The paradox of tuition and salary

Meanwhile, the ironic reality is that tuition fees for training in health sciences, especially medicine, are currently very high, in some places reaching nearly 200 million VND/year.

MEDICAL TUITION FEES ARE VERY HIGH

It can be said that the tuition fee of the medical sector has never been as high as it is today, especially in the medical sector (training of general practitioners) and dentistry (training of dentists). The tuition fee of public universities is currently stipulated in Decree 97 of the Government on amending and supplementing a number of articles of Decree 81/2021 regulating the mechanism of tuition fee collection and management for educational institutions in the national education system and the policy of exemption, reduction of tuition fees, support for study costs; service prices in the field of education and training.

According to the HP announced for the 2024-2025 school year, non-autonomous schools can collect a maximum of 27.6 million VND/year (10 months); schools that ensure regular expenditures can collect a maximum of 55.2 million VND/year; schools that are autonomous in regular expenditures and investment expenditures can collect up to 69 million VND/year. Not to mention, with quality-accredited programs, universities can determine their own HP collection levels based on technical and economic norms issued by the school. Therefore, HP for medical training programs at public universities have many different levels.

Medical students study hard, pay high tuition fees, and after graduation have great work pressure but their income is not commensurate.

It can be said that medicine is one of the majors with the highest HP today. Among them, the public university training in the health sector with the highest HP is Ho Chi Minh City University of Medicine and Pharmacy, with 2 majors training doctors with HP of over 80 million VND/year. Meanwhile, the University of Medicine and Pharmacy (Thai Nguyen University) has an HP of over 30 million VND/year.

In non-public universities, the highest medical tuition fee belongs to Hong Bang International University with 180 million VND/year. Next are Tan Tao University and Nguyen Tat Thanh University with 150 million VND/year.

Compared to 10 years ago, the highest HP industry in the medical and pharmaceutical sector has increased more than tenfold. The maximum HP ceiling for the medical and pharmaceutical sector in the 2014-2015 school year is only 800,000 VND/month (equivalent to 8 million VND/10-month school year).

STUDY, WORK HARD, SALARY IS NOT ENOUGH TO LIVE

Not only do medical students have high HP, they also have to go through a long and arduous learning process. However, the income of young doctors in public health facilities today is not compatible with the investment of students.

Nguyen Thu Phuong graduated from the Faculty of Medicine at the University of Medicine and Pharmacy, Ho Chi Minh City in 2022, and was then accepted to work at a hospital in Thu Duc City (HCMC). At first, Phuong had to undergo a 2-month apprenticeship, with a support of 1.5 million VND/month, and after 2 months of probation, she received 85% of her basic salary (coefficient 2.34), which was nearly 3 million VND. After this period, she received her full basic salary of 3.5 million VND/month.

With such a low income, Phuong cannot afford the expensive life in the city. At this time, Phuong does not have a practicing certificate, so she cannot work extra at the clinic to earn more income.

After studying for 12 months to get a practicing certificate, Phuong worked in Thu Duc City, and on weekends drove to a hospital in Long An to work extra. She didn't take a day off all week, and had to stay up all night. "Many days when I went from Ho Chi Minh City to Long An, I had to pull over and take a nap in the middle of the road to have the energy to continue working," the young female doctor recounted.

Admitted students complete admission procedures at the University of Medicine and Pharmacy, Ho Chi Minh City. The health sector is currently ranked among the sectors with the highest tuition fees.

PHOTO: DAO NGOC THACH

Phuong's current income, including salary, allowances, and night shift pay at the main hospital, is about 8 million VND/month, and her part-time job at the hospital is 4 million VND/month. "Working without days off and under such pressure, but it's just enough to cover living expenses in Ho Chi Minh City. Sometimes I think about it and feel very sorry for myself. Thinking that I studied for 6 years and spent another year to get a certificate, the learning process was longer and harder than many of my friends, and when I started working, it was also much harder, but my friends' income was 2-3 times higher than mine. Then I had to console myself that I had just graduated, I needed to accumulate more expertise and experience, and when I became a good doctor, my income would be better, but that process would probably be very long," Phuong confided.

NTK (a young doctor working in Ho Chi Minh City) said that his current income from the hospital is over 10 million VND/month. Of which, the fixed salary is about 8 million VND and other income from: surgery (3.8 million VND/month); procedures (2 million VND/month); on-call (nearly 680,000 VND/month)...

HB (a doctor working at a private clinic) shared: "The average income is about 900,000 to 1.5 million VND/day and only works a maximum of 2 days per week. Thus, the average income is about 4 - 6 million VND/month".

HB said: "A doctor who graduates and practices for about 1-3 years will have an income. The average level is usually under 6-8 million VND/month, if working overtime diligently, it can reach 12-15 million VND/month, not including the cost of regular study investment in that month. This level is low, not commensurate with the effort spent working and studying, not enough to cover daily living expenses for oneself, let alone taking care of children."

A.D (a young doctor at a hospital in District 3, Ho Chi Minh City) also acknowledged: "Within 5 - 10 years after graduation, the income cannot be equal to the amount of money invested in studying."

A SERIES OF DOCTORS AND PUBLIC HEALTH WORKERS QUIT WORK

The direct consequence of low income and high work pressure is that a series of doctors and public health workers have resigned in recent times. Most recently, medical staff at the professional department level of Thuan An City Medical Center (Binh Duong) submitted resignation applications. Previously, in the first 7 months of 2022, this locality had up to 166 doctors, medical workers, and public health workers resign or quit their jobs. According to a report by the Binh Duong Department of Health, the reasons leading to the situation of doctors, medical workers resigning or quitting their jobs are due to low salaries and benefits, stressful working environment, hard work, constant exposure to hazardous factors... In addition, there are a number of reasons due to family circumstances, going to school and having other choices.

Nghe An also recorded 119 doctors and nurses at public hospitals who resigned from the beginning of 2021 to July 2022. Of these, nearly half were doctors and two-thirds of those who resigned moved to work at private hospitals. At that time, according to information from the Nghe An Department of Health, a newly graduated doctor working at a public hospital had a salary of only 5-7 million VND/month, but private hospitals were willing to pay 15-20 million VND/month. A resident doctor who graduated from Nghe An General Hospital paid the highest salary of only 15 million VND/month, but private hospitals could pay 70-100 million VND/month.

Dr. Truong Huu Khanh, an epidemiologist and former Head of the Department of Infectious Diseases and Neurology at Children's Hospital 1 (HCMC), said that currently, medical staff in the public system are under a lot of pressure, including the fact that their income is not commensurate with their expertise and from jobs outside their expertise. Those who want to stay and work in the public system, if not to contribute, then because they want an environment to learn and develop their expertise. The more talented people are, the more options they have. If talented people leave the public system, in the end, it is the poor patients who suffer.

"Talking about income in public hospitals, it can be said that it is not commensurate with the effort they put in, not compared to other professions. Therefore, it can be said that the first 10 years after graduation is the 'easiest' period for medical staff due to limited income while having to do many things," Dr. Khanh commented.

Source: https://thanhnien.vn/dao-tao-bac-si-nghich-ly-hoc-phi-va-luong-18524102323030931.htm