There is disparity in what we intend to produce and what we are doing-Moyn Aly

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Medical, Dental Education in Pakistan
There is disparity in what we intend to
produce and what we are doing-Moyn Aly
There is disconnect between the policy makers 
and Researchers in medical education - Lubna Baig
Learning is detection and correction of
errors-Ayesha Abdullah

LAHORE: Prof. Junaid Sarfraz Registrar at NUMS along with Dr. Saima Chaudhry chaired the session devoted to “What the Experts Say” during the Shalamar Medical & Dental College 4th International Conference held here from February 1-2, 2020. Dr. Syed Moyn Aly from JSMU Karachi was the first speaker who talked about challenges of Change: Bringing the dream of undergraduate medical, dental education closer to reality. He was of the view that there is a disparity in what we intend to produce and what we are doing. We wish most of the medical graduates to settle in general practice but they are all trained in tertiary care hospitals. We do produce specialists but we do not produce GPs.

Group photograph of chairpersons, guest speakers and some participants of the session
“What Experts Say”  during the recently held 4th Int. Conference of SMDC held on
February 1-2, 2020.

Continuing Dr. Syed Moyn Aly said that during the four years of basic sciences, there is overlap of clinical sciences. We are giving too much time to subjects in which the students are not interested, is too much time is being spent on teaching basic sciences in medicine and dentistry while we need to allocate substantial time for Family Medicine. Most of the dental students are being trained general dental practitioners. They are not given enough training on history taking and physical examination. Dental graduates are not happy with their examinations. At present the dental students learn in one year what the medical students are supposed to learn in three years. We need to train the medical and dental graduates in communication skills, leadership skills, patient safety, professionalism and research. The regulatory bodies and universities need to realign their goals, he remarked.

Prof. Lubna Baig also from JSMU spoke about Whimsicality of Policy makers and incumbent chaos. She pointed out that better patient care will improve our health indicators. Speaking about the current state of affairs as regards PM&DC or PMC, profession, Higher Education Commission, she said at present there is lot of confusion and chaos among the faculty members. She also talked about value of the degree and changes in experience certificate. Previously the students were allowed upto four attempts to clear the exam but now there is no time bar and a student might spend ten to twelve years in a medical school. There is lack of continuity of policies, there is disconnect between the policy makers and researchers particularly in medical education. Policy changes are based on personal preferences. She was of the view that we need evidence based policy and need to involve all the stake holders. We must also ensure that policy is based on principles. At present there appears to be no policy and it will give license to kill. In HEC there is none with a medical background which is a greatest set back, she added.

Syeda Kausar Ali from JSMU discussed facilitating the change. Change, she opined, is always painful. A positive change is always based on principles. Speaking about the changes in higher education she referred to harassment policy in institutions. She also referred to cultural change and emphasized the importance of planning for a culture change. We also need to define complexity and scope, what will be the impact of the proposed change and we need to create an environment for a change. There will always be some resistance to change. One needs to communicate properly how you intend to bring the change. Create competent teams, provide needed support, go for capacity building, strengthen the culture of teaming, decentralize and change management plan in academia. Keep on continuously talking to the people, inspire them for a change. Change should be evolved and develop leadership allegiance who will change it. If you work on change, it will bring sustainable change, she added.

Picture on left shows Mr. Shaukat Ali Jawaid Chief Editor Pakistan Journal of Medical
Sciences presenting a Memento to Prof. Junaid Sarfraz who chaired the session on
“What Experts Say on Medical Education” during the 4th In. Conference of Shalamar
Medical & Dental College held on February 1-2, 2020. On right Prof. Junaid Sarfraz is
presenting mementoes to the invited guest speakers in this session i.e. Dr. Syed Moyn Aly,
Prof. Lubna Baig and Dr. Syeda Kausar Ali. On extreme right is Dr. Saima Chaudhry who
co-chaired the session.

Dr. Ayesha Abdullah from Peshawar Medical College talked about existional challenges, what medical educators do, change and learning and what is exactly meant by existional challenge. Change, she said, means to become different. She also referred to professional death and pointed out that change is at border of scrutiny and excitement. Learning is detection and correction of errors. If there is no learning, there is no education and no change. No change in behaviour means no learning and no education. Education changes the society and the profession. There is self consciousness and perceptions how others see it i.e. patients, society, teachers. Peers are also important players. Me will make us change “I”. She then referred to organization of profession and how to respond to challenge of change. She also talked about the nature of change what we are currently experiencing. How health is changing and what is being done to help facilitate this change taking place. Now teachers have become facilitators and guide, students have become colleagues, patients have become clients and health has transformed from a human right to an industry. Health care has changed from life saving to life threatening. Radical change is more difficult while peripheral, change has low resistance and incremental change has moderate resistance. Referring to a change in life, she said if we cut some branches of a tree, they will be replaced by new ones.

Dr. Sadia Shahzad was the next speaker and she shared the findings of her study regarding perception of undergraduate medical students regarding educational environment at a private medical college at Lahore. The problem, she said was more emphasis on training with very little focus on whole educational environment. At present there are gaps. Weaker are indisciplined and these issues are not addressed accordingly. She laid emphasis on regular assessment of educational environment. There were 375 students who participated in this study from first to fifth year class. It included 55.5% female and the mean age of the students was 21.4 years. Her findings were that 23.2% needed some more training, 17.8% had more negative aspects, 24.3% felt there were many issues which need to be changed while 28% felt it was not a nice place. Negative aspects need follow up. She concluded her presentation by emphasizing the importance of regular assessment of educational environment as it keeps on changing. She was of the view that it was time to change our approach.

One of the students of SMDC was the next speaker and she felt that it was the attitude of junior doctors which makes the difference. We professional students should be more careful in our personal life. Findings of the two teaching sessions showed that there was improvement in professional attitude of students after intervention in the Dept. of Obstetrics & Gynaecology. They became better professionals. During the discussion it was pointed out that we need to produce Family Medicine specialists. Summing up the session, Prof. Junaid Sarfraz sad that we all are facing existional crisis and challenges. Change should be incremental to be sustainable.

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