13,348 Pakistani physicians are in active practice in USA while 25% of Residents are IMGs-Jack Boulet

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 ICHPE 2018 Proceedings-III

 13,348 Pakistani physicians are in
active practice in USA while 25%
of Residents are IMGs-Jack Boulet

Virtual Patients are increasingly used in medical education
in developing clinical reasoning skills-Hesham Marei

Assessment has now moved to a more holistic
and subjective notions-Dr. Eraky

LAHORE: The first plenary session during the Second International Conference on Health Professions Education organized by University of Lahore from October 14-17th was jointly chaired by Dr.Gohar Wajid, Prof. Idrees Anwar and Prof. Rahila Yasmeen. Dr. Jack Boulet from USA was the first speaker who spoke on the Contribution of Pakistani educated physicians to the international health workforce. He pointed out that at present International Medical Graduates (IMGs) account for 24% doctors in USA and the number of Pakistani educated physicians in active practice in United States was 13,348. During the last few years there has been an overall 16% increase in physicians and 13% increase in Pakistan medical graduates. He termed it as brain circulation instead of brain drain. Of these Pakistani physicians working in United States, 12,333 are citizens of Pakistan and it includes 8,799 male and 44% of them are working in primary healthcare.


Prof. Awais Rauf, Dr. Gohar Wajid, Prof. Rehan Khan along with other guests photographed
at the formal launch of Health Professions Education Journal which has been published by
the University of Lahore and Society of Medical Educationists (SOME) a newly formed body
of medical educationists and University College of Medicine and Dentistry during the
inaugural session of ICHPE 2018 on October 16th 2018.

Giving further details about these Pakistani physicians Dr. Jack Boulet said that 3,295 are graduates of Dow Medical College, 2,108 are graduates of King Edward Medical College while 1,394 were graduates of Aga Khan University Medical College. The number of doctors now going to United States, he further stated, has decreased and after 2023 only those graduates who have passed form institutions accredited by World Federation of Medical Education (WFME) will be eligible for residency training in United States. In Step-1 of ECFMG Pakistani doctors are doing better. Doctors are going overseas because of inappropriate healthcare set up locally. However, since public funding for training of doctors is paid by the society, there are some apprehensions about this brain drain. Workforce disparity in United States, he said, will continue and it will continue to rely on International Medical Graduates in the years to come as well, he added.

Assessment of personal qualities

Dr. Mohammad Al-Eraky from Saudi Arabia spoke about the Assessment of personal qualities at the “IS” level. Assessment, he said, has now moved to a more holistic and subjective notions. New domains of assessment have emerged over the past few years beyond the individual’s knowledge and competence. It has a great impact on the future careers of healthcare professionals. He explained this theory by saying that one must have a pilot Gene to become a Pilot. His presentation in fact posed more questions than providing answers. He wondered as to what general personal qualities are a must while selecting students for medical and dental schools. Empathy, emotional intelligence and personality traits are important. MMI is reliable and acceptable.


Prof. M. A. Rauf presenting Mementoes to Guest speakers from ( L to R) Dr. Eraky from
Saudi Arabia, Prof. Jack Boulet from USA and Dr. Hesham Marei at Gala Dinner during
the ICHPE 2018 held at UOL Campus on October 16th 2018. Prof. Shahid Mahmud
Malik is also seen in the picture in the center.

We must ensure as a team potential in the applicants. They must have ability to tolerate uncertainty. Must be a team player, conscious, honest and reflect integrity. They must be aware of relationship with other healthcare team members, possess resilience, emotional and social intelligence. They must have potential qualities for specialization and above all potential to be a professional. Assessment of personal qualities should not be too much judgmental, he remarked.

Use of Virtual Patients in Medical Education

Dr. Hesham Marei’s presentation was on “Twelve Tips for effective design and integration of virtual patients in medical education”. He pointed out that a Virtual Patient (VP) is recognized in the context of medical education as an interactive computer simulation of a real-life clinical scenario for the purpose of teaching, learning and assessment. Virtual patients are being applied at an increasing rate and with growing levels of success in developing clinical reasoning skills.


Invited Guest speakers at the Second International Conference on Health Professions
Education photographed alongwith Prof. Awais Rauf who was the chief guest in
the inaugural session of 2nd ICHPE 2018 organized by University of Lahore
from October 14-17th, 2018.

They are positively perceived both by learners and the medical teachers. However, it needs further research to find out how virtual patients can be effectively integrated into a curriculum. For use of virtual patients, one must define the needs, clinical and ethical reasoning. He also talked about knowledge acquisition and retraction. One has to decide about their intended use and follow specific dramatic structure. One has to produce virtual patient. He also briefly spoke about monitor teacher, cognitive load and faculty development programme. Virtual patient is a resource intensive tool, he added.


Prof. Rehan Khan moderated this session. During the discussion it was pointed out that excessive use of technology has its own problems. It was also stated that with the use of modern technology, now patients die more documented and in fact death has been made much more expensive. Prof. Jack Boulet responding to this remarked that it all depends on the available resources. Answering yet another question regarding the increasing use of Patient Assistants (PAs) and Nurse Practitioners in primary care in USA and other developed countries, he said, it might spread to other countries in the days to come. The concept of these Assistants needs to be re-visited. Admission criteria to medical schools should be based on what are our needs.


Members of the Editorial Board of Health Professions Education Journal published by
University of Lahore photographed alongwith Patron Prof. Awais Rauf at the formeal
launch ceremony of the journal held durning the inaugural session of Second
International Conference of Health Professions Education.

The importance of emotional intelligence, empathy was highlighted. Some of the participants felt that the student’s induction criteria can be improved further. When the fresh medical graduates deal with actual patients, they feel difficulty in reality. Hence, it is important to create fine balance between virtual and reality. Policy can be changed with good evidence. It was also suggested that we can pick up the students early and put them in special class to become doctors. With the increasing use of virtual patients, virtual teachers and online medical schools, the total medical practice is going to change in the days to come. Dr. Hesham opined that technology should be used to facilitate learning. Sometimes the students have to be trained on real patients. We need diversity of physicians. There are certain qualities like attitudes and aptitudes which one cannot teach.


Summing up the discussion the Prof. Rahila Yasmin said that personal abilities and qualities of students to become doctors are important. We need to identify good colleges to produce good physicians. Attitudes and behavour also counts a lot. Prof. Idrees said that it was good thing to have too many questions. We need to ensure effective use of future medical educators. They must have basic knowledge and then one can improve functions of medical education. We need to do better than what we have been doing. Dr. Gohar Wajid laid emphasis on standardization and during the discussion there has been a good analysis as to what are these standards, he remarked.

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