The doctor glut

Published Jul 19, 2013 03:31pm

It used to be that there were just a few medical colleges in the country. The majority were state run institutions and a handful were private establishments that required hefty fees. Admission to the public medical schools was highly competitive. Students crammed for months, especially those who by the misfortunes of ethnicity were left to fight for the small numbers of spots that were reserved for candidates applying purely on the basis of academic merit. The day the admission list was posted on the bulletin board outside the colleges was one where the futures of many were deigned. In the mathematics of meager opportunity that is the fate of those pushing to get ahead, many thousands competed for a few hundred and those left off the lists faced a dead end.

Then the market responded. Egged on by more lenient rules and the possibility of large profits, the numbers of medical schools increased exponentially. If you couldn’t get into a competitive public medical school, there were suddenly scores of private ones where you could also get a medical education. The quality of the education was of course another matter, but the result in all cases was supposed to be the same; a degree that made you a doctor and set you on the path of riches.

While the number of medical schools increased furiously, and enabled lesser students to obtain a medical education the market for Pakistani doctors declined. In the past few years, a number of global factors have colluded to create a particular sort of crisis. The United States, often the first choice for Pakistani doctors seeking a return on their investment, has implemented a number of security regulations that make it difficult for Pakistani medical graduates to obtain visas with the same ease and speed as medical graduates in India or China or Eastern Europe. This has negatively impacted their ability to compete for residency spots in that country. Similarly, in the United Kingdom, with an economy barely recovering from recession and an influx of doctors from Poland (now benefiting from EU labor regulations), has significantly reduced training and employment opportunities for Pakistani medical graduates in that country. If all this wasn’t bad enough, Saudi Arabia, the longtime importer of Pakistani doctors has in recent years also changed its iqama or work visa regulations with the intention of training Saudi nationals for skilled jobs in medicine. This represents yet another closed door to the Pakistani doctor.

Of course, there is always Pakistan, and serving one’s own country is a noble goal indeed. However, according to statements made by various members of the Pakistan Medical Association and other representative bodies, the number of training spots available for medical graduates is far too small compared to the numbers of doctors that are being churned out. That is, of course, only half of the dismal problem. Month after month, television channels and newspapers report situations where doctors have not been paid any stipends The low morale, unprofessionalism, and apathy of these vast numbers of unpaid and untrained doctors inflicts the sum of its wrath on those more hapless than they – the patients. Recent months and years have revealed case after case of wrong limbs amputated, incorrect medicines administered, as well as the misdiagnosis of illnesses. In the mad mix of all these problems the Federal Investigation Agency revealed last week, that a preliminary investigation of documents obtained from the Pakistan Medical Dental Council showed that 19 medical colleges currently operating in the country have fake registrations. In turn, 40 doctors have fake registrations and 150 have registrations currently under investigations. Those are of course, just the ones that have been caught.

For everyone else, the message is simple. The middle class mantra of becoming a doctor as a means to a better life, or a tolerable life is no longer supported by facts. Unless gullible and shortsighted parents stop pushing their offspring into medical schools based on old equations of supply and demand, the country will continue to produce more and more jobless doctors. While glib suggestions of serving Pakistan’s poor (which are indeed lacking in even the most basic healthcare) may sound comforting, they are unlikely to untie the knots in the system which imagines trained doctors serving them without being paid a wage on which they can survive. There are many things Pakistan needs, more doctors is simply not one of them.


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Rafia Zakaria is a columnist for DAWN. She is a writer and PhD candidate in Political Philosophy whose work and views have been featured in the New York Times, Dissent the Progressive, Guernica, and on Al Jazeera English, the BBC, and National Public Radio.

She is the author of Silence in Karachi, forthcoming from Beacon Press.


The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.

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Comments (62) Closed


sharif
Jul 19, 2013 02:29pm

Such a true story of my life and thousands of doctors like me ! I can swear that I could have live with meagre salary and poor living but working under threat of life specially in karachi primary hosp. is next to impossible .so I left too for greener pastures . There is no day spent when I dont think about my people and country.

excalibur
Jul 19, 2013 02:57pm

A patronising piece of negativity. Instead of advocating the urgent need of empowering and ensuring strict regulatory mechanism to improve the quality of medical education, licensing and proper deployment in the healthcare sector, all has been equated to money alone. Quite rightly doctors deserve not only to be trained and paid well they have to be respected also.

