Quota crisis in medical schools without hospitals

Did the Council of Higher Education (YÖK) grant foundation universities an additional 3-year extension? 

Some medical schools are facing difficult times due to the requirement that they must have their own hospitals, a condition imposed on the rapidly increasing number of foundation university medical faculties in recent years. Rumors that have been circulating for a few weeks, suggesting that“medical schools at foundation universities without their own hospitals will not be allowed to admit students this year” have caused panic in many faculties. It was even suggested that medical schools unable to admit students for the 2024-2025 academic year could be closed down a year later. 

As the 2023-2024 academic year began, there was great anticipation regarding the decision YÖK would make in line with existing legal regulations, given that 27 foundation university medical schools lacked their own hospitals. The chaotic process, which has been discussed for years but could not be resolved despite the law, appears to have been postponed as of yesterday, with YÖK granting these medical schools an additional 3-year extension. 

According to information provided by an academic from a foundation university medical school, there is also talk of a new regulation regarding the impasse experienced in recent weeks; they state, “We don't know how accurate it is, but it is said that there is a clause in the omnibus bill regarding the repeal of the relevant provision and that its passage is being awaited. It is said that instead of the requirement for every faculty to have its own hospital, affiliations made with hospitals will also be accepted.”

UNCERTAINTY PERSISTS WITH ONLY DAYS LEFT UNTIL THE PREFERENCE PERIOD

The deadline previously granted by YÖK to medical schools without hospitals expired on October 20, 2023, and this year's debates flared up as that deadline was reached.

The uncertainty experienced in the medical schools of foundation universities in recent months has caused tensions to rise even further. With only days left until the university entrance exam results are announced, the persistence of this uncertainty has triggered panic among faculty members and students.   

As is known, universities hold promotional days every year following the announcement of exam results in the second week of July so that students can evaluate their choices accurately. Some academics state that instead of preparing for these promotional days, they have been waiting for an announcement from the Council of Higher Education (YÖK) for the past month, asking, "Will we be able to accept students this year?" 

One of the officials I received information from stated that YÖK's decision for a 3-year postponement reached the universities yesterday, but that there has been no announcement yet regarding student quotas. 

THERE ARE 10 FOUNDATION MEDICAL SCHOOLS WITH 200-BED HOSPITALS 

As of the 2023-2024 academic year, there are 128 medical schools in our country. 91 of these are affiliated with state universities and 37 with foundation universities. 76 of these medical schools are currently graduating students. While there are 30 medical schools in Istanbul, 13 in Ankara, and 8 in Izmir—the three provinces with the highest number of medical schools—medical education is provided in a total of 60 provinces across the country.  

The criteria for establishing a medical school at foundation universities are regulated according to Law No. 2547, additional article 3, and temporary article 82 of the same law, which were accepted by the Grand National Assembly of Turkey (TBMM) on October 16, 2020. Accordingly, the sixth article of a new regulation made in the "Public Financial Management and Control Law" stipulates:"Foundation university medical schools must have a hospital with a minimum capacity of 200 beds that meets YÖK's criteria for the provision of education and training services." The seventh article of the same Law contains the provision that "foundation university medical schools that cannot fulfill these obligations within 2 years from the date this Law enters into force will be closed, and no student quotas will be granted to them by YÖK."

As stated in the report prepared by the Turkish Medical Association (TTB) Education Branch, while medical schools are required to meet the criteria set by the Council of Higher Education (YÖK) and possess a hospital with a capacity of at least 200 beds, only 10 foundation university medical schools have such a facility. Others are attempting to resolve the issue by entering into agreements with various private hospitals. The TTB report states, “In this situation, in accordance with the relevant article of the YÖK, foundation medical schools that do not have their own hospitals must be closed.” it is noted.

WILL FACULTIES THAT ONLY HAVE A SIGNBOARD ALSO ADMIT STUDENTS? 

Four of the newly opened foundation university medical schools exist only in name, meaning they have a signboard but no students. It is stated that these faculties, three of which are in Istanbul and one in Kayseri and which were expected to be closed, may be able to admit students for the first time in the upcoming academic year following the new regulation by YÖK. These universities are: Hasan Kalyoncu University Faculty of Medicine, İstanbul Bilgi University Faculty of Medicine, İstanbul Sabahattin Zaim University Faculty of Medicine, and Kayseri Nuh Naci Yazgan University Faculty of Medicine.

The TTB report also points out that when foundation university medical schools are evaluated in terms of accreditation, only 12 out of 37 are accredited; in short, two out of every three medical schools in Turkey are not accredited. It is emphasized that many of the newly opened state or foundation medical schools do not meet these criteria and therefore have not been accredited. 

THE SITUATION IS THE SAME IN BOTH STATE AND PRIVATE SECTORS 

Thirty-two state medical schools do not have their own hospitals. These medical schools have joint-use cooperation protocols with Ministry of Health hospitals. One medical school has a joint-use cooperation protocol with a Ministry of Health hospital in addition to its own hospital. As for the 10 foundation medical schools that use private hospitals due to cooperation protocols, these schools send their students to state hospitals for practical training. 

CHP Bursa Deputy Prof. Dr. Kayıhan Pala, whom I consulted on the matter, stated, "Normally, a medical school is expected to have a hospital. A place without a hospital and without the opportunity for clinical practice should not be called a medical school. It was stated that YÖK would take definitive action regarding this issue, which was brought up at a meeting about three weeks ago. Even if it does not happen this year, the decision will be implemented next year." he said. 

Emphasizing that Turkey has very serious problems regarding medical education, according to Prof. Dr. Kayıhan Pala, this is not limited only to the medical schools of foundation universities. 

"The initiative by the Ministry of Health and YÖK to increase the number of medical doctors, pursued independently of quality, has unfortunately led to students being admitted and degrees being granted in some medical schools where educational facilities are very limited. This has resulted in a decline in the quality of medical education," he said, summarizing the issues that have been frequently highlighted in recent years. 

“THERE CAN BE NO SUCH THING AS CONTINUOUS POSTPONEMENT IN THE LAW!”

Prof. Dr. Semih Baskan, former dean of Ankara University Faculty of Medicine and Okan University Faculty of Medicine, who has analyzed the situation in medical schools in recent years, also stated that the Council of Higher Education (YÖK) must now make a decision and implement it. Prof. Dr. Semih Baskan’s assessment of the current situation is as follows: 

“A requirement was introduced for newly established foundation university medical schools to build their own faculty hospitals with at least 200 beds. A one-year flexibility was granted, and it was stated that if this was not met, no student quotas would be provided. It was later stated that if necessary, the medical school would be closed.

For this reason, there was curiosity and anticipation regarding what decision YÖK would make for the 2023-2024 academic year. There are also four 'signboard universities.' They do not appear in YÖK ATLAS because they have no programs and do not accept students. Three are in Istanbul and one is in Kayseri. This is also interesting; how long will they wait? YÖK needs to make a decision and enforce this article of the law. There can be no such thing as continuous postponement in the law. Therefore, an important duty falls upon YÖK.”