off record
Shaukat Ali Jawaid

Don’t push your
opponents to the wall

College of Physicians & Surgeons Pakistan (CPSP) is perhaps the only Pakistani medical institution in the field of postgraduate medical education which enjoys international recognition and credibility. The degrees and diplomas awarded by CPSP are recognized the world over and it has successfully maintained its credibility by holding the examinations on time which are never postponed. Established in 1962 by Lt. Gen. W.A. Burki the then Federal Health Minister in the Martial Law Government, every successive council since then have played its role in further improving its functioning and expanding its various programmes. It is an uphill task to build and maintain any institution but it can be destroyed within no time. Hence, anyone who indulges or conspires to weaken or destroy this institution cannot be the well-wisher of Pakistan.

However, having said that it is also the responsibility of the CPSP leadership to ensure that CPSP is run and managed in an efficient manner, listen to constructive criticism, make amends if needed and do not compromise on democratic traditions. With the passage of time, certain changes in its structure, rules and regulations also become necessary and if such steps are not taken in time or kept on postponing for various reasons, it amounts to weakening of the institutions. When I first suggested twenty five years ago that no councilor should be eligible to contest elections after having completed two terms, though they can contest again after a gap of four years, the first phone call that I received objecting to this suggestion was from Prof. Tariq Iqbal Bhutta from Nishtar Medical College Multan which was followed by a phone call from Prof. Haque Nawaz from Lahore. I had also suggested that no elected councilor should be appointed as Regional Director of the CPSP, Controller of Examinations, Director International Relations or to any other post which must be filled up by other Fellows. It had double advantage, firstly concentration of too many powers in individuals will be avoided as power usually corrupts and absolute power corrupts absolutely and secondly it will enlarge the power base of the CPSP providing opportunities to more fellows to contribute to the development of this institution. The councilors from Karachi also got annoyed but I told all of them that they may or may not agree with my viewpoint but I feel it is in the interest of the CPSP. Using their majority, when despite advice by many Prof. Sultan Farooqui group acted against the then sitting President Prof. Kh. Saadiq Hussain an honest upright man whose intellectually integrity remains unquestionable till today and who enjoys tremendous respect among the healthcare professionals in Pakistan, is known as the soul of the medical profession, they had in fact accomplished a suicidal mission. As expected, the entire group was routed in the next elections. What happened later is now a part of history, where are those councilors now?

I had also repeatedly told the CPSP leadership that in the days to come, they will no longer enjoy the monopoly in the field of postgraduate medical education. But they are still in a denial phase and are not prepared to accept the bitter facts. One of the foolish decisions which the CPSP leadership in the past took which was reversed after about ten years, was not to select those faculty members as Examiners for MCPS, FCPS who were also either supervisors or training postgraduates doing MS of MD in different subjects. It did lot of damage to the CPSP and created a rift within the faculty members as even today there are many who are either trained in UK or North America and even all the CPSP fellows do not fully support the policies of the present leadership. They all put together becomes a force to be reckoned with and if they are not engaged, they will get an opportunity to take revenge. Common sense demands that one should never push one’s opponents to the wall. The CPSP leadership has recently tasted the fruits of its ill-conceived, ill planned polices. There was a highly malicious report on Dunya News television channel and then Punjab Health Minister Prof. Yasmin Rashid’s frontal attack on the CPSP which was prominently highlighted by the media has seriously affected the credibility of CPSP not withstanding the later damage control measures taken by the Minister by issuing a statement praising the CPSP leadership.

In all fairness to be selected and appointed as Vice Chancellor of a Medical University is the highest coveted post in academics which one can dream of. Once selected for this post the incumbent CPSP councilors’ should have resigned from CPSP councillorship giving opportunity to others to contribute and concentrate their all energies on the progress and development of the respective universities. One does not need any office to contribute something to an institution if one is sincere and it will also not provide an opportunity to the opponents to conspire or hurt the interests of CPSP as it did. No one is going to believe that CPSP as an institution was behind the agitation by the young doctors, someone in his individual capacity might have had soft corner for the genuine demands of the young doctors but maligning the CPSP as an institutions was not fair at all. In the first instance it was wrong and in the second instance, failure of the CPSP leadership to respond effectively then and there in the meeting, also not only contributed to strengthening the allegations against CPSP but also exposed their weaknesses. The conflict of interest had come in their way and they perhaps preferred to save their jobs.