A dismissive mindset fails to rectify the dismal Health spend budget as also the yawning need of improving the doctor patient ratio.

a
Jul 19, 2013 03:20pm

As you said, given the gullibility of parents and hope for the greener pastures, the medical colleges albeit substandard will keep on sprouting. Political stunts of inaugurating new colleges without any hospital facilities to train their students at, add fuel to the fire. The last tertiary care hospital built in Punjab was way back in 1994 when Benazir Bhutto inaugurated Jinnah Hospital, Lahore. Since then the number of medical graduates has risen more then 10-20 folds, most of them coming from colleges which take drop outs or students who don't even have the bare minimum of 60% marks in the secondary boards to appear in the MCAT. I have see students with appalling 55% marks get into a private school with no respectable hospitals to train them at. I had gotten admission to a medical college with 89% on my boards and that was 8 years ago.I can only imagine the competition in public institutions now.

The problem of producing too many graduates for too little training spots plus a massive number of sub-standard doctors from various private sector schools will only do more harm then good to an already crumbling medical field in Pakistan.

karamba
Jul 19, 2013 03:47pm

I totally agree. Sadly parents think this is the best option for their child towards becoming rich and respectable forcing them to enter the field without wanting to. Like learning by rote, there is no imagination, innovation or enterpreneurship that takes place. Patients lives are at stake with no ethical boundaries taught or followed and no guidelines implemented. Responsible? It is the PMDC and the government who are corrupt to the core and who have played with peoples lives. Just see the number of so called 'doctors' in parliament and ask how many are worthy of the title.

zahid
Jul 19, 2013 03:48pm

What a Sad facts. When my brother got admission in King Edwards, the whole town came in our house and show their happiness. Today those days are gone and just the memories left.

dr makraja
Jul 19, 2013 04:28pm

Dear Rafia, well-researched and written. Being a medical student of the bygone era i.e. state run institutions, I still can recall that we were effectively unemployed when we graduated and received a stipend of rupees 1500 for our house job. After that if there were no public service commission examinations/interviews ... one was pretty much baikar and dushman anaaj ka. Of course one could open up his/her own shop or work in the private sector but many chose to get on with higher exams, once again a limitation of infrastructure and medical education. I do feel sorry for the forthcoming doctors and you have rightly pointed out the limitation of training posts and if I may add poor quality training which is the possible cause of the medical mishaps that you mention. I believe the whole structure needs to be overhauled as the world at large has moved on to specialisation both super and sub. When we will actually catch up is the question. A political debate needs to be carried out to address this issue.

Guest63
Jul 19, 2013 04:30pm

I beg to differ with you Miss , could you please from your vast data for analysis , enlighten us the poor uneducated lot , What is the number of a Doctor vis number of people he or she serves in the primary health care i.e a guiding factor about the effectiveness of acceptable health care services (other than the Hospitals, medicines,paramedics ) . I am sure its no where near any level advised by the WHO , so how on earth it is the glut of doctors , when people can not get basic needed health service by a qualified physician in this supposed to be an atomic power country ??? In My humble opinion , Glut will not be there be even you can each on par to the Dr vis people ratio as per the WHO . We have not managed that for the past 65 years , so another 65 years on , its not glut .......... its the need of the hour unless , you consider an acceptable basic primary health care for every citizen , as a luxury

Sania
Jul 19, 2013 05:13pm

From a point of someone born and being raised here , I have plans to study in Pakistan , only to return here . Money is not the sole reason to come up here again , but the alienation there we have to face . From drinking water to the extra time it takes us at the cash counter , awkardly looking at each note , recognising 'my' money ( pun intended ).

Ali S
Jul 19, 2013 06:40pm

As a 3rd year MBBS student at a private medical college, I largely agree with you - parents have unrealistic expectations of what lies ahead for a MBBS graduate in today's market. However, I wouldn't say that the quality of medical education is inferior in private medical colleges (most of them, anyway) compared to state-run ones - the difference is mainly in the student population. Those who make it to state-run medical colleges on merit are the cream of the crop of our education system, while students who failed to make to it in state-run colleges (our second-tier students) end up in private medical colleges.

