My prime objective now is to improve quality and standard of MHPE programme in Pakistan

Print

Interview: Dr. Syed Moyn Aly

My prime objective now is to improve quality
and standard of MHPE programme in Pakistan

Feedback from students should not be considered criticism as
it provides an opportunity to make improvements

By Shaukat Ali Jawaid

KARACHI: Dr. Syed Moyn Aly is a noted medical educationist. He graduated from Dow Medical College in 1989 and then after completing house job at Civil Hospital Karachi joined Dept. of Physiology at Baqai Medical University where he served for eight years. He then joined Department of Medical Education at College of Physicians & Surgeons Pakistan. He earned his Masters in Health Professional Education (MHPE) from Holland in 2003. He went to Saudi Arabia in 2005 and joined Taif University as instructor in medical education. In the year 2010 it became a department and was appointed Head of the Department, the position he holds at present. Currently he is also enrolled in PhD programme in a University in Italy. A soft spoken, man of few words, Dr. Syed Moyn Aly is also Course Director for MHPE programme at Dow University of Health Sciences at Karachi. During his recent visit to Pakistan, in an exclusive interview with Pulse International, Dr. Syed Moyn Aly discussed a number of issues regarding medical education in Pakistan, in Saudi Arabia and his mission to improve quality and standard of MHPE programme in Pakistan. Given below are excerpts from the conversation:


Dr. Syed Moyn Aly

What is the significance and importance of having a department of medical education in an institution?

In the past we had guidelines and not rules for teaching by the Pakistan Medical and Dental Council. Principals of medical colleges used to follow those guidelines but a need was felt to improve those guidelines. Establishment of department of medical education can help design curriculum for their respective institutions. We have medical colleges all over the country and needs, requirements of every institution are different. Hence these departments can have a curriculum for their institution based on the PM&DC guidelines. These departments of medical education can also help their respective institution improve assessment and examination system. At present what is happening is that many students who need not pass, get pass and those who need to pass get fail. The medical education department can give their institutions suggestions how to eliminate such incidents, make necessary improvements and also do some research work. They can help people to learn how to teach, offering help and suggestions to the faculty members to teach better.

Do you think having a diploma/degree in medical education is going to become mandatory for the faculty members in medical institutions?

It is going to be so. Many universities and medical colleges are thinking of having a mandatory medical education qualification for their faculty members. At least three medical universities in Pakistan have approached me for help and guidance. Most of the clinicians after having done their FCPS have good theoretical knowledge but many of them do not know how to use this knowledge. Fresh medical graduates start learning the art of medicine during their house job when they have their clinical posting in the wards. Hence why not expose them to clinical medicine earlier on so that they can learn better and are able to use the knowledge they acquire.
In UK, USA and many other countries, having a degree in medical education has become mandatory. In many other developed countries faculty members must have a degree in medical education. Not only that even the consultants who are not faculty members but do get some students for teaching and training, they are required to have some short training courses so that they can teach better. Even in Saudi Arabia this is the trend. They have started Master’s Programme in medical education in two places at Riyadh and at Jeddah.

Don’t you think those faculty members who fail to get any diploma/degree in medical education will suffer form inferiority complex while serving on the faculty?

Gradually all the faculty members will either join and become a member of the team willing to change or fade out automatically. These are the two natural processes.

How many medical schools Saudi Arabia has at present and do they have enough faculty members?

There are thirty five medical colleges and they require a large number of faculty members. Even in the next ten years, they will have to depend on faculty members from overseas particularly in the basic subjects. In the clinical sciences, the trend is there and more and more Saudis are going for post graduation in clinical medicine but not in basic sciences.

What about the various terminologies like Problem Based Learning, Students centered and teacher centered learning which we hear?

They all represent various schools of thought and philosophy. There has been a lot of research in medical education even in 1940s and some even suggest even much earlier. The concept of learning has changed. It is extremely important that one should know how to use the knowledge one has. Hence people need to be guided, enabled to use their knowledge better. Literature search will reveal there have been many studies in this regard and now we have many specialized journals of medical education in various countries. Medical Teacher is a well known journal in medical education. We do not have any medical education journal at present but in the days to come, we might have one.

For the last few years we hear a lot about integrated medical education but there is also strong resistance from the teachers from basic medical sciences. Is this resistance justified and how one can improve the situation?

This resistance on the part of basic science teachers is justified to some extent but it is based on some misconceptions. They fear that once integration takes place, basic sciences will disappear. It might lead to having just one department of clinical faculty and one department of basic science faculty. The individual departments of Pathology, Microbiology, Anatomy etc., having various Heads of Departments will disappear and we will have some sort of a system like Aga Khan University. In reality it is not like that. We need integration at different levels and not a single unit. Medical institutions can keep the various departments as per their requirements. These misconceptions of basic science teachers need to be removed through capacity building measures. A change is taking place, thinking is changing. Various institutions are moving forward for integration and eventually it will come. Vice Chancellors of various medical universities as well as Pakistan Medical and Dental Council has created lot of awareness in this regard. Now medical teachers are aware and they are also mentally prepared for this change. Hence in the days to come we will achieve and accomplish integrated medical teaching.

