, only the Ministry of Justice of KR approves Charters of HEIs, in compliance with non-medical juridical standards.
Table 2.Information about number of medical training programs, accreditation, and clinical bases according to data provided by MESKR (as for the year 2020)
No. Name of HEI Number of MBBS (5-year study in English) or equivalent (5- 6-year local
Accreditation Number
of clinical bases
445
program)
1 KSMA 8 Every 5 years (state accreditation)
2019 – independent accreditation
195
2 OshSU 2 2018 – independent accreditation
(IAAR)
2020 – independent accreditation EdNet 2020 – state accreditation
22
3 JASU 3 Every 5 years (state accreditation)
2020 – independent accreditation (IAAR)
27
4 Tentishev AsMI
3 Every 5 years (state accreditation) 2017 – independent accreditation
14
5 IHSM 1 AAEPO,
IAAR
16
6 Ala-Too 1 IAAR 9
7 SRMSI 2 AAEPO 8
8 IMU 6 Independent accreditation – 2 times 47
9 EIMU 1 19
10 ADAM 2 10
11 Salymbekov 2 11
12 Avicenna 1 5
13 RMU 1 5
14 KNU 1 AAEPO 4
15 KRSU 4 2017 – Independent accreditation
(EdNet)
2019 – state accreditation (Russia) 2020 – state accreditation (Kyrgyzstan)
43
16 IUK
17 ABC 1 3
18 IUSB
19 OshIMU 1 4
„National‟ and „State‟ types of universities can be presented as equivalent of „Public‟ ones in western countries. Many universities have relatively big history, and provide 6-year MD and other local medical programs. However, local 6-year system is based on standards of Soviet medical education traditions, based on 11-year secondary education[9].
Kyrgyzstani post-soviet medical education program has many differences in comparison to standards and programs in the Commonwealth countries and the USA. Many foreign students prefer to take a 5-year MD program in English, on the basis of 12-year secondary education, which is similar to MBBS [10].
According the PMC Minutes [6], there was a significant growth in number of HEIs with medical education for export between 2013 and 2018. If we analyze the MESKR data, the growth will not stop: several universities have opened admission between 2018 and 2020 (Table 1, Graduation).
Next 4 (four) years number of Pakistani graduates from Kyrgyz HEIs will increase from 412 in 2020 to 5929 (5517+412), or 6154 (5842+412) (Table 1, TOTAL). Along with this we have to
446
take into account divergent number of 8495 students admitted in 2019, as by the Embassy of Pakistan in Kyrgyzstan and PMC [6]. Of course, not all students will finish study and graduate.
However, the real number of graduated students will be close to the roughly estimated one.
Discussion
An essential note to be added about the case described above is the lack of statistical data and academic research about the phenomena of medical education for export in Kyrgyzstan and other countries of CIS[11].
Due to the failure to find comprehensive reliable information about real situation it becomes impossible to analyze social, economic, political, and other causes and effects deeply. We encourage researchers to do their research works in the field of this phenomenon [12].
Conclusion Main key-factors caused the situation are presented below.
First is the uncontrolled role of agents, which is mentioned in PMC Minutes. It lies beyond this article, and has to be explored.
Second is PMC failure in paying attention to the problem. More than seven years of unrevealed and uninvestigated business cannot be reimbursed by simple blacklisting (embargo) medical HEIs of a whole country.
Third is the lack of state control of Kyrgyzstani government over medical HEIs, providing education on the basis of the MD program. As it‟s mentioned in the profiles of medical HEIs, they work under several normative documents: Kyrgyz Law “On Education” [7], the Regulation No 525 of the Government of the Kyrgyz Republic[13], and Charter. The Government does not set up reliable barriers to enter the market. Only 3 (three) universities were graduating Pakistani students in 2015 in Kyrgyzstan (Table 1, Graduation). Over the past 5 (five) years number of medical HEIs graduating Pakistani students has increased more than 6 (six) times. It leads to low quality of graduated specialists, corruption, and other deception cases.
The case of deception of Pakistani students by options of receiving medical education in Kyrgyzstan has many roots. Misconduct of governments and people of both countries underlie the situation.
