PESHAWAR: The passage of Khyber Pakhtunkhwa Medical Teaching Institutions Reforms Act 2015 from the provincial assembly will improve medical education and patient care in the province, health experts say.

The law ensures selection of officials for top positions on merit. In the past, the posts of principals and deans of medical educational institutions were filled from a panel of three senior most professors but now all the BPS-20 professors will be able to apply for such posts.

The rules of Pakistan Medical and Dental Council (PM&DC) are very clear about the appointment of the principal and dean. The PM&DC’s rules 31 and 44 recommend that a senior professor shall be appointed as principal/dean. However, the rules do not say “the senior most”. To define ‘senior’, one has to look at rules for the election of the members of the council of the PM&DC wherein a professor of four years standing is considered ‘senior’ and is eligible to contest for it.

Restricting the appointment of principals and deans to the three senior most professors was discriminatory, violation of the basic constitutional rights and limited the choice for such an important post.

Making seniority the sole criteria for holding a post was an attempt to get away with the virtue called ‘competence’.

A dean or principal is a BPS-20 officer and as per general rules, a BPS-20 officer of the same cadre is eligible to be posted as dean/principal. Restricting it to the three senior most was a violation of the General Services Rules.

New law ensures selection of officials for top positions on merit

The post of head (dean/principal) of an educational institution shall never be doled out as medal of honour for a senior faculty member’s lifelong achievement as this amounts to the institutional suicide and one important cause for deteriorating educational institutions in our country, according to a senior medical teacher.

“We need to learn lesson from history. If processes and mechanisms are the same, how can one expect a change or progress,” he questioned.

Additionally, the law ensures selection of head of departments through a competitive process and removal by the Board of Governor (BoG) while a group of doctors was demanding that senior most person should be appointed as chairperson till retirement.

According to the new legislation, the Postgraduate Medical Institute (PGMI) is also being devolved. The PGMI was established through executive order 30 years ago to cater for the need of human resource in health care. It was supposed to run diploma courses and the Lady Reading Hospital (LRH) was its dedicated hospital. Except for the first decade of its inception, PGMI has been used for the vested interest of both the staff and union leaders of the postgraduate students. Most of the students enrolled in diploma courses do not even bother to sit in the examination; they just want to use it for staying in Peshawar, according to experts.

The College of Physicians and Surgeon of Pakistan (CPSP) is a constitutional federal body for awarding FCPS degrees. Instead of concentrating on its original obligation, the PGMI took over the placement of trainee medical officers (TMOs) which gave it the opportunity to extend itself into other institutions.

Currently, around Rs.260 million are being spent annually as stipend on TMOs but passing rate has hardly touched double digits which speaks volumes about its effectiveness.

With the establishment of Khyber Medical University (KMU), PGMI has lost its role as postgraduate training is the lawful responsibility of KMU.

The provision in the law that all autonomous health institution shall be allowed to enroll postgraduate medical students in courses duly affiliated with medical university is the way forward and in the greater interest of the institutions, TMOs and public. This would help them improve services, generate funds and provide much needed human resource. It will also help establish at least nine institutions in as many medical colleges which will impart both undergraduate and postgraduate training for no extra cost.

“Thus, instead of one PGMI extending tentacles to other autonomous institutions, the province will have nine medical institutions. It is not dissolution but proliferation of the concept of the postgraduate medical institution,” experts said.

Some doctors are citing difficulty in placing TMOs when PGMI is devolved but they are ignoring the difficulties faced by TMOs with a single PGMI for the whole province. With the new system in place, there may be a joint induction committee, which shall work on the analogy of Joint Admission Committee for admission into medical colleges of the province.

Another point in the new law is about private practice of the doctors. The government has shown enough flexibility and has the moral grounds by making the institution-based practice (IBP) optional.

Experts believe that it is moral obligation of the government to extend financial protection to those who opt for IBP and ensure that those who opt for practice outside the institution shall continue on the same terms and conditions. The law is exactly doing the same. Those who opt for practice outside the institution will have their annual increments and general financial benefits as announced by the government in annual provincial budget. They will also have no problem in their promotion.

Those, who opt for IBP, will be given financial protection in the form of special enhancement in salary and in case of outstanding performance they will be given bonuses which will be decided by the BoG. Those who practice outside the institution will not have claim to such special packages.

The doctors were demanding that senior registrars (SRs) shall be included in teaching faculty. The new law has included assistant professor (AP) and above in the teaching faculty because worldwide, senior registrar is a training post. PM&DC recommends that students of third year shall be taught by assistant professor, fourth year by associate professor and final year by a professor whereas senior registrars don’t figure in these recommendations.

Published in Dawn January 15th , 2015

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