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.