Panel Discussion on Pakistan Accreditation System and Standards for Medical Education


 6th Int. Conference on Health Professions Education at KMU

Panel Discussion on Pakistan Accreditation 
System and Standards for Medical Education

For achieving the Sustainable Development Goals 
education is the Gateway - Dr.  Gohar Wajid

PM&DC needs proper restructuring and 
autonomy - Junaid Sarfraz Khan

From our correspondent

PESHAWAR: Dr. Gohar Wajid from World Health Organization, WHO EMRO moderated the panel discussion on “Pakistan Accreditation System and Standards for Medical Education” during the  6th International Conference on Health Professions Education and Research held at Khyber Medical University on second day of the conference on   April 21st 2018. Members of the Experts panel included Prof.Arshad Javed Vice Chancellor KMU, Prof. Idrees Anwar Dean Surgery RMU, Prof. Junaid Sarfraz Khan, Prof. Shahjehan Katpar from DUHS, Dr. Moyn Aly from JSMU, Dr. Mohammad El-Eraky from Saudi Arabia, Dr.Syed Hassan Shoaib from UOL Lahore, Dr. Sumera Badar Ehsan from FMU, Dr.Brekhna Jamil and Dr. Ahsan Sethi both from IHPER KMU and Prof. Ghulam Rasool.

Justice Shakirullah Jan President PM&DC (third from right) chairing the inaugural session of Health 
Professions Education organized by IHPE&R at KMU from April 19-21st, 2018. Also sitting 
on the dais are Dr. Gohar Wajid, Prof. Arshad Javed VC KMU and Prof. Daud Khan.

In his introductory remarks Dr. Gohar Wajid said that we are going through huge transformation. The whole medical education system is being transformed. We are faced with new challenges and we must come up with answer to these challenges. We must plan till 2050.We needs to develop information system. Plans up to 2030 is documented. For achieving the Sustainable Development Goals education is the gateway. It is not the number of medical colleges and Institutes which matter the most but it is the quality of education. We must look at our production capacity. We need more institutions. There has to be a vision aligned with that but he asked do we have the capacity to develop all this?

Continuing Dr. Gohar Wajid said that at present we have six regulatory councils related to healthcare which include Pakistan Medical & Dental Council, Pakistan Nursing Council, Tibbi Council, and Homeopathy Council and so on but we need one umbrella organization which should have representation from all the above bodies. He also disclosed that we in the PM&DC have set the pace and it needs to be followed by other councils. He also referred to lack of standardization in the PM&DC. Dental profession remains neglected but it should be on the forefront.

Panel during on “Pakistan Accreditation System and Standards for Medical Education” was an important 
part of the scientific programme during the Health Professions Education conference held at KMU 
recently. Members of the experts’ panel participating in the discussion from (L to R) are Dr. Eraky, 
Prof.Shah Jahan Katpar, Prof. Ghulam Rasool, Prof.Junaid Sarfraz Khan, Dr. Moyn Aly, Dr. Syed Hassan 
Shoaib, Prof. Arshad Javed, Dr. Brekhna Jamil and Dr. Ahsan Sethi. Prof. Idrees Anwar 
and Dr.Sumera Badar Ehsan were also included in the panel.

Participating in the discussion Prof. Junaid Sarfraz Khan opined that autonomy for the PM&DC is extremely important. We can follow the CPSP model. We need to bring about changes in the PM&DC by taking along all the stake holders. To begin with we have to change ourselves. There has been lack of consistency in leadership. We have to ensure justice in accreditation. Let us have plans which suits to our local environments. Requisite Faculty should be available with all the institution.

Dr. Moyn Aly remarked that the PM&DC leadership lacks credibility. Medical profession does not trust them. They do not have any long term plans how they are going to move forward. He was of the view that all healthcare professionals including doctors, nurses, pharmacists, paramedics should come together. At present unfortunately the PM&DC does not have capacity to take decisions.

Dr. Brekhna Jamil stated that the adhoc committee of PM&DC takes some decisions; will they be accepted by the new Council which will emerge after elections? This is going to be a major problem. At present during inspection the PM&DC just looks at the infrastructure but does not look at the quality of education being imparted in these medical and dental institutions. Dr.Ahsan Sethi remarked that the PM&DC has no plans for PhD. He opined that we need to give more space to the discipline of medical education. To ensure this, we should call all the stake holders at a national conference. Rules should be clear and there should be no discrimination. If the rules are vague, people can manipulate them to suit them and they will take advantage of it.

Prof. Daud Khan Founder VC KMU (second from right) chairing the concluding session 
of HPE held at KMU during April 2018.

