Abdul Razak Shaikh
THERE are around 85000 female doctors, who completed their medical education on the expense of the State or privately but they are not part of the medical workforce in Pakistan. If only 50 per cent of these out of profession female doctors are mobilized, 70 per cent health issues of people in low-income group communities can be resolved. A large number of women in lower income group communities in Pakistan don’t have access to healthcare facilities but there are thousands of out-of-profession female doctors, who can be mobilized to serve these patients through telemedicine. This would not only lower disease burden but would also save thousands of lives in the country.
An expert in medical profession has informed that about 50 per cent of women, who graduated from medical colleges, never worked. Pakistan Medical and Dental Council (PMDC) sources said that female medical students occupied the general merit seats in public sector medical colleges and got subsidy but after completing their education they never started their professional career. The government spends Rs 2.4m on each medical student who takes admission to a medical college on general merit seat. Only 50 per cent of female doctors are working. On the other hand, a number of doctors (mostly males) have gone out of the country. There are around 50,000 to 60,000 medical practitioners against the demand of 600,000 in the country. Pakistan is producing around 14,000 doctors per year out of whom 70 per cent are women. In Pakistan only $9.3 are spent on the healthcare of each citizen per year against the international standard of $60.With such scant resources and a number of medical practitioners, Pakistan cannot meet its needs for healthcare.
Moreover, the migration of doctors and the rapidly increasing population is adding to the problem. Students who got admission to medical colleges on general merit seats paid around Rs15, 000 to Rs20, 000 fee a year, so they completed their MBBS by spending around Rs100, 000. Unfortunately, after completion of the course, most of the female medical graduates never worked. Those who want to work try to leave the country and settle abroad. We really do not know how many women doctors work. And in the absence of any evidence, we really have no basis to claim that a majority of them do not work. In fact, the little evidence we do have (like PMDC registration statistics), it shows that every year, more and more women doctors complete their house job and register them with PMDC with the intent to practice.
The government body that regulates the medical profession, the Pakistan Medical and Dental Council, says more than 70% of medical students are women. In other words, perhaps the success of women students is not so much their own hard work; it is embedded in the culture of keeping girls at home. And government figures suggest most of these bright female undergraduate doctors do not actually go on to practise. Only 23% of registered doctors are female. This is a model that does not fit the experiences of the majority of women (and many men, for that matter, in the current state of our economy). Actual careers of actual women doctors are much more complicated and almost impossible to label. Do not get me wrong. We need doctors to work in our hospitals, to be available in emergencies 24/7, to look after our mothers and children whenever the need arises.
We need women to work because otherwise, we miss out on their perspectives, their ability to empathize, to care and to listen. But this cannot happen without taking a deep and critical look at our homes and our workplaces. Stand behind the doctor’s table in the emergency ward, with 10 patients thrusting their parchi in your face. Go to the OPD, where you won’t be able to walk through the crowded corridors. Spend a night trying to manage a diabetic patient in ketoacidosis, or trying to alleviate the pain of a patient with tetanus. Or see a young child die of dehydration or a mother due to eclampsia. Then go home. Pick up your child’s toys from the floor. Pick your spouse’s laundry. Wash the dishes. Cook a salan, knead some flour and make rotis. Press the uniforms and dress you need to wear tomorrow. Make lunches and fill water bottles. Check that your children have done their homework. And when everyone sleeps, make that crown that your daughter’s teacher asked her to bring. So next time you feel the urge to say that women doctors leave their career out of choice, walk a mile in their shoes first. Health experts demanded to revise the open merit admission policy in medical colleges to overcome the doctor’s shortage in future.
The PMDC has abolished merit-based admission policy for medical colleges and instead reserved 50 per cent seats for boys and the other 50 per cent for girls in 2014 but later on Lahore High Court rejected the Notification of PMDC, gender-based admission policy in MBBS, calling it a violation of fundamental rights protected by the Constitution. The PMDC may formulate a proposal under which every student who got admission to a medical college on the general seat would be bound to work in the government or private sector in the country for at least three years after graduation. Those who want to go abroad would have to pay the amount of subsidy ie Rs 2.4 million, paid by the government for their medical education.
— The writer is retired officer of Sindh Govt.