The poor state of Pakistan’s medical education reflects a health system in crisis. The development of good medical services in the country is almost entirely dependent upon the medical education imparted in the various medical colleges of the country. The country has the highest rates of mortality from diarrhoea, pneumonia and hepatitis, creating pressure to train more physicians. Patients are regularly denied treatment at public hospitals that are so overcrowded, often the only way to see a doctor is to go to a private hospital.
Medical teachers have been vested in the authority and the enormous responsibility of producing competent doctors. In a sense, they are the angels, who safe-guard the health and well-being of millions of our population. It is not by accident that the first step in safeguarding patient safety is the implementation of high-quality medical training and rigorous assessment methods. The decision to permit a person to practice medicine should not and cannot be taken lightly as it has enormous consequences for the health and safety of patients who may seek the services of this person at a later date. However, what goes on in the name of training and in examinations during the medical course is inconsistent, to say the least.
Medical profession is considered to be the noblest of all professions because it deals directly with the lives of patients. The doctors earn high respect from the society because of the noble work they are associated with. Considering the sensitive nature of the profession, where even minor mistakes can have serious repercussions, it is highly imperative that the standard of medical education should be strictly regulated and regularly updated.
The question of reliance on private medical colleges in Pakistan is of importance in providing health care services to the populace at large in Pakistan. While the government has failed to provide adequate medical services to its citizens due to lack of qualified doctors and infrastructure, private medical colleges have come up to make up the gap. There is acute shortage of medical doctors in the country serving in the rural areas.
It is true that there are brilliant students in government medical colleges but it is also true that there are equally brilliant students in some private medical colleges. As long as the private medical college has good teaching, infrastructure, faculty, facilities and most important patient load, they are doing as well as in any government medical college.
Pakistan government has paid less attention towards assuring at least 6 percent of the GDP to allocate for the health sector. Pakistan Medical and Dental Council PMDC have been given the authority to regulate quality of medical education and it has been empowered to recognize medical colleges based on certain criteria. It is assumed that recognized medical colleges have achieved the minimum requirements for medical education. The process of assessing quality education has been revised from time to time. However, corrupt practices have led to the compromise in the medical education and underhand practices for recognition has led to the menace of mushrooming of private medical colleges in the country. Efforts of the PMDC in routine monitoring of standard of education should be strengthened and corrupt practices should be checked.
Concerns have been raised over the quality of output from the private medical colleges. Considering the seriousness of damage that can be caused by the slightest of mistake by the medical personnel, quality of medical service cannot be compromised at any level. So, this issue has to be seriously looked into to seek out some remedial measures to maintain a high standard of medical education in Pakistan.
It is unfortunate that the focus of private medical colleges, in general, has shifted to earning from capitation fees, tuition fees rather than providing quality medical education. This has led to the public opinion of poor quality of medical doctors graduating from the private medical colleges in Pakistan. However, we need to understand that not all private medical colleges are of poor standards. There are many private medical colleges which have produced renowned doctors.
In Pakistan today only a few private medical colleges stand near the international constitute after consideration of the faculty, infrastructure, publications, quality of education as assessed by the students, public image, etc. The contribution of the private medical colleges in medical education is still minimal considering the fact there are a large number private medical colleges in the country (94 medical colleges in Pakistan, 39 of which are public and 55 private). The usual public opinion that doctors from private medical colleges will try to get back their money through unethical private practices seems to stem out of this poor standards of education in private medical colleges.
We need private institutions but they must maintain the standard of education with facilities, faculties and social obligations. Some of these colleges have a very good infra-structure, teaching faculty and social structure. These institutions do admit merit students. In such a situation when institutions are working towards the doctors for tomorrow, government must help with policies that will assist both the management and the students. Policies of health are not election manifesto of party politics. Higher education simply cannot flourish under social threats and legal ramblings. PMDC has specific rules and regulations with respect to building, hospital facilities, teaching and other requirements. Corrupt practice, personal biases and limitation of vision must not stifle the growth of higher education.
One way of ensuring the provision of quality medical education in private medical colleges is by providing more robust policies. Such a need can be satisfied with a specified standard among the private medical educational institutions. Once we achieve the minimum target then we can also regulate medical education similar to the public medical colleges through a single window of admissions and examination to set a uniform pattern of evaluation. Therefore it is necessary that the PMDC create a healthy environment jointly to promote medical education to flourish keeping the common man’s healthcare in perspective.
The writer is a professor of psychiatry and consultant forensic psychiatrist in the UK. He can be contacted at [email protected]