Prof. Arshad Javed pointed out that the medical universities were taking care of all the healthcare professionals including doctors, nurses and paramedics. Autonomy to the PM&DC is a real issue. CPSP has a limited mandate and within that it has made lot of progress. We need to look into it how we can make the PM&DC more autonomous. We also need to look into the state of medical education, healthcare delivery and how to improve it. PM&DC is an institution. We in the Khyber Medical University have developed a sustainable model by upholding merit. All the chairpersons of the departments are selected and appointed on merit. The Dean of Lady Reading Hospital Peshawar was appointed from UK. It has helped a lot to improve the patient care and overall healthcare delivery. It was also pointed out that the PM&DC should do some outsourcing as it was not possible to undertake all the functions it is required.  Looking after training is just one part of its responsibilities. PM&DC has to accomplish a lot but it can do that by sharing some of its responsibilities with the medical universities.

Dr. Gohar Wajid remarked that at present there are about fifteen medical universities in the country but we must plan for at least fifty medical universities and over three hundred medical and dental colleges in the days to come.  PM&DC it was further stated must change its bureaucratic approach with technocratic approach. We need technical people. PM&DC should not copy and paste what is being implemented in the West. There is a need to develop a system of ranking of medical universities laying emphasis on quality of medical education. Do not go for buildings but look at the quality of medical and dental education being imparted by these institutions and the faculty. During the last few years we have seen a mushroom growth of medical and dental colleges particularly in the private sector. Many of these institutions are facing acute shortage of teaching faculty and equipment. We need people who are upright with strong character.

During the discussion it was time and again emphasized that we must plan up to 2050. Sustainability was most important. Any system that we develop must be sustainable in the long run. Let us develop a system, Flexner did it in United States many years ago and it helped put things right in the medical schools in United States. We can invite visiting faculty, experts from overseas on voluntary basis. The importance of academic monitoring was also highlighted for which we need honest people. Mr. Shaukat Ali Jawaid Chief Editor Pulse International pointed out that we have been following the British system of medical education all these years. The British have changed but we still continue to follow the same old system. They realized it long time ago that to monitor the medical profession, involvement of some non-medical personnel in the regulatory bodies was essential. Hence to begin with they opted for at least 30% membership of the General Medical Council should consist of non-medical persons. However, they should not be politicians but those who are affiliated with healthcare and educational institutions like Foundations and Trusts running these institutions. Why we cannot do that and have at least some non-medical persons as members of the PM&DC. Some time ago the government had decided to look into it and a delegation consisting of Federal Health Secretary and DG Health had visited UK to study the composition and functioning of General Medical Council, he added.

Prof.Arshad Javed said that it has been realized that we need to have a full time Chief Operating Officer who will look after the affairs of the Council. The council should be a separate body. Majority of its membership should be from the medical and dental profession. It should make the policies. Then there should be an Executive Committee which should have representation from all the stake holders. The various committees should consist of Principals and Deans and all these ideas are at present being discussed. We need proper restructuring of the Pakistan Medial & Dental Council.

Concluding Session

Prof.Daud Khan Founder Vice Chancellor of Khyber Medical University was the chief guest in the concluding session of the conference which was moderated by Dr.Brekhna Jamil. Also sitting on the dais on this occasion were Prof.Arshad Javed VC KMU, Dr. Gohar Wajid and Prof. Ghulam Rasool representing Khyber College of Dentistry. Dr. Brekhna Jamil summing up the conference programme stated that we had three hundred twenty registered delegates, three plenary sessions, twenty five posters and fifty oral presentations in different sessions. PM&DC should not do policing but give guidelines. We need to do critical analysis, integration leads to re-thinking what to do and what not to do.

Participants of the 6th Int. Conference on Health Professions Education organized by IHPE&R at Khyber 
Medical University photograph after the dinner reception held at a local restaurant.

Prof. Daud Khan in his speech at this occasion said that at present healthcare delivery is not properly regulated.  We have many institutes and there has been lot of haphazard development He commended the contributions of Prof. Hafeezullah the former VC and Prof. Arshad Javed the current Vice Chancellor of Khyber Medical University. Prof.Daud Khan suggested that students and the patients should be given due importance. Students should be engaged in learning management systems. No healthcare can be successful without meeting the manpower requirements for which we need adequate resources. He further advised those present never to compromise on quality. He also referred to the National Eye Care programme of 1979 conducted under the directive of then President General Ziaul Haque with the help of WHO consultants. It revealed that the prevalence of blindness in the country was 2%. To improve the situation we needed proper health infrastructure as technology alone cannot help. We started the National Programme for Prevention of Blindness. Another survey was undertaken in 2004 which showed that the prevalence of blindness had come down to 0.9%. He laid emphasis that we need to do some research to find out where we stand and then plan where we want to go. We must utilize our strength and utilize the opportunities available. We all need to show some commitment, find out what we have and what we will like to achieve in the coming years. It is all possible with sincerity, devotion and dedication of all those involved, Prof. Daud Khan remarked.

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