The fault lines in the medical education system of Pakistan

Better education will lead to better doctors

Pakistan’s medical education system is riddled with a myriad of fault lines, with flawed entrance examination, the contentious teaching pattern, lack of proper infrastructure and resources in the medical colleges, compromised quality of the information being imparted, lack of pragmatic, inclusive and innovative learning, the outdated syllabi, the erroneous pattern of professional examination and the last but not the least is pretty-penny bombastic, useless and inefficient growth of private medical colleges which are meandering a degree into just piece of paper and plaguing the medical education system in Pakistan. It has long been evident that Pakistan’s medical education system is in dire need of greater regulation in order to ensure that a quality standard is being met across the globe. This is imperative if we truly wish to provide our graduates with a level playing field and equal opportunities in their future prospects. Yet, despite these pressing concerns, it comes across as no surprise that the regulatory body is instead more fixated on mandating facile and cosmetic changes in Pakistan’s medical education system in an attempt to ensure that private medical colleges’ monopoly remains a cornerstone of the medical education system.

The first and foremost thing that is maligning Pakistan’s medical education or education as a whole is the methodology of learning and it is even worse to think institutions in Pakistan judge the same methodology during their entrance examination. It is plagued with anomalies like rote learning and memorization, dwindling scope of dissent, parroting of facts, distortion and falsification of the facts. Furthermore during medical entrance examination the total aggregate is based on 50 percent from the rote learned entrance exam and 50 percent from the matriculation and intermediate and these both are also the exams of rote learning. In Sindh these exams of matriculation and intermediate are even more controversial for gross copy culture and getting grades by spending money in the boards. Just think if a student is coming from this background how can he/she learn to critically evaluate the things and how he/she would be a good doctor after all. Moreover, the bad thing that is happening from previous years is that the key of the medical entrance exam is being sold out in the market you can just purchase it and get your exam pass. It means that there is nothing to be worried about for those who have money they can just spend money in the boards, purchase the key for entry test from test conducting bodies and get their child selected.

Secondly the thing that is plaguing the medical education system in Pakistan is the teaching pattern. In most of the medical colleges in Pakistan, if not all, there is one way teaching methodology. The teacher comes and reads hundreds of slides and goes. No discussion and nothing at all. The absence of concept-based learning that fails to develop problem-solving and analytical skills in our medical students is the fundamental gap in our medical education system. While this certainly applies to public sector medical colleges, private medical colleges do share their part in widening this gap as the teaching methods; in general, tend to gravitate more towards rote-learning. If we are going to make a shift in our trajectory towards a more developed, educated and enlightened country, we have to focus singularly on revolutionizing how education is delivered to our students. There is a dire need to bring much more concept-based learning into medical schools at all levels, whether they are top-tier private medical schools or low-income public sector medical schools.

Thirdly, the immensely lamentable aspect is that there is scarcity of innovation in the examination department of almost every college especially in the province of Sindh where the exams are conducted in a very frayed fashion. The students are inculcated whole year with the syllabus that they anticipate from which their exams would be conducted but instead the whole other fiasco of so called‘Past papers’ come into the play and those past papers encompass the knowledge which is most likely deemed redundant in these advancing times. The situation of these exams gets worse when we take a glimpse at the private sector. They mainly hunker around the idea of getting more money out of the people so their examination system is more or less desultory. So what will you expect from a student/doctor who relied on these archaic past papers all of their academic years.

Fourthly, there is lack of novelty in the research department of many renowned institutes. Students are not chaperoned well enough to flourish in this field which is of great assistance when it comes to broaden the horizons of students and the future which they have plotted for themselves. It is said that the socio-economic progress of any nation can be achieved through innovative applications and the commercialization of research but Pakistan is way behind in this norm; particularly in the medical field. The culture of research with analytical skills, critical thinking and strategic insight is essential for transforming a country from being poor and underdeveloped to a successful one. Societies where there is a culture of innovative and creative medical research are able to turn around and seek excellence in human and social development with a focus on better medical education and vibrant medical institutions, but Pakistan has failed on all these fronts.

The other prominent issues include flaws in admissionn processes students are admitted to private medical colleges on lower grades and a lack of transparency in charging the sky rocketing fees dues across different medical colleges.

Fifthly, in most of the medical colleges, if not all, there is no proper infrastructure and resources. Medical colleges lack proper departments, laboratories and instruments. There were only two medical colleges at the time of independence. It was dominated by the public sector till 1990. The corporate sector was then allowed to establish private medical colleges and the balance inclined towards the private sector. According to Pakistan Medical Commission there are currently 48 medical and 18 dental colleges in the public sector and 74 medical and 43 dental colleges in the private sector.  It shows the rapid increase in private medical colleges over the last two decades. Privatization has led to unhealthy competition, poor infrastructure and shortage of teaching faculty, all of which engender incompetent graduates with poor practical skills. The other prominent issues include flaws in admissionn processes students are admitted to private medical colleges on lower grades and a lack of transparency in charging the sky rocketing fees dues across different medical colleges. The system of medical education and healthcare delivery is negatively affected by misdistribution of resources, lack of updated curriculum, flaws in assessment and deficiency of appropriate faculty development programs. Moreover, the direct involvement of private and commercial interests in the higher education has made it a profit industry.

Conclusively, for providing better health care facilities it is compulsory to improve the standards and quality of education being offered throughout the country. In order to promote the social advancement vis-a-vis globe it is pertinent to point out these pitfalls and plan strategies accordingly. There is a dire need of innovative reforms for providing better health care facilities across Pakistan and it is nearly impossible without reforms. Long live the medical arena.

Dr Saqib Javed Arain
Dr Saqib Javed Arain
The writer is graduate of Gambat Medical College and author of two medical books

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