What about the faculty members who will still resist any change in integrated medical education?

With the passage of time, they will also change and support this movement for integrated medical education, because there won’t be any other option and they might find themselves out of the system.

Feed back from the students about their teachers, it is said, should be taken and their views conveyed to the faculty members to help improve the quality of teaching. Do you think it is feasible and practical in our circumstances as we do not have such a culture?

As you have yourself stated, we do not have such a culture. Feed back should not be considered as criticism. It provides us opportunity to make improvements. This feed back should be two ways and not just from the students. We are reluctant to adopt such a culture which is of course extremely important. The misconceptions about feed back among the faculty members needs to be removed. This culture will also develop gradually as medical education departments are being established. However, it is important that these medical education departments should be staffed with competent, qualified and experienced people which are now going to become available in greater number as many medical institutions including medical universities have started Diploma/Masters programmes in Medical Education. As more and more people will qualify, they will be available to serve in these departments.

Don’t you think we are having a mushroom growth of such programmes and no one is paying any attention to quality and standards?

One of my prime aims now is to work on how to maintain quality and standard of MHPE programme in Pakistan. At present we are lacking in quality. In the coming days we will have proper Departments of medical education in all the medical institutions and hopefully they will be functional as well. Many trained people will become available and the institutions can use their services. They will have proper guidelines on medical education which will be implemented.

How you are going to achieve that?

I have had discussions with relevant people and we had lot of interaction. We have discussed the issues we are facing in MHPE programme. Our discussions continue how to solve them. We are hopeful to find a solution which will be helpful for all and won’t harm any one. I am very hopeful that we will achieve this because people in authority listen to me and they are positive about it.

What you think should be the criteria for selection of faculty members?

They must have proper qualifications which are a must .Then they should have done some courses in medical education. Above all it is extremely important to get some feed back from the institution with which they have remained affiliated in the past.

You have served in medical institutions in Pakistan and now you are affiliated with a medical university in Saudi Arabia. What differences in medical education you have observed in Pakistan and Saudi Arabia?

Saudi Arabia has got lot of money and the Saudi Health Authorities are also eager to make improvements keeping pace with the latest developments. What is also more important is the fact that Saudis also spend their money wisely. We in Pakistan lack financial resources. Saudi Arabia knows they have to change but here in Pakistan we resist any change. Deans Committee which was established in Saudi Arabia only a few years ago has done a lot of good work. They have accomplished a lot of improvement in academic work. They know that either they have to modernize or they will be left behind, hence they are prepared for making rapid progress and development but we in Pakistan not yet seem to be prepared for all this.

All these new developments in medical education is the result of some serious research work or is it a part of gradual shift towards professionalism? Now examination system has also undergone lot of changes and examines are trained how to examine the students though in the past there was no such system and still we had some of the best medical teachers in our institutions?

It is the result of both, research as well as the move for going for professionalism. You are absolutely right that despite the fact that we had no such developments in the past but we had some excellent teachers and they did a commendable job and produced best quality of healthcare professionals despite lack of facilities and meager resources. Now we have MCQ banks, the concept of problem based learning has been introduced. A need was felt and as there is always some room for improvement, hence these new development took place.

What do you think are the qualities of a good teacher?

First of all he or she must be skilled in teaching in his/her own specialty. They should know the problems they face and how to solve them. Thirdly a good teacher must be sensitive to the needs of the students, respond to them and must be capable of teaching the students “How to catch the Fish” as the famous Chinese proverb says. They should be friendly and easily accessible, approachable to the students and also know the cultural changes.

We have seen revolution in information technology. How has it affected the medical education?

Developments in information technology have given birth to e learning. Even in our houses we see the children playing with computers, may be games or doing some academic work. We will have to keep pace with these changes taking place at a very fast pace. We now see students reading from iPads rather than books. Lot of books, journals are now available online. People’s requirements have changed rapidly. However, human touch remains important and it will remain. We see lot of developments in telemedicine. In some countries, it may not be possible to provide for actual patients hence teach the students on simulated patients but in developing Third world countries like Pakistan we won’t have such problems at all. We will have enough patients available for teaching, hence this human and emotional touch will remain there.

Finally what attracted you to Saudi Arabia?

I wanted to have some experience of working oversees as well. I also needed some challenge hence when I got an opportunity, I availed it and went to Saudi Arabia, have learnt a lot while working there.