Another important factor that you forgot to mention is that the situation is worsened by the fact that most females pursuing medical education (who form the vast majority of medical students these days) have no intentions of pursing medicine as a career - so even the minimal infrastructure that is available ends up being underutilized.

Salman
Jul 19, 2013 07:44pm

What else profession could be adopted? Which could contain all those things which parents think are good for their ward & offcourse which they do see in medical..

SS
Jul 19, 2013 07:56pm

Not sure if all the facts have been verified in this article. Saudi Arabia has actually recently increased the recruitment of doctors tremendously as part of its plan to increase health care services in the kingdom. Saudi Ministry of Health teams have visited Pakistan for recruitment more than once in last 2 years.

Dr Ansar
Jul 19, 2013 08:26pm

@sharif: plz try to come back to Pak and enjoy living in ur own homeland , somewhere where its safer like Lahore or any city you fancy . no place like home and bro trust me as we have returned from green pastures ourselves after living there for over a decade & being a doctors family its our sincere advise to you , best of luck for future

AB Uzair
Jul 19, 2013 08:34pm

A large number of un-utilized doctors and still a poor doctor-to-patient ratio? Well, the reason is none of these doctors want to serve in rural areas, where the bulk of population lives.

dccbmc
Jul 19, 2013 10:33pm

A blend of facts and research ,it can be considered as a well written document .And can be an eye opener for so many who want an odyssey to an unknown destination.

Md Imran
Jul 19, 2013 11:10pm

What a tragedy and travesty ! Pakistani doctors and healthcare specialists single handedly built the modern day NHS in UK and the Canadian medical care. Let them block Pakistani doctors - who are usually considered as some of the best in the world if not best. It will result in a total collapse of NHS and CMC.

Bekar
Jul 19, 2013 11:40pm

Story of becoming an engineer is same.

AR
Jul 20, 2013 12:11am

Being a professional, coming from middle class who has witnesses many doctors succeed, I strongly disagree with the article. In my opinion, there is no profession good or bad by itself be it a doctor, engineer, IT professional,actor, journalist, auto mechanic or electrician......What actually matters is the personal effort and networking in a given field to succeed.

Lightbulb
Jul 20, 2013 12:35am

To put it in a humble way a bit of an unusual thought process you've got.Please don't be a pessimist and stop finding negativity in every fact.Instead you need to increase your spending on the health sector. Competition brings the best out of you.Think about it.

Sameer K
Jul 20, 2013 12:49am

Extremely one sided article as far as USA & UK is concerned. Being an active member of APPNA, I have the figures to show that the number of % visas and denials for Pak are not significantly greater than any other country. Also ECFMG ( Educational commission for foreign medical graduates ) has the relevant data to show how many Pakistanis are in residency programs. You should have done some research before blasting off doctors. Furthermore GMC has the relevant data for facts and figures in UK, and the earlier trend of doctors coming in from EU does not hold true anymore secondary to their graduates non English speaking skills. Having said that please let us know the number of applicants and percentage acceptance for AKU, KEMC now and compared to 5 years ago. Poorly researched even though I respect your views but it is not factually correct. Regards

Tufail
Jul 20, 2013 12:52am

The problem is not too many doctors but limited training institutions. Pakistan is still not producing even 20% of the required numbers of doctors per year to meet the WHO minimal health standards. So , we do need more doctors and on an ongoing basis. USA trains thousands of doctors everyday and mind it , their doctors don't go anywhere , they stay and practice in USA but still they have a shortage of doctors to provide the needed medical care to their community. The biggest problem Pakistan is facing is the kidnapping and killing of doctors for ransom . That is something which needs to stop , not producing more doctors.

ahsan
Jul 20, 2013 02:54am

@sharif: Same sentiments here bro

saqib
Jul 20, 2013 02:55am

So what profession and studies will you suggest for those poor peoples who want to survive???

Amarnath
Jul 20, 2013 03:56am

Rafia, shortage of training spots for medical graduates IS NOT EQUAL TO glut of doctors. shortage of training spots for medical graduates IS EQUAL TO shortage of hospitals/fecilities. Stipends not being paid IS NOT EQUAL TO glut of doctors stipends not being paid IS EQUAL TO problems/mismanagement by hospitals.

Your objective of article is not very clear. Are you speaking about Glut of doctors (as title suggests) or Career for doctors in Pak (as concluding para suggests)? These are two separate topics.

