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Yıl:2009; Cilt: 10; Sayı: Ek 2>> Özet
Anadolu Psikiyatri Dergisi; 2009;10(Ek 2):70-71
Küreselleşme ve Türkiye: Tıp eğitimi nasıl etkileniyor?
H Balcıoğlu
Ankara Üniversitesi Tıp Fakültesi Tıp Eğitimi Anabilim Dalı, Ankara
Küreselleşme kavramı kapitalizmin uzun tarihsel gelişimi içinde değerlendirildiğinde sistemin kriz karşısında yeniden yapılanmasına denk düşmektedir. Türkiye bir çevre kapitalist ülke olarak küreselleşme olarak da ifade edilen yeni liberal politikaların etkisi altındadır. Bu paradigmaya uygun olarak kamu hizmetleri alanı daralmakta ve sermaye için kar alanı olarak yeniden düzenlenmekte, kamu yararı düşüncesi değersizleşmektedir. Bu süreçte “eğitim ve sağlık” hak olmaktan çıkarılıp metalaştırılmaktadır.

1980 sonrası uygulanmaya başlayan bu yönelimle devlet yeniden yapılandırılmış, 1990’lı yılların başından itibaren belirgin etki ortaya çıkmış, 2002 sonrası AKP tek parti iktidarı ile uygulanması hız kazanmıştır. Yeni liberal politi-kaların sağlık ve tıp bağlamında uygulanması AKP iktidarında “Sağlıkta dönüşüm programı” adıyla yürütülmüştür. Sağlık hizmet sunumu ve finansmanında devletin toplumsal sorumluluklarından geri çekildiği bu süreçte sağlık, Pazarda bir kar etme aracına dönüştürülmektedir. Bu yazı bağlamında küreselleşme sürecinin Türkiye’de tıp eğitiminin nasıl etkilendiği sorusuna yanıt aranmıştır.

Bu yönelimle uygulanan politikalarla Tıp Fakül-tesi sayısı ve öğrenci kontenjanları altyapı hesaba katılmadan artırılmaktadır. Bu durum tıp eğitiminin niteliğini olumsuz etkilemektedir.

Özünde eğitim hastanesi olan Tıp Fakültesi hastanelerine kamusal destek yıllarla azaltılmıştır. Üniversite hastaneleri döner sermaye gelirleriyle sağlık hizmeti veren işletmelere dönüştürülmekte, uygulamaya sokulan sağlık hizmet sunumu ile ilgili yasalarla piyasada rekabete zorlanmaktadır. Bu ortamda Tıp Fakültesi hastanelerinin büyük bölümü finansal krizdedir. Bu koşullar, mezuniyet öncesi ve sonrası tıp eğitiminde önemli bir yeri olan tıp fakültelerinde eğitimi hizmetin gerisine itmektedir.

Sağlık bakanlığı eğitim ve araştırma hastanelerinde de sorun bir başka boyutta yaşanmaktadır. Sağlık harcamalarından daha büyük pay alan bu kurumlarda performans uygulaması nedeniyle hizmet sunumu eğitimi ötelemektedir.

Türkiye’de tıp eğitiminin mezuniyet öncesi ve sonrası döneme ait var olan sorunları yeni liberal politikaların etkisiyle daha da çoğalmaktadır. Bu süreçte eğitim ve sağlığın ticarileşmesi/ piyasalaşmasının tıp eğitimine önemli zararlar verdiği gözlenmektedir.
Globalisation and Turkey: How medical education is affected?
When we consider its long historical development, it is possible to see the concept of globalisation as a restructuring initiative of the existed economic-political system. Turkey, as a peripheral capitalistic country, is under effect of these neo-liberal policies, so-called globalization. Parallel to this paradigm, the area of public services is getting narrower and rearranged for the capital as a profit source, and the thought “public good” is devaluated. Education and health services are transformed from a basic right to a commodity in this historical process.

After the coup-de-estate in 1980, the state was re-structured in Turkey, in a process which was accelarated in the beginning of 90s’, especially since 2002, after the one-party government of AKP came into power. Neo-liberal policies was carried out in the context of health and medicine by a special World Bank project, namely “Transformation of Health”, in the era of AKP government. In this process, which was characterized by the withdrawing of state from the providing and financing health care services, health is getting transformed into a commodity for profit.

In this study, the question of how the globalization process affected the medical education in Turkey was examined. As a first thing to mention of these effects, number of medical students are constantly increased without taking into consideration the infrastructure of medical schools, and it is affecting the medical education negatively. Besides, public finance of medical schools, which are basically an education institution, was dramatically decreased in [year]s. University hospitals are being converted into companies that provide health care services with its own incomes, and are forced to compete with the private sector. In this conditions, medical schools’ hospitals are in a deep financial crisis. These circumstances is pushing the medical education back, and the service providing is becoming the first priority in order to survive of institutions.

The problem exists in a different dimension in the case of Ministry of Health’s education and research hospitals. In these institutions, which get much more share from the health care expenditures, education has become secondary because of performance-based fee policy.

The existed problems of medical education in Turkey is clearly increasing by the effect of neo-liberal policies. It is possible to claim that commodification of health and education is hugely damaging the medical education.

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