In Pakistan, medical education at the national level is facing multidimensional issues best described by the situation where the public is asking for more and better doctors, young doctors demanding better facilities & training opportunities, older graduates and specialists wanting robust continuing medical education CME programs, both students and teachers in medical colleges dissatisfied with present conditions and regulatory mechanisms.
Above all, the relevant stakeholders such as; the medical organizations (PMA, PMDC, CPSP, etc), the policymakers, and civil society organizations, are not responsive to the situation and show the least interest to reform the scenario. Pakistan is not the only country where such problems exist in the field of medical education1. These problems appear to be universal and all concerned stakeholders are striving to explore ways of solving the crises. Fsc Pre Medical education at the national level should not be seen in isolation; a system approach with holistic and integrated imperatives is the way forward to avert the deepening crisis. The health system (all activities relating to the care of the people) has three components: medical education, the centerpiece (health human resource development), service delivery (care facilities), and research (culture of evidence and use of information).
The effectiveness and efficiency of the health system are judged by the level of social responsibility being fulfilled by the respective component.
At the time of inception, only two medical colleges existed, and, over the years, 61 medical and 25 new dental colleges have emerged. It is also said that the actual number of medical & dental colleges are 98 and 39, respectively, with a total of 137 instead of 86 medical and dental colleges as most of them are in the pipeline and carry some sort of recognition by PMDC.
Presently, the College of Physicians and Surgeons, Pakistan alone is offering 85 post-graduate programs. The annual output of doctors is more than 6000. The impact of medical education at the national level can be analyzed in the light of the burden of disease (BOD), and in Pakistan, both communicable and non-communicable diseases (NCD) exist almost in equal proportions while in West NCD are prevalent. The double BOD poses a major challenge requiring different teaching strategies, provision of care services, and research imperatives; sustainable and substantial resources are needed to overcome both communicable and NCD. Pakistan is not likely to achieve MDGs in 2015 and may touch the targets in 2020 and beyond.
The suggested way forward is to have the following perspectives from ilmibook:
• Integration of academic and service delivery research components would yield an effective & efficient health system to tackle the BOD
• Correcting imbalances in the health workforce and urban-rural facilities would ensure accessible and equitable care.
• Focus of academics on common health problems using appropriate technology with a holistic approach held in the community settings; and in a cost–effective manner.
• Regular update of the curriculum in the context of BOD and evidence-based scientific research; and establishing medical education departments.
• Service providers to be lifelong self-learners; mandatory relicensing and recertification How to do it! A standing commission of stakeholders comprising policymakers, planners, regulators, managers, teachers, students, community organizations should be established to undertake the task.
- Ilmi Book