Powerful elements out to sabotage long-awaited medical education reforms

PESHAWAR: The federal government has for the first time initiated efforts to streamline affairs of the public and private medical and dental colleges to improve medical education but some powerful elements are out to sabotage these long-awaited reforms by hook or by crook, well-placed sources at the Pakistan Medical and Dental Council (PMDC) told The News.The task is challenging as it is for the first time the government has decided to inspect medical and teaching institutions through an independent team.Ex-chief justice of Pakistan, Mian Saqib Nisar, had dissolved the PMDC and formed an ad hoc council under former Supreme Court judge, Mian Shakirullah Jan for dealing with issues related to the PMDC.Justice Shakirullah Jan later constituted an ad hoc medical education committee. It was headed by Prof Arshad Javaid, vice-chancellor, Khyber Medical University (KMU) Peshawar.The committee developed 12 accreditation standards and measuring tools for public and private medical colleges.The new council amalgamated the new and old standards. Attention was focused on improving medical education, students’ welfare and facilitation and academic organisation.President Arif Alvi through an ordinance has now constituted a new council for the PMDC and tasked it to handle all the issues.The biggest task has been given to Prof Dr Aamir Bilal, head of the Department of Cardiothoracic Surgery, Lady Reading Hospital (LRH) in Peshawar.The council has constituted an evaluation committee and Dr Aamir Bilal has been made its chairman.There are 167 approved medical and dental colleges in the country. Another 12 have applied for registration with the PMDC.The evaluation committee has decided to inspect all public and private medical and dental colleges to assess them as per new standards of the council. A comprehensive proforma has been developed for the purpose.As the majority of the colleges had not been inspected by the council for years after their establishment, it created unrest among the owners of certain private medical and dental colleges as most had certain serious deficiencies.During a training workshop organised by the Khyber Medical University (KMU) at the LRH for the PMDC inspectors, Dr Aamir Bilal said certain influential people don’t want the council to inspect their institutions and let them do whatever they have been doing for years.He complained that he had been receiving threats and bribes. He vowed to continue efforts for overhauling the system pertaining to medical education.Dr Aamir Bilal said private medical and dental colleges had become one of the most profitable businesses in Pakistan. He disclosed that one college was making Rs90 million profit per month.In Punjab and Sindh, he complained that 85 percent of the doctors backed out of their commitment to attend training workshop held for the PMDC inspectors last month as they were concerned about losing patients at their private clinics.In Khyber Pakhtunkhwa, he proudly stated that all the doctors honoured their commitment and turned up at the training workshop.The inspectors would spare two days, voluntarily, and the college of one province would be inspected by the inspectors from other provinces.“We are not in the business of shutting down colleges, though I could have closed some of the so-called colleges. The effort is to work together and improve medical education in the country,” Dr Aamir Bilal explained.The council would start the countrywide inspections of the colleges this month. According to insiders, the council recently visited four medical colleges in KP, two each public and private, and found one public sector college in Peshawar not fulfilling criteria of the council as per the new standards.One private medical college was found as per standards set up for category A. However, another private medical college in Peshawar didn’t fulfill the council’s criteria.Prof Dr Arshad Javaid said the prime objective of the new standards was to improve medical education, particularly in the private sector which was never touched in the past.One such private college run by a retired general in Punjab was closed by the council due to serious deficiencies. The Supreme Court of Pakistan didn’t give it relief but the college continued to admit students.Another purpose of the exercise is to rank the colleges.The college would need to provide biometric attendance of the faculty. The inspectors would not challenge the credibility and professional worth of the faculty accredited by the PMDC.The colleges getting 85 percent marks would be ranked as A-plus. Besides other financial benefits, the college would be exempted from inspection for three years.The college found below the rank would be given one year for removing deficiencies till the next inspection.In case it failed again, the college would be closed and the students accommodated in other colleges. The students of private colleges would be adjusted in another private college.For recognition, a college needs to have proper clinical specialties, including 75 beds each for internal medicines and general surgery, 50 beds of obstetrics and gynaecology, 15 beds each for eye, ENT, orthopedics, 10 beds for anesthesia, 5 beds each for psychiatry, dermatology, cardiology, CCU, neurology, nephrology, dialysis and gastroenterology and a 10-bed medical ICU.Also, the hospital should have any one of rheumatology, endocrinology, oncology or infectious diseases unit of five beds.The hospitals would need to provide patients data verifiable from Health Management Information Systems (HMIS), OPD load per speciality, inpatient load, and at least 70 percent bed occupancy in 12 months. Besides meeting legal and infrastructure requirements, the college will be required to have 90 percent each of equipment, faculty and teaching staff at the teaching hospital.The inspectors would include biomedical engineers, institution management experts, basic sciences faculty, medical education experts, clinical sciences faculty and architects/civil engineers.

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