Let us not forget the stands taken by the medical Giants in the past when they were confronted with such a situation. Who can forget the speech which Prof. Iftikhar Ahmad the then Principal of King Edward Medical College made when he invited President General Ziaul Haque as the Chief Guest at the KEMC Convocation and within minutes he earned Grade-22 for the medical teachers as well which was denied to them so far. Earlier he had objected to the lateral entry of AMC officers as Medical Teachers in the public sector institutions by the PPP Government lead by Mr. Bhutto. When Prof. Naseer Sheikh as DG Health in Z.A.Bhutto Government decided to organize a Medical Teachers Conference at KEMC and invited one physician posted through such lateral entry to chair the first session, Prof. Iftikhar Ahmad left the meeting to record his protest and he was followed by most of those present leaving just half a dozen people sitting in the hall. Prof. Naseer Sheikh who was an intelligent person realized the gravity of the situation. He went after him and persuaded him to return to the hall but Prof. Iftikhar and his colleagues did not agree till he gave them assurance that the orders issued earlier will be cancelled the next day and he did fulfill his promise the next week. Who can forget the speech made by Prof. Mahmood Ali Malik as Principal of Allama Iqbal Medical College when he invited Prime Minister Mian Nawaz Sharif as Chief Guest to the AIMC Convocation? Let us also not forget the speech which he made at Fatima Jinnah Medical College as Chairman of the Board of Governors when sitting on the Dais the then Governor of Punjab Lt.Gen. Khalid Maqbool and the then Health Minister Prof. Mahmood Ahmad Chaudhry were sweating. When Prof. Mahmood Ali Malik finished his speech, he got tremendous applause of having the courage to speak the truth by the audience who kept on clapping for well over five minutes. If the Governor next day removed him a Chairman Board of Governors of FJMC, it did not affect Prof. Mahmood Ali Malik at all. Even today he enjoys tremendous respect in the medical profession.

Mr. Pervez Masud is one of the most intelligent, honest and upright bureaucrat who first served as Punjab Health Secretary and later retired as Chief Secretary Punjab. He once told me that doctors do not need any outside enemy as they are self-sufficient in this. When Prof. A.U. Lone retired from KEMC the post of Professor of ENT fell vacant. Prof. Riaz Ahsan Siddiqui was the next senior person but he did not apply. Mr. Pervez Masud rang up Prof. Riaz Siddiqui and asked him “Are you not interested in going to KEMC as he has not applied?” Prof. Riaz Ahsan Siddiqui replied that as per government rules I am the senior most professor of ENT now and it is my right to be posted in the KEMC. Why should I apply”? Mr. Pervez Masud who always took decisions on merit was convinced and he immediately posted Prof. Riaz Ahsan Siddiqui at the KEMC. Prof. Eice Mohammad had objected to the speech of the then Governor Lt. Gen. Sawar Khan saying that “doctors are willing to go and serve in the rural areas provided there is no exception. If the son or daughter of an ordinary person is posted in rural areas, the sons and daughters of the elite including Army officers should also be posted there and there should be no exception “. Later he was arrested and put behind bars on false corruption cases only to be reinstated later with all benefits and privileges.

When the PA to the Chief Secretary Punjab rang up Principal KEMC Prof. Ijaz Ahsan conveying the message that the son-in-law of the Chief Secretary on a visit from USA is going to make a presentation in the APPNA/KEMCANA symposium where the chief secretary along with his family members wish to be present, they should be given appropriate protocol and a few seats in the front row should be reserved for them, Prof. Ijaz Ahsan did not like it. He rang up the Health Secretary and told him that he cannot do that and he was going on leave on that day. Even the Chief Secretary did not have the courtesy to call him personally and the message was conveyed to him by his PA, the Secretary was told. When the Punjab Health Secretary did not stop interfering in the affairs of KEMC, he was constantly opposed by Prof. Ijaz Ahsan. The Health Secretary then once rang him and “asked Prof. Ijaz Ahsan as to what was the problem”. Prof. Ijaz Ahsan replied “Mr. Secretary you are my biggest problem. If you have to interfere in every matter concerning KEMC and take decisions, what is the need of having a Principal?” The next day Prof. Ijaz Ahsan resigned as Principal of KEMC and went home.

