The approval of a medicine programme at Portugal¡¯s Fernando Pessoa University (UFP) with only 10?places for domestic students has provoked anger, with the national doctors¡¯ regulator also raising quality concerns.

Portugal¡¯s Higher Education Assessment and Accreditation Agency (A3ES) recently gave UFP the green light to?begin offering the six-year programme in?Porto, which will have spaces for 30 fee-paying international students.

Pedro Teixeira, the country¡¯s secretary of state for higher education, said the low proportion of domestic students was approved despite candidates to study medicine at one public university in Porto having to score 96?per cent on their national exams to secure a place, and while the fierce competition was driving hundreds to study medicine in Slovenia or the Czech Republic.

¡°For public opinion, it¡¯s very hard to justify why you would reserve such a share of positions for high-fee international students, especially in public universities ¨C not least because there are hundreds of Portuguese students paying those kind of fees abroad in medical schools in central and eastern Europe or in Spain,¡± said Professor Teixeira, who is also director of the Centre of Research on Higher Education Policy (CIPES), an institute founded by the universities of Aveiro and Porto.

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The approval, which initially allows UFP to run the course for a year if it meets clinical training conditions, came despite quality concerns raised by the national doctors¡¯ regulator, the Order of Physicians. It said it feared that students would not get enough access to patients because UFP¡¯s private hospital lacked the full range of specialisms required, and cooperating public hospitals were too tied up with students from public medical schools. In its submission to the agency, it added that the UFP curriculum was also ¡°very unclear¡± and lacked suitable evaluation methods.

Nadine Rombert Trigo, director of UFP¡¯s international relations office, said she was confident that it would meet the conditions, explaining that the approval came at the end of an ¡°almost 20-year process¡± for the private university. ¡°There is still a strong ideological prejudice against private higher education, especially as we venture into areas that are not common for private education,¡± she said.

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In Portugal, the number of private health students ¨C mainly in dentistry, physiotherapy and pharmacology ¨C rose from 560 in 2011-12 to 3,121 in 2019-20, 790 of whom were at UFP. Over the same period, the number of international students in Portugal more than doubled, from about 21,000 to roughly 48,000.

Most international students in Portugal come from Brazil, but for private health studies French and Italian students dominate, noted Cristina Sin, a researcher at Universidade Lus¨®fona. European Union equality of access rules have led to state-level disputes about medical schools favouring domestic students, with several cases reaching the European Court of Justice in the 2000s and and among those receiving slaps on the wrist for treating foreigners less favourably.

UFP has faced controversy before. In 2020, its president, Salvato Trigo, was and given a suspended prison sentence for transferring €2.2?million (?1.9?million) from the university¡¯s parent foundation to a family-owned charity. Nadine Trigo, who is Salvato¡¯s daughter, said the verdict, upheld on appeal, had not contributed to the current controversy.

UFP also sought to be an early mover abroad, attempting to open branch campuses in Italy, France and Spain in the early 2010s, before being stymied by regulatory changes prompted in part by indignation that the branch programmes would circumvent local caps on student numbers. Dr Trigo said UFP was now focusing on Portugal alone, and that about 40 per cent of its students came from abroad.

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Potential higher education reforms, in February, would eliminate caps on international admissions. Dr Trigo said Portugal¡¯s ageing population meant that it would be a ¡°very irresponsible move¡± to limit international students on private medical programmes, both because of the decline in domestic student numbers and the growing need for qualified doctors.

The change would allow private universities to admit up to 75 per cent international students, a limit that UFP intends to hit, while their public counterparts are barred from admitting any overseas students, in part because of the ¡°enormous¡± domestic demand, said Professor Teixeira. ¡°Part of the negative reaction that you had in public opinion was jealousy on the part of the public medical schools ¨C it may be related to the fact they would like to have international students,¡± he said.

Dr Sin said regulations and expectations around international intakes might change as Portugal faces ¡°dire¡± demographic projections over the coming decades. ¡°It¡¯s a question of survival, really, for many institutions,¡± she said, adding that rural, inland universities were particularly at risk.

ben.upton@timeshighereducation.com