I suggest you change the heading of the article to "Career in Medicine for Pakistanis". The current title does not match up with the content.

Waqar
Jul 20, 2013 04:43am

Your statement, "influx of doctors from Poland (now benefiting from EU labor regulations), has significantly reduced training and employment opportunities for Pakistani medical graduates in that country", is inaccurate and does not reflect ground facts.

There are very few migrants from Eastern Europe, especially Poland working in the UK at professional capacities such as Doctors. There are a lot more Pakistani's working as doctors, surgeons and consultants in general practices and hospitals than you care to think.

hassaan
Jul 20, 2013 04:50am

Can't disagree with a single word in this... But most of the students in Medical schools in Pakistan are Females (e.g in my class, 80 : 210 ratio is there) . Parents send/force there daughters into medicine for a number of reasons. And most of these don't bother 2 practice after graduating... The real problem is to tackle the Giant of Private Institutions .. majority need considerable change.

hassaan
Jul 20, 2013 04:53am

@Guest63: Dear U re right in 1 regard,, there is a severe shortage of doctors... but on the other hand there is inflation as well.... You can't find a good training / Consultant post in Lahore even with a good CV.... But areas like rajanpur, Sahiwal, even Bahawalpur are long waiting 4 Dr vacancies to b filled.. it's the duty of our Moron CM and other relevant authorities to end this difference ... if there will be good facilities in smaller cities as well, dr will move to these areas also,, and hence U'll no longer have the shortage....

Jawad
Jul 20, 2013 04:56am

1,529. That is the doctor to population ratio of Pakistan. Really. I mean. Please research for a total of five seconds (that is how long it takes to google a figure) before passing on a qualified judgement that Pakistan has more than enough doctors.

Better stick to political philosophy.

assad
Jul 20, 2013 05:15am

Precise, serves as great advise for future medical students.

khurram Rashid
Jul 20, 2013 05:42am

@sharif: so what do you planned for the people of your country , how you make a beneficiary for them or just thinking

William Blakers
Jul 20, 2013 07:11am

A good story. What needs to happen is strict assessment and control from a non-corrupt government agency into the running of these colleges so that all graduates are truly qualified to meet the needs of the people. You need diversification of training opportunities to produce all the specialists that the country needs. This requires well funded teaching hospitals. And you need people to accept that being a doctor is not the only career in the medical profession. Dentistry, medical scientists and technicians, laboratory technicians,nurses, medical orderlies are all essential occupations in a well managed health care system. I think you can bring medical knowledge to the poor by training doctors for free provided that they serve in poorer communities before they actually get their qualifications. Often the best medicine is knowledge and not drugs. And lastly you could create a medical tourism sector and encourage those from richer countries to come for cheaper procedures than that that they currently get in their own countries. Many thousands of people from Australia, for example, travel to asian countries for plastic surgery and dentistry procedures because of their affordability. All you have to do is make Pakistan a safe, reliable and non corrupt place to stay.

dr mahmood
Jul 20, 2013 07:23am

very well written but only drs know these facts ....rest of population cant understand these harsh realities

Your Friend MD
Jul 20, 2013 08:59am

In my humble opinion getting into and through a medical school accounts for less than 10% of becoming a successful doctor. I agree that different medical universities do have different standards of teaching and education. However, the most important factor for coming on a world stage (UK/USA) is the individual's own hard work regardless of which medical school one has attended. I say this based on my personal experience of being a graduate of a mediocre medical school. More than a decade ago, I went through rigorous residency and fellowship training in US. I was able to accomplish it because of my hard work and efforts. Nobody in US cared about my Medical School but they did care about my scores on FMGEMS and FLEX. I was later granted US citizenship based on national interest petition and served health physician shortage area for two years. After recertifying American Board two times everything is history.

The point that the author has made is well taken but I do want to encourage our youth to keep hope, work hard, trust in GOD and you all will be successful (inshallah)

Deendayal M.Lulla
Jul 20, 2013 11:56am

Are there private medical colleges in Pakistan,which admit students by taking hefty donations,like India? The Supreme Court of India has scrapped the Single window National Eligibility-Entrance-Test (NEET),and has dealt a body blow to uniform admission norms for MBBS,BDS and MD seats in all medical colleges. It has opened doors to allow private medical colleges to frame their own admission norms,and private colleges charge a hefty capitation fees. One advocate knew the judgement in advance. For more details,read the front page report of ,"The Times of India" ,dated July 19,2013.