Abbreviations KSMA – Kyrgyz State Medical Academy
OshSU – Osh State University JASU – Jalal-Abad State University
AsMI – Asian Medical Institute named after Tentishev IHSM – International Higher School of Medicine Ala-Too – Ataturk Ala-Too University
SRMSI – Scientific and Research Medico-Social Institute IMU – International Medical University
EIMU – Eurasian International Medical University ADAM – ADAM University
Salymbekov – Salymbekov University
Avicenna – Avicenna International Medical University
447
RMU – Royal Metropolitan University KNU – Kyrgyz National University
KRSU – Kyrgyz-Russian Slavic University IUK – International University of Kyrgyzstan ABC – ABC Academy
IUSB – International University of Science and Business OshIMU – Osh International Medical University
PMC – Pakistan Medical Council
MESKR – Ministry of Education and Science of Kyrgyz Republic HEI – Higher Education Institution
References
[1] Omurzakova, A. M. (2020). Problems in reformation of medical HEIs in Kyrgyzstan.
International Journal of Innovative Technologies in Social Science, 6(27).https://doi.org/10.31435/rsglobal_ijitss/30092020/7180
[2] Karle, H., Fenoll-Brunet, M. R., Mirecka, J., Christensen, L., Green, R., Sayek, I., et al.
(2007). WFME Global Standards For Quality Improvement in Medical Education:
European Specifications. MEDINE The Thematic Network on Medical Education in Europe. Copenhagen.
[3] Younas, A. (2020). A case of South Asian Students Migrants in Kyrgyz Medical Institutes:
Motivations, Policies, Issues and Challenges. https://dx.doi.org/10.2139/ssrn.3614459 [4] Tahir, M. W., Kauser, R., Tahir, M. A. (2011). Brain Drain of Doctors; Causes and
Consequences in Pakistan. International Scholarly and Scientific Research & Innovation, 5(3), 406-407. https://doi.org/10.5281/zenodo.1328498
[5] Reetz, D. (2017). Mediating Mobile Traditions: The Tablighi Jama„at and the International Islamic University between Pakistan and Central Asia (Kyrgyzstan, Tajikistan). Leibniz-Zentrum Moderner Orient, Berlin, Transcultural Studies.
[6] Pakistan Medical Commission. (2020). PMC Minutes of the 3rd council meeting, 10th November, 2020, Islamabad.
[7] Law of the Kyrgyz Republic (2003, April 30). The Law of the Kyrgyz Republic “On Education” No 92.
[8] Resolution of the Government of the Kyrgyz Republic No. 334. (2018, July 23).
Temporary position on the procedure for licensing educational activities in the Kyrgyz Republic.
[9] Ministry of Education and Science of the Kyrgyz Republic. (2012). The Concept of education-development in the Kyrgyz Republic till 2020. Retrieved fromhttp://cbd.minjust.gov.kg/act/view/ru-ru/92984
[10] Independent Agency for Accreditation and Rating IAAR. (2019). Report on the results of the assessment of educational institution "International Higher School of Medicine” for compliance with institutional accreditation standards MES and the Ministry of Health of the Kyrgyz Republic by an external expert commission. Bishkek.
[11] Jenish, N. (2012). Export of Higher Education Services in Kyrgyzstan. Working Paper No.7. University of Central Asia-Institute of Public Policy and Administration.
[12] Seitova, A., Belov, G., Muratov, Zh., Murzalieva, A., Abdullaeva, Zh., Zhanbaeva, A., et al. (2021). Physiological, Anatomical, Psychological and Cultural-Ethnic Aspects of
448
Indian Students Adaptation during Study in Kyrgyzstan Medical Universities. Open Journal of Medical Psychology, 10(1), 1-10. https://doi.org/10.4236/ojmp.2021.101001 [13] Government of the Kyrgyz Republic. (2016, October 4). Regulation No 525 on making
amendments to the Regulation of the Government of the Kyrgyz Republic “On approval of acts on independent accreditation in the system of education of the Kyrgyz Republic”.
