Punjab’s medical governance: An imperial system that isn’t interested in training specialists

We all know about doctors going on strikes and the nuisance and discomfort caused by these events. Our media loves to tell us, “doctors ki ghaflat ki waja sa aik aur mareez zindagi har gaya

These lines are becoming a part of daily tickers and breaking news in almost all media franchises, especially in the Punjab province where almost half of the Pakistani population resides.

So where is the problem? Although the problem primarily lies in our improper eating habits and our unhygienic drinking water consumption, we simply know that doctors are once again on the road causing poor people discomfort and causing us to lose precious lives due to their arrogance and demands. This picture is portrayed by our electronic and print media almost daily. The irony is after the strikes end, the common people are still unable to fathom why doctors are protesting. For this I blame the poor media management by the doctors’ fraternity.

By using this forum I will try to explain why doctors are protesting. Let’s start with Central Induction Policy (CIP).

The CIP is a policy in which doctors are appointed among different teaching hospitals and different departments to start their training in their respective fields. The problem is that around 1,000 seats are in CIP and there is very little chance that you can get training in your choice of department. Let me phrase this simply by saying that if a doctor wants to be a child specialist (pediatrician), there is big chance that he/she might not get a seat in pediatrics in the entire Punjab province. This doctor may be able to secure a seat in dermatology or psychiatry instead. Considering this: the doctor is in a dilemma about either to wait for a seat in his/her desired field or join the offered seat and start training.

My question is: how one can expect a doctor to give 100% in a field in which he/she holds no interest?

The other problem, which is usually not highlighted enough, is that the Punjab government is inducting medical officers on regular basis – almost 3,000 regular medical officers have been inducted in the last 2-3 years. A medical officer has fixed 36 duty hours to complete per week. At the same time, a post graduate trainee is working 56 duty hours minimum per week. The pay of post graduate trainee is far less than that of medical officer, so one begins to wonder why the provincial government is creating more and more seats for medical officers but not creating enough posts for trainees. Some say that most of the medical officers’ seats are in the primary and secondary health department, where they post these medical officers in far flung areas basic health units, rural health centers and tehsil headquarters. They are right to an extent, but a huge number of these medical officers are deputed in district head quarters and teaching hospitals too. For instance,in a recent newspaper there is an advertisement of vacancies for 229 medical officers for Mayo Surgical Tower only. If you compare this to this year’s post graduate trainee induction, which would be around 100-120 in Mayo Hospital, it is only then that you realize that Punjab government is keen on inducting more medical officers than post graduate trainees. But why is this so? The answer to this is that a medical officer can be terminated with a simple stroke of pen without any notice and medical officers do not participate in strikes. They do what they are told to do. This imperial system is hurting the medical field badly because rather than making more specialists, it is making more and more doctors who are just passing their duty time.

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  1. Dr Hashir Amin Malik says

    Perfectly summed up the agony of young doctors

  2. NASIM ILYAS says

    Very good article

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