Med Student Protests May Mean No New Doctors in Morocco This Year

Dana Najjar

June 26, 2019

Students of public medical schools in Morocco have been on strike for nearly 3 months, protesting against the government's decision to grant private medical school graduates access to public hospitals for training.

Students began taking to the streets and staging sit-ins in March of this year, citing the privatization of medical education, lack of training equipment, and inadequate training facilities as their main grievances.

Although covered in regional media, the issue has received almost no coverage in Western outlets. A fourth-year medical student contacted Medscape Medical News via Instagram, and asked to remain anonymous because of safety concerns.

"We never imagined the protests would last this long," the fourth-year medical student said. "We expected a response from the government but got none."

https://twitter.com/MoroccanMed/status/1139640242028331008

Tensions between the Ministry of Education and students of public medical, dental, and pharmacy schools have been rising for years, according to several students, and allowing private school students to share already overburdened public facilities was seen by many as the final straw. The government's decision to add a sixth year to the dental training program is also a major point of contention.

A meeting between student representatives and the government was held in May but did not result in an agreement. Since then, students across all three disciplines have refused to attend classes and boycotted all exams, including final exams. Reportedly, nearly 100% of the 18,000 students across all three faculties (medical, dental, and pharmacy) participated in the boycott.

There are seven public medical schools across the kingdom, and admission to them is highly competitive. What's more, students must compete for limited residency spots at the public hospitals after their general training is complete. Added competition from private school students vying for the same spots is generally viewed as unfair, and as an additional strain on an already broken system.

Resources are so limited that public school students sometimes have to themselves pay for the costs of procedures they have to perform to graduate, according to a dentistry student who also requested anonymity.

https://twitter.com/MoroccanMed/status/1139659332604350464

Private medical, dental, and pharmacy schools are a relatively new phenomenon in Morocco, and acceptance to them is less competitive than their public counterparts: "You just need money to start your career as a [private] medical student," Aladin Lijassi, PharmD, who trained in Morocco, told Medscape Medical News. "The government does not have the resources to build private hospitals or clinics, so they allow private medical students to use public resources," he added.

The government's response to the protests has reportedly been to crack down on students and their parents: Students have described menacing phone calls in the middle of the night and threats of expulsion from their dorms. Several parents of protesters had their pharmacies shut down.

Doctors are not immune either: three medical professors were fired for voicing solidarity with the boycott, leading to the hashtag #DoctorsUnderOppression, which is trending on Moroccan Twitter.

According to one source, the Minister of the Interior gave the students an ultimatum yesterday: Allow student representatives to approve and sign an agreement without conducting a general vote, or else he will change discussion tactics, which implies a threat.

Efforts to reach a government representative for comment were unsuccessful.

An image that has come to represent the unity and outrage of the 18,000 public school students. Translation: Don't touch my brother, don't touch my sister, don't touch my professor

This turmoil is unfolding against the backdrop of a healthcare and health education system that has been under strain for years. Morocco has 6.2 physicians for every 10,0000 people, which is well below the World Health Organization's minimum recommended threshold of 22.8 physicians per 10,000 people just to meet basic needs.

What's more, public physicians have long decried the "catastrophic conditions in the health sector," and frequent resignations have become a matter of course.

Last October, the Union of Public Sector Doctors issued a statement declaring a "week of anger" and encouraged strikes and collective resignations.

In April, 305 professors resigned in protest of "the absence of [proper] work conditions in public hospitals."

The government has scheduled remedial final exams for July, but the students are firm in their resolve not to sit for them. "It's sad to see a strike of future doctors lasting 3 months and being taken so lightly," said the fourth-year medical student. "We're tired and mentally drained, but we won't give in."

Ultimately, Morocco needs more doctors and more teaching hospitals if it's going to meet international healthcare standards or even the targets set by its own government for 2025. But it's still unclear how any of it will be accomplished.

"I hope things get resolved," said Lijassi. "We are worried about the next generation."

Liz Neporent contributed to this report.

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