I HAD a shocking encounter recently at the Pakistan Institute of Medical Sciences (Pims) in Islamabad, which shed light on a deeply troubling practice within the healthcare system. Following a medical check-up at Pims, I visited the cafeteria for a cup of tea. A gentleman at my table introduced himself as a doctor.

Upon further inquiry, I learned he was a medical graduate from Kyrgyzstan, currently serving as an honorary house officer at Pims to gain recognition for his degree. What truly appalled me was the revelation that he had been working there without any salary or stipend at all. To compound this grave injustice, his duties frequently involved 24-hour shifts. The doctor, aged 31, was married and had two young children.

The entire narrative left me numb and in a state of shock. How can we expect a doctor, whose heart is heavy and broken by financial hardship, to provide optimal care to his patients?

When I asked him about his monthly expenses in Islamabad, and how he was managing his affairs, he said he was spending more or less Rs50,000 per month, relying on a joint family system for support.

I find it utterly inhuman, immoral and illegal to engage medical professionals, especially in a critical specialty like medicine, on an honorary basis without any remuneration. This practice not only exploits dedicated individuals, it also compromises the quality of healthcare.

The relevant authorities must intervene immediately and formulate stringent rules to prohibit all hospital administrations from hiring doctors without remuneration. Payment should be mandatory for medical practitioners without any exception. If there is a surplus of doctors in the country, the focus should shift to accommodating existing professionals adequately even if it necessitates a temporary halt in the establishment of new medical colleges.

The Pakistan Medical and Dental Council (PMDC), the Ministry of National Health Services, Regulations and Coordination, the judiciary, and human rights organisations should take immediate and concrete action against this unethical and exploitative practice that is afflicting medical professionals.

It is high time we ensured dignity and fair compensation for all those medical practitioners who continue to dedicate their lives to saving the life of others.

Dr Ahmed Bakhsh
Rawalpindi

Published in Dawn, August 25th, 2025