For middle class,aspiring to be a doctor is very costly,due to very high fees - donation for admissions,and the annual fees,which runs into lakhs of rupees. One can imagine the calibre of doctors coming out from private medical colleges,which do not have even basic facilities for training students.

peace_lover
Jul 20, 2013 12:59pm

well when more than half of the girls who go med school and dont work after graduation what would you expect. If it is made complusory that one has to serve in rural areas for 3 to 5 years after MBBS and govt. can makes it possible funds, better accomodation and security then only genuine people will get into the profession and this will solve the problem of non availability of doctors in rural areas not to mention only passionate people entering the profession.

Amir
Jul 20, 2013 02:27pm

A usual peach from Rafia - a brilliant thinker. The article outlines a real problem. It is interesting to note that a 'top notch' student - one who has done well in his/her F.Sc or A-levels in Pakistan is directed by the parents, mainly towards two major disciplines - Engineering and Medicine. So-called average students are diverted to IT, business, law or accounting. The worst lot is asked to take up Arts. The ones who don't want to study or do not fit the bill of our education system, usually go into a trade or private business. Additionally, a great number of graduates in Pakistan are the folks who have graduated by way of 'private' exams. Whilst there are graduates of other disciplines, the ones mentioned above seem to be the favourite ones in Pakistan. Such is the state of education system in Pakistan. There are a few things here: First, Pakistani students make choices that are heavily skewed by the limited opportunities. Second, I contend that the examination standard in Pakistan doesn't screen out enough average students - it seems to reward the 'ratta' students more than the analytical ones ; It is churning out too many 'top' students. Third, once these 'top' students graduate from their schools, they are thrown in the deep end, without any serious accountability, essentially to learn from their mistakes. Some doctors have privately confessed to me that hit-and-trial is the method used in Pakistani public hospitals. In short, the whole system needs to be revamped and 'lesser' professions such as trades, science, bio-tech, finance and research need to be encouraged.

gangadin
Jul 20, 2013 02:40pm

Unfortunately, medicine is no longer a noble profession. Just because some one has a diploma, that doesn't mean that he/she is suitable to be a doctor. I agree with the author about the factories of doctors producing useless people that have made this profession a business. So now like any other business, doctors are under public scrutiny on a daily basis and do not have the prestige of profession. That's very unfortunate. On top of that, all those who can afford, go abroad for treatment. That says a lot of this profession. There is no need to produce any statistics/numbers to satisfy any one's argument, the facts on the ground dictate that Pakistani doctors are sub-standard and every body is not suitable to become a doctor.

Uzair
Jul 20, 2013 03:16pm

@Jawad: Yes Pakistan needs more doctors but it can't afford more doctors is the actual thing. Just like many other things including oil, power etc.

iqbal
Jul 20, 2013 03:21pm

now a day gender ratio in medical colleges is 9:1, females out numbering males!......? better future or better match..?

Umar
Jul 20, 2013 04:07pm

Mostly I agree. All it comes down to demand and supply. And demand for health care is limited by the ability to pay for it. While private medical school were much needed as the population grows, there should be some degree of regulation. The attitude of putting the blame on doctors is misfortunate. Doctors are human and can make mistake, no matter how good and hardworking. The need is for a system which can make hospital a safer place for the patients. Hospitals needs to be regulated to ensure they have instituted safety checks to prevent such mistakes.

kashif
Jul 20, 2013 04:41pm

very well written.

A. Khan
Jul 20, 2013 06:14pm

@Sameer K: Your comments are not entirely accurate either. Having lived in the UK, I know non-EU doctors have a a problem of finding residency posts there. They do prefer East European doctors (not just Polish) because of EU regulations. A few years ago, I believe a Pakistani medical graduate committed suicide in UK to protest against his not being able to get a residency despite finishing his post grad work there.

Perhaps you are confusing issuance of visa to doctors for post graduate study as opposed to going there for finishing residency.

Farooq
Jul 20, 2013 06:15pm

@Your Friend MD : agreed.