More recently a few years ago when Prof. Muhammad Akbar Chaudhry was Principal of Fatima Jinnah Medical College and I had gone to see him in his office, a member of the Punjab Assembly entered his office accompanied by a few of his friends and started shouting saying that he had sent a patient from his constituency who had a fracture and he was not looked after properly. Prof. Akbar Chaudhry asked him to take seat and explain the problem he faces. After listening to him, Prof. Akbar Chaudhry said that when that patient came, the orthopedic surgeon on duty was contacted, the patient had X-ray done and after plaster to manage the fracture, he was asked to come back for follow up after two weeks as he did not need hospitalization. When the MPA continued to speak in a loud voice just to impress his friends who had come along with him, Prof. Akbar Chaudhry who is always very humble and polite, suddenly lost his temper. Addressing the MPA he said “whatever was the best treatment was given to the patient. Do you want the Principal to go with the patient to the X-Ray, Emergency and the Ward? This is not possible, you must learn to behave and understand the dignity of the office of Principal. Stop speaking in a loud voice.” Then he stood up, pushed his seat of Principal away and said, you can go and do whatever you want to. I don’t care about this Chair. I can continue working as Professor of Medicine and no one can deny me that right. He then immediately rang up the Punjab Health Minister Dr. Javed who was visiting his constituency and told him as to what has happened and also asked him to tell their MPAs to behave when they visit the Principal’s office.“ I have never seen Prof. Akbar Chaudhry in such a furious mood.

The above incidents have been quoted just to recall how these “Medical Giants” protected their respect and dignity. No one could ever dare to take them for a ride and get away with all that but alas these characteristics are lacking in most of the present day faculty members and those occupying coveted posts of Principals or Vice Chancellors of medical universities. The present leadership of CPSP is happy because the difference in the votes they got against their opponents in the last elections has increased further but little do they realize that in fact it has further weakened them and shaken the foundations of the CPSP. They better accept the reality that the days of CPSP enjoying monopoly in the field of postgraduate medical education are over. The medical universities are here to stay and they are going to make a big difference in the coming few years. At present it is a fact that only those who cannot do FCPS opt for MS and MD degrees but the situation will not remain so in the next few years. The presentation which Prof. Mohammad Umar Vice Chancellor of Rawalpindi Medical University made at the Inter-university Board meeting and convention of MS. MD at the University of Health Sciences last year was an eye opener. The details of the Residency programme which he shared with the participants and which are going to be implemented in all the medical universities who have also agreed to have Inter-University Board of Examiners to ensure uniformity and standardization of their degrees were heartening. It looked almost the same as followed by CPSP and even much better in certain respects as regards monitoring of the postgraduates. IF this all is implemented in letter and spirit, it will give a major boost to the credibility of MS and MD Degrees awarded by the medical universities. Gulf countries have already announced acceptance of these degrees opening up job opportunities for these specialists. Hence it is in the interest of CPSP as well as the medical universities to collaborate and cooperate with each other rather than competing with each other. Let them share the examiners with each other, CPSP appointing a few examiners for MS, MD exam and in response the medical universities appointing some examiners for the FCPS. It is heartening to note that at present cordial relations exist between the Vice Chancellors of three public sector medical universities in Lahore i.e. UHS, KEMU and FJMU, the latter two being headed by elected Councilors of CPSP. This relationship needs to be further strengthened.

My suggestions to the CPSP presented twenty five years ago are still relevant. The manifesto of the other group which contested elections against the present CPSP leadership contains some very genuine demands ensuring real representative character of the elected councilors. They also include some very honest, extremely intelligent and competent medical teachers and there won’t be any harm if some of them were invited to come and contribute their share in running and managing CPSP efficiently. Not only that an international conference organized by the CPSP itself at Karachi a few years ago wherein invited guest speakers from various Royal Colleges from UK, Australia, New Zealand and other Asian countries had made some very useful suggestions. One of them was to establish a Young Fellows Forum. It called for identifying and selecting some young fellows, grooming them, sending them overseas on short visits to various institutions, holding their regular meetings and prepare them as future leadership. Other suggestions were broadening the power base of the institution which are all excellent and positive suggestions which the present CPSP leadership seems to have forgotten or not giving it a serious thought. Prof. Zafarullah Chaudhry the current President of CPSP has done a lot to further enhance the image and prestige of CPSP but his greatest failure is he could not produce his successor, a very common disease in Pakistani healthcare professionals. Let us remember, no one is indispensable and the graveyards are full of such people who once considered them as indispensable. Hence, better wake up before it is too late and make sure that history which is very cruel, remembers us all with good words. One of the greatest positive things about the present CPSP leadership is that it does listen to constructive criticism but whether it accepts some of the suggestions or not is a different thing.

CPSP charges handsome fee for workshop on Research Methodology from all the residents as it is one of the mandatory workshops before they appear in the FCPS examination. However, after attending this workshop most of these Fellows even after having done FCPS do not know even How to write a structured abstract, write a case report or scientific paper and select a topic. This fact was brought to the notice of the President CPSP Prof. Zafarullah Chaudhry about five years ago but the situation has not changed even till today. CPSP is happy as it generates for them lot of funding and if it does not help these Fellows to strengthen their professional capacity, the CPSP seems to be least bothered.

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