A SEMINAR was recently convened by Appna, the Association of Pakistani Physicians in North America, in order to get to the root of what has turned out to be a complicated problem concerning female medical students in Pakistan today. Why is it that when 80pc of Pakistan’s medical students are female, only 30pc of those graduates go on to practise medicine in Pakistan later on?

The seminar brought together physicians based in North America, Sindh medical school leaders, and students at local medical schools. Whereas the doctors spoke with voices of authority, experience and compassion for the medical students’ dilemmas, the students revealed the truth about the intense pressure that these young women face to stop practising medicine — in other words, to give up what is most dear to them.

When the Supreme Court recently struck down the quota restricting the percentage of women medical students to 20pc to 80pc male students, it was hailed as a great decision for equality and women’s rights.

The representation of women to men in medical school swung wildly the other way. Pakistani women clearly have as much intellectual aptitude and passion for the subject as the men. And nobody, not even the students themselves, wants to return to the days of the quota system, because they know that the merit-based system is fair.

The problem isn’t what happens during the five years of medical school. It is what happens almost on the day after she graduates: she’s pressured into giving up the house job that a young medical graduate must undertake before being able to specialise. Out of 24,000 doctors that go on to specialise in their profession, only 7,000 of those are women. The rate of dropouts in the medical profession is staggeringly high for its female graduates.

The result: a serious shortage of medical personnel unable to serve their communities or pay back the investment that the government made in their educational career. And Pakistani women are suffering the consequences of not being able to go to a female doctor for their medical issues.

The principal of SMBB Medical College Lyari, Dr Anjum Rehman, told the panel that rates of female-specific cancers and subsequent mortality rates are shockingly high, especially for women living in rural areas and the peripheries of the big cities of Pakistan, because there aren’t enough female doctors to treat them.

Is this because, as one panelist suggested, Pakistani women lack the will to work, or feel no need to do so because they are being taken care of by their husbands after marriage? The young women listening in the audience were quick to disabuse us of those misconceptions. “It isn’t that we lack the will to work,” said one young woman who had left her family in Balochistan to come live in a hostel and attend Sindh Medical College, against the criticism and disapproval of her extended family members. “We have decided that no matter what happens, we will complete our studies.”

The truth is that young women doctors are discouraged from working by the families that they marry into, particularly the mothers-in-law. These matriarchs dream of having a doctor as a daughter-in-law, but when she arrives, they feel that there’s no better sign of obedience than her staying home and not going out to make use of the degree that she spent so much time and effort to earn.

Husbands play along with this power struggle, or denigrate the women’s low salaries, taunting them with the fact that they could earn much more if they had gone to school for an MBA instead.

That’s not all: the rates of sexual harassment and bullying of female doctors in local hospitals is extremely high. I heard tales of broken locks on duty room doors, patients who harass doctors but are untouchable because of their political connections, and female doctors who have nowhere to change their clothes before they go into the operating theatre. With these kinds of working environments, is it any wonder that our young female doctors get discouraged and decide that it is better to drop out?

There are solutions to this problem: the implementation of anti-harassment and anti-bullying laws in the workplace, better salaries for young working doctors, flex time and childcare facilities as well as professional tracks that enable young women to get back into the workforce after maternity leave.

The US Pakistan Women’s Council is trying to put a mentoring programme in place that will match young medical students to practising physicians in order to give them the encouragement and support that they need. But we need to eliminate the mindset that says a young woman doctor is better left as a trophy to gather dust on the shelf if we truly want to help Pakistan’s daughters succeed in the noblest profession.

The writer is an author.

Twitter: @binashah