Saleem Shah
Jul 20, 2013 06:41pm

Becoming a doctor was always more about status and money than actual interest in the medical field. With Pakistan being a status-obsessed society this glut of doctors will only get worse. Let us also acknowledge that these doctors who go to US and UK after getting education in Pakistan benefit those countries and their pocketbooks. They don't return any benefit to Pakistan.

Dr Mirza Arshad Beg
Jul 20, 2013 06:48pm

A hurriedly and hastily churned out piece of blog...wish the writer had done some research before writing the statement , " There are many things Pakistan needs, more doctors is simply not one of them." . Just look at the apathy of the locals coming to the hospitals and I think the writer would think twice before writing that piece of information .

Dr Wequar
Jul 20, 2013 08:19pm

Very thought provoking article indeed.But the important point is, shall we let our guards down because of various reasons? It,s time we think out of the box and get the new doctors to go into fields associated with medical science, of which there are many branches, Medical engineering, for one. They have to equip themselves with other aspect of medical science such as accupuncture, Chiropractic, or even become Qualified by Homeopath in addition to MBBS. Today unless they diversify,their knowledge they will keep feeling the pinch.Times are changing.

Muziqmonk
Jul 20, 2013 09:07pm

The cream of the crop of doctors leave Pakistan soon after finishing medical school. The rest want to leave too but are either not qualified enough or lack resources to apply for US/UK competency tests. In short, you get dissatisfied doctors serving in a highly dysfunctional system trying to do their best to survive and also serve humanity. The system needs to be fixed. Doctors should be given incentives to encourage them to serve in rural and impoverished areas. Doctors are assets to any society. In the long run, Pakistan might be better served if the medical profession is not selected purely on the basis of monetary value and prestige but because of personal interest and a desire to serve under difficult circumstances. Maybe that way we have less dissatisfied physicians and more people intentionally willing to stay and serve Pakistan rather than being forced to serve in Pakistan because they were unable to join their counterparts in US or UK.

malik
Jul 21, 2013 12:34am

Each time I go back home I get sick. When I go see a doctor it is a harrowing experience for me. The knowledge of doctors and the condition of hospitals is pathetic to say the least. One doctor see you and gives some medicine. Next time someone else sees you and gives you some other medicine and none of them work. You see some specialist and his prescriptions does not work either. This cycle continues for my whole stay of two months. Until I final return and see my family physician and get well in days.

alexbaj
Jul 21, 2013 02:48am

It is good that thinkers are watching and reporting the global economic currents and their impact on societies. Pakistan produces labor but not entrepreneurs which they become most of the time when they leave the country. The social structure is a hindrance. Status conscious society and a culture of doing some work that is inferior in others eyes had depleted the self respect, generated idleness and lethargy in the majority of population. I wish there could be some major curriculum shift, intellectual discourse that results in solutions to lift collective spirit of Pakistanis as a nation. We have a great human resource with huge potential but sans leadership and vision of the elected junta.

khan
Jul 21, 2013 02:50am

I think every profession is facing the same problem.And it will not get better untill we change our priorities as a nation.

Dr Saad
Jul 21, 2013 03:14am

A typically unresearched piece, charachteristic of our country's journalism these days. As a grduate of a goverment-run college, I can assure you that the medical school is not the issue here, as Your Friend MD pointed out. What I do want to bring to your attention is the stark ineptitude of examination invigilators, throught my 5 years of college I have witnessed an alarming fall in safeguards against cheating. Consequently, not a single student in a class of over 150 students, failed the written component of any subject in our final year (supposedly the toughest professional exam). This is the root of our current healthcare issues. Thoroughly incompetent individuals are clearing written exams through ineptitude of invigilators while the practical/vivas are delt with thanks to our community's age old nuisance of nepotism/sifarish.

How it will be curbed, after trying and failing to get the relevant authorities' attention for 5 years, I have no idea.

Amir
Jul 21, 2013 08:15am

The main premises of the author/editors is totally wrong that there is a glut of doctors in a country with a huge population.

'Journalists' need to get their facts straight before misguiding the whole public with their self righteous tone.

A better article would have been 'Jobless doctors' or below par quality doctors or ways govt or private sector can accomodate them to serve public.

Khadim Karrar
Jul 21, 2013 11:16am

Instead of discouraging would be doctors and fresh graduates, you should have written about what they can do to improve their future prospects.

