KARACHI, July 15: A survey conducted at the two top government medical colleges of the city reveals that an exceptionally large number of female students oppose the open merit system currently in vogue.

The survey, meant for girls only, was conducted to seek students’ opinion on the open merit system. Zehra Kazmi of the Dow Medical College, Madiha Tawfik and Mahreen Shaikh of the Sindh Medical College assisted in conducting the survey titled ‘Did the open merit system benefit us?’

A sampling of 344 girl students was randomly drawn from around 1,000 students (both boys and girls) of the MBBS fourth and final years of the Dow and Sindh medical colleges.

Fifty-six per cent regard their family members, especially parents, and peers as the driving force behind their decision to join the profession whereas 40 per cent took the decision on their own and four per cent declined to respond in this regard.

Social attitudes

Eighty-five girls agreed that most of the female doctors leave the profession soon after their graduation or within five to 10 years mainly due to social pressures especially after getting married thus contributing towards the problem of shortage of doctors.

The survey results show that 75 per cent of the students rejecting the open merit system asserted that the number of seats for male candidates be increased as regressive attitude towards ‘working women’ was still prevalent in our society, so male students should not be made to suffer due to this system.

Besides social pressures like opposition by the in-laws, a number of other reasons surfaced during the research that compels female students to leave the profession. Nineteen per cent of the students held long working hours as a major cause for leaving the profession; 19 per cent did not answer while four per cent cited lack of interest on part of the students as the reason for the discontinuation of medical practice.

Shortage of doctors

In order to overcome the problem, 33 per cent of the students suggested allocation of equal number of seats for boys and girls in medical institutions while 15 per cent felt that the boy-girl ratio be changed to 60:40. Around 30 per cent of the students called for a revision of the present salary structures and 21 per cent demanded of the government to offer special incentives to the women so as to encourage them to continue working after marriage. Besides, nine per cent of the girls favoured a restriction that makes it obligatory on the students to work for at least five years after graduation.

Night duty and other concerns

Seventy per cent of the students expressed their reservations on night duties, 85 per cent have security concerns in hospitals while 80 per cent were of the view that girls were not generally very receptive of the idea of working in rural areas. Fifty-five per cent thought that girls were open to various specialties like surgery and medicine, while 45 per cent felt the opposite.

When asked about the need for more male doctors keeping in view the various problems being faced by the female students, 73 per cent favoured the idea, 16 per cent were in opposition while 11 per cent did not expressed their views.

‘Change in attitudes a must’

Talking about the survey results, Madiha Tawfik, an SMC final year student, said that this showed that, by and large, girls realised the gravity of the situation and its likely repercussions in the years to come.

She said that nobody was against the system of open merit but the problem of doctors’ shortage was also a ground reality. Instead of blindly supporting this system we should acknowledge this problem which was somehow directly linked to our peculiar social setup where women were supposed to look after homes and children after marriage, she added.

Ms Tawfik said that we needed open-mindedness and change in attitudes instead of open merit to effectively resolve issues plaguing the health sector of the country.

Some important facts

Observers may recall that the open merit system was introduced over a decade ago when the Supreme Court of Pakistan acted upon a petition filed by a girl who was deprived of admission to a medical college on the basis of quota system.

Today a significant number of medical professionals, however, believe that the current shortage of doctors, especially male, is very much due to this open merit system as a large number of girls leave the profession after some years following their graduation.

According to a study ‘Migration, medical education, and health care: A view from Pakistan’, conducted by Dr Jamsheer J. Talati of the Aga Khan University and Hospital, approximately 74,000 physicians were practising in Pakistan in 2005.

Annually, local medical schools and international medical graduate certification provides 5,400 physicians, soon to reach 6,800; 1,150 physicians emigrate and an estimated 570 physicians stop practicing for various reasons.

The current ratio (0.473) of physicians to 1,000 people is inadequate to maintain the nation’s health. Future physician workforce shortages for Pakistan range between 57,900 and 451,102 physicians in 2020, depending upon assumptions about future needs.

The study also says that: “Gender-related factors are a major reason that physicians stop or slow down their practice. Because of marriage, childbearing and family, a sizeable number of women graduates are not practicing. Anecdotal estimates of the percentage range from 5 to 50 per cent. On average, 50 per cent of those admitted to medical schools are women. However, despite a higher pass rate for women than for men, as of December 2005, only 38 per cent of registered physicians are women”.