KATHMANDU, Feb 6 - About 400 students who completed their four-year MBBS course in 2007 in China are facing an uncertain future because of the government's abrupt policy change on pre-internship, the 48-week practical course done by medical student after completing their theoretical training.

In May 2007, the government took a decision prohibiting students switching from a medical college abroad to a hospital in Nepal for their pre-internship.

On Tuesday, the Ministry of Health and Population issued a notice warning hospitals in the country not to take any new foreign MBBS graduate for pre-internship.

The 400 students in question did their MBBS in China under self-financing. The teaching medium was English, which means they cannot do their pre-internship in China.

To do pre-internship in China, the students should have done the four-year MBBS course in Chinese.

"Even if in an exceptional case a student who studied the MBBS in English is allowed to do pre-internship in China, it becomes very difficult because of the language barrier," says R K Manandhar, guardian of one of the China-trained medical students.

Those who go to China under government fellowships do a one-year Chinese language course before starting on their MBBS. Such students do the pre-internship in China itself.

Before the May 2007 decision, the government was allowing students who did their MBBS abroad to do pre-internships in Nepal.

The policy change has shattered the dreams of people like Gopal Mishra, who sold property in Kathmandu to fulfill his daughter's wish to become a doctor.

"She passed the entrance examination at Kathmandu Medical College in second position. But then, it would have been expensive [to study medicine] here, and the frequent strikes were also worrisome," says Mishra, whose daughter Bijaya completed her MBBS from Tianjin Medical University in Beijing.

Bijaya was a topper at the University. Today, Bijaya has nowhere to go to do her pre-internship.

Pushpa Ratna Shakya, coordinator of the Nepal-China National Doctors' Parents' Association, said that it would be fair to apply the new policy in the case of students who went to China after the government's decision. "But how can the government not allow students, who went abroad before that decision was taken, to do their pre-internships here?" Shakya questioned.

Parents of the 400 students have been protesting in front of the Health Ministry for the past one week demanding that the government allow their children to do pre-internship courses in Nepal.

In Tuesday's statement, the Health Ministry said that according to international norms, students have to do their pre-internships in the same college where they did their four-year MBBS, as the pre-internship is part of the MBBS program.

Students doing pre-internships in hospitals here after doing their MBBS courses abroad are flouting provisions of the Nepal Medical Council, said the statement.

The ministry has warned all government hospitals not to allow MBBS students to practice medicine under pre-internship unless and until they complete their MBBS program at the medical college they studied in.

However, the ministry has said that for just once the government would allow students who are already in government hospitals to do their pre-intership, to complete their course.