Khan
Jul 21, 2013 01:42pm

I am witness to this transition and its immediate and long term effects. I got admission in Khyber Medical College in 1998 after securing top grades in all the exams. Then, there were only 19 MedicalColleges in Pakistan and getting into a government one was considered really tough while on the contrary getting into a private one was'nt. In 2005, we had more than 60 medical colleges. It was a shame that I couldn't manage grab myself a job out of hundreds announced by the government and i still remember other private colleges graduates and ones returning from Russia and Phillipines were able to get those jobs by bribing the Lords who rule the job market in pakistan. This was heart breaking and I had to come to UK where I managed to get into a good training job after a little struggle. I still think there is an unmet need of doctors in UK and Australia. My friends here are happy and those back home are equally happy too. Depends upon your priorities in life where it takes you, if you want to support you family at an early stage then going abroad is a better option.

Anonymous
Jul 21, 2013 06:38pm

Have you come across this? http://timesofindia.indiatimes.com/india/Check-on-your-doctor-before-check-up-1-in-5-via-management-quota/articleshow/21201980.cms

Sikandar
Jul 21, 2013 08:06pm

@Khadim Karrar: the last line pen down by author is great that you should seek other degrees instead of just choosing medical or engineering

Sikandar
Jul 21, 2013 08:06pm

@Khadim Karrar: the last line pen down by author is great that you should seek other degrees instead of just choosing medical or engineering

NMA
Jul 21, 2013 09:07pm

Unfortunately this is just a reflection of pretty much every other institution and profession in Pakistan now.

The real issue is the rules regarding proper registration which exist have to be properly enforced. And also those who spend state money to become a doctor extremely cheaply (compared to international costs of medical education ) should be required to return something to the system. A student loan system or something should be enforced....This will ensure that the current system where a large chunk of the state subsidised seats at the best institutions are not taken by those from well off families looking for a rishta abroad !

Dr. Amer
Jul 22, 2013 02:34am

The mantra of becoming a doctor still prevails, as unfortunately, girls are more preferred to be married to if they are doctors.

And still we heavily require doctors in large numbers, the question is where.

It is our unjust and inefficient system that doctors are not evenly divided and become saturated in the big cities and the overall doctor to patient ratio remains low.

And the author is again wrong when pointing out being doctor no more a lucrative field due to lack of jobs. Because even an MBBS doctor is able to open his private clinic in a shop and able to financially sustain himself good.

Eesha Muneeb
Jul 22, 2013 07:31am

This is a highly questionable article. I get the author's point of there being a lack of GOOD doctors in Pakistan, but again, without proper facts and numbers to back up the various points put forward, how can one make an informed conclusion on the matter?

What Pakistan needs is more BETTER doctors, and to simply out forward a blanket statement saying it doesn't need more doctors is foolish.

Mir
Jul 22, 2013 08:29am

I agree to this article one hundred percent. If they are not tackle now they will destroy the Islamic world.

Sameer k
Jul 22, 2013 09:41am

@A. Khan: I get your point, I was generalizing the residency and non training posts as a whole.. However I am also referring to the GMC figures as a whole which are available on the GMC website. Thank you for pointing out.. But in short an extremely poor and discouraging article from "just a journalist", and we know what their reputation is as compared to doctors.

Shezhad
Jul 22, 2013 01:01pm

The article is not properly researched and is poorly written. I met a doctor a few years ago who came from Pakistan. He told me that from his graduation badge of 150 to 175 (can't remember the exact number) only 25 stayed in Pakistan the rest went a board. He started to give me his reason for leaving Pakistan, not a enough salary, can't keep a family on that salary. I did not ask for an explanation but he thought one was need to be given. I think he felt guilty of leaving a country where the people need doctors who paid for his eduction and invested in him, not for him to come abroad to make money. I told him if you new that the salary was not good you should have gone in another profession. He had no answer. People may disagree but I have been told by British born asians who have become doctors studying here in United Kingdom that when I ever go to the hospital or GP never see a foreign doctor if you want to life. In gatherings with people (pakistani origin) they all tell of their bad experience of using doctors from Pakistan. They have different opinions and various reasons for the competency of these doctors. However, they all agree on one thing that they are here to make money and not look after the well being of patients. They work against the basic principle of being a doctor. I too some time questions their basic ethics of being a doctor. Readers may disagree that all are not like that, please note that the majority are hiding behind the minority who value ethics above everting else.