off record
Shaukat Ali Jawaid

The Royal Carriage


Sometimes the most interesting points are raised and highlighted during the discussion rather than the presentations at the conferences and seminars. That is why it is essential that adequate time must be kept for discussions after presentations. Similarly the socializing during the break for Tea and Lunch provides an opportunity to meet many participants and discuss some issues which though related could not be addressed during the meeting. It was one such occasion when at the tea interval during the recently concluded annual conference of Pakistan Society of Cardiothoracic Surgeons held at Aga Khan University where the present sate of affairs of our medical institutions i.e. postgraduate medical institutes and medical universities was being discussed. Prof. Arifur Rehman, Prof. of Cardiac Surgery at National Institute of Cardiovascular Diseases at Karachi opined that these institutions, organizations are just like the Royal Carriage. He then elaborated this concept like this.

“If you have seen the Royal Carriage, it is driven by two horses in the lead followed by a number of other horses. It is the two foolish horses in front who pull the carriage while the others following them, most of them are not only cunning, do not utilize any energies to pull the carriage but also think themselves the most intelligent. They feel happy that they are also getting the credit and remain in limelight though their own contribution is none or very little. The same is the case with most of our postgraduate medical institutions, medical universities and it can also hold true for any other organization, though exceptions are always there.
If the entire faculty members in these institutions work hard with dedication and devotion in close harmony with each other, discharge their duties of patient care, teaching and training besides conducting some research, these institutions would progress and prosper a lot thereby emerging as Centers of Excellence. But alas, it is not so. The ground realities are very different. To improve the situation, it is extