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This presentation highlighted the process that the MoH in Oman used to build consensus on the importance of establishing the role of NP in Oman. All of what has been presented could be used by other health systems especially in GCC
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2. Glossary of Terms
BOG: Board of Governors
CM: Chief Minister
CIS: Central Induction System
GMC: General Medical Council
ЈРМА: Journal of Pakistan Medical
Association
JPMS: Journal of Pioneering Medical
Sciences
LHC: Lahore High Court
SCP: Supreme Court of Pakistan
METCD: Medical Education & Tertiary
Care Department, Punjab
PMDC : Pakistan Medical & Dental
Council
PNC: Pakistan Nursing Council
WFME : World Federation for Medical
Education
PMC Pakistan Medical Council
YDA Young Doctors Association
UHS University of Health Sciences
SH&ME Specilaized Health and Medical
Educaion
3. Statement of the Problem
• Medical education has major implication for health sector of a country and well being of its
citizen. Low quality of Medical Education in Pakistan poses major risks for users of health
facilities. If not corrected this state of affairs can have drastic consequences for health care
system as well as economy of Pakistan.
• This paper explores the current state of Private Medical Education in Punjab and reviews the
challenges of quality it faces.
4. Key Research Question
What measures are required to be taken to improve the medical
education system in Punjab and how can medical education be made
better?
5. Historical Background
• The Public sector was the sole custodian of the medical dental and
health education till 1997.
• The First private medical college was established on20 March 1997
and it remained the only one till 1999.
• On 4th August 1999, Health Deptt. Introduced policy for establishment
of private medial colleges.
• As per policy the private sector was permitted to establish medical
colleges in line with PMDC SOPs.
• (Source. Specialized Health Care & Medical Educaiton Deptt Punjab)
6. Medical Education Options
• Public Medical & Dental Colleges / Universities.
• Private Medical & Dental Colleges / Universities.
• Nursing Colleges.
• Homeopathic Medical Colleges.
• Tibbia Colleges.
7. Back Ground and introduction
• The number of private medical colleges in Pakistan has grown
exponentially over the past two decades especially after 2008.
• The issue of Medical Education has become a matter of much
importance as the doctors and allied health science staff deals with
the human life.
• We have witnessed a mushroom growth of private medical college in
the past few years. 43 Colleges in Punjab.
• High merits and limited numbers of seats.
9. Medical Statistics of Pakistan
• Europe has 3.5 doctors against 1000 patients.
• WHO says 1.3 doctors against 1000 patients in third world countries.
• Pakistan has 0.7 doctors against 1000 patients. A dismal picture.
• Total Numbers of doctors in Pakistan 1,70,000.
• Out of these 5500 are foreign degree holders.
• (Source. World Health Organizaion Report 2022)
11. Province wise figures of Doctors
Punjab KPK Sindh Baluchistan AJK
70190 64975 68790 3579 20792
12. University of Health Sciences
• It was created on 28 September 2002 with a vision to reform
• Medical Education
• Health Research
• Improvement in health care delivery.
• Section 37 of UHS Ordinance 2007 empowers it to harmonize medical
education.
• All the Public and Private Sector Medical institutions got affiliated
with it which ensured the transparency in examination systems.
13. International Medical Institutions
• The best international medical institutions are private like Howard,
Jhon Hopkins, Stanford, Yale, Mayo. We need to have in our country.
14. Situation in the other world
• There are almost 3,000 medical Colleges in the world. With India
having 532 medical colleges, Brazil 277, China 194, USA 192 and
Pakistan on number five position in the world with 114 medical
Colleges.
15. Causes
• It is the dream of every student to become a doctor but
commercialization of the medical education has worsened the
situations.
• Enormous growth of the Population.
• Lack of Public Sector medical colleges.
• Unemployment in other fields of education.
• Pandemic Covid 19, the Dengue calamity posed a serious danger to
the community. Such epidemics necessitated the enhanced number
of doctors nurses and allied health professionals in the provinces.
16. Causes
We have the alarming rates of mortality from diarrhea, pneumonia
and hepatitis, excreting pressure to train more physicians.
Patients are regularly denied treatment at public hospitals that are so
overcrowded, often the only way to see a doctor is to go to a private
hospital.
The vast majority of parents in Pakistan dream of seeing their children
in white coats.
Encouraged by Idealism, a large number of young people are
aspirants to become a doctor after passing FSC.
17. Causes
• There were 8 medical colleges till 2008 and uncontrolled proliferation
of private medical colleges exhibited a sharp decline in quality of
education.
• Focus shifted from uplift of education to maximization of the profit.
• The research work almost fell into oblivion.
• The nursing and allied health sciences being less lucrative were
neglected resulting decline in the health professionals.
• Resultantly numbers of doctors increased giving entailing
unemployment.
19. Challenges
• Lack of strong medical education regulatory system and quality
assurance processes.
• The most of the private medical colleges are giving out fake results
and enhanced performance reports.
• Commercial Motives
• The mounting political influence, commercialism in medical
education, weak regulatory capacity of accrediting body, violation of
rules, lack of skilled inspectors and objective assessment criteria.
• At present a large majority of students do not have access to
international standards of medical education.
21. PMC ACT 2020 & NLE(National Licensing Examination)
• PMC Act was passed on 23rd September 2020.
• After this Act Pakistan Medical & Dental Council PMDC was renamed
as Pakistan Medical Council PMC.
• As per this act, every doctor is required to pass National Licensing
Examination NLE irrespective of his institution.
• This step has ensured harmony and uniformity.
• It assesses the student without discrimination of public or private
sector institution.
22. Issues
• High Fee Structure; The major disadvantage of private medical
colleges is their high fee structure. They create their fee structure
without any rules and regulations.
• Inexperienced faculty; in most of the private colleges the faculty is of
low or average standards.
23. Issues
• Private medical colleges are earning millions and millions of rupees in
the name of admission forms, pre-admission tests, exorbitant
admission and tuition fees and donations.
• There are no quota seats/scholarships for the under privileged.
• Doctors from private medical colleges will try to get back their money
through unethical private practices seems to stem out of these poor
standards of education in private medical colleges.
• Only a few private medical colleges stand near the international
standards, lacking good faculty, infrastructure, publications, quality of
education as assessed by the students, public image, etc.
24. Flaws in Monitoring System of Examination
• Mounting political influence
• Bias in the selection of inspectors
• accreditation standards
• Public-Private sector divide
• Rapid growth of medical colleges
• Increased faculty turnover
• Commercialism in medical education
25. IMPACT / ANALYSIS
• Shortage of professional teachers.
• Infrastructural problem
• Attitude of Doctors
• Outdated curricula
• Syllabus variations
• Complexity of Medical Education.
• Role of university of Health Science.
• Forged Performance
27. Global Practices
• In china Russia Uzbekistan and India, we have witnessed a massive
growth of private medical colleges which are catering to the
indigenous need along with housing a large number of foreign
students.
28. RECOMMENDATIONS
• The medical institution must have the approval of an international
accreditation body after 10 years of establishment.
• There should be written, more transparent, strict and strict parameters for
admission in private medical colleges.
• There should be incentives and preferences for jobs and scholarships for
graduates of internationally recognized institutions.
• Strict disciplinary action should be taken against institutions that fail to
comply with the standards recognized by the PMC.
• There should be a limited period of identification by PMC (5-8 years) after
which it must be re-examined. It will also include an overview of existing
facilities upgrades.
29. RECOMMENDATION
• Having a few institutions of high quality and international standards is
far better than the fish market of non-quality medical colleges.
• The head of the regulatory body should never be a government
employee and there should be no political or financial interference
from governments.
• It is recommended that PMC place more emphasis on quality
parameters to improve medical education, as observed by various
international accreditation bodies.
• PMC has to play a leading role in achieving and maintaining the
highest standard of medical education in the country.
30. Recommendations/ Conclusion
• Every institution should have fully functional and well stocked library,
well equipped laboratory, museum, dissection hall, lecture and
tutorial hall, and hostel facility.
31. Conclusion / Recommendations
• Medical colleges should also be allowed to experiment with different
teaching methods and staff patterns.
• Medical Colleges should only be evaluated on the performance of
their graduates.
• Strict Assessment of the curricula and examination system.
32. Conclusion / Recommendation
• Both external and internal audit of private medical institution be
conducted on regular basis.
• Definition of standards for establishing private medical college.
• The college must own a land more than 15 acres.
• The college must have its own hospital with all the specialties.
• Financial feasibility and infrastructural adequacy be given much
consideration while granting permission.
• Highly qualified faculty with job security so that they may perform
duties with full devotion and dedication.
33. Bibliography
• Creswell, JW and Creswell JD. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches
SAGE Publications, 2017.
• Shehnaz SI. Privatisation of medical education: Viewpoints with a global perspective. Sultan Qaboos Univ
Med J 2010;10:6-11.
• http://www.pmdc.org.pk/UGraduate/ tabid/294/Default.aspx
• Accreditation of medical institutions. Report of a technical meeting. WHO-WFME task force on accreditation.
Copenhagen; 2004
• Chaudry A. PMDC bars admission to 17 medical colleges. The DAWN 2015 Jul 2:sect.National: 18
• Leaping Forward. A report on higher education in Pakistan. New York: Promotion of education in Pakistan
foundation; 2006 Feb. P 125
• Hansen MN. Private education and academic performance among medical students. Tidsskr Nor Laegeforen
2005;25:2216–8.
• Recommendations of Symposium on Medical Education. JPMA. Nov. 1987, JPMA., 1988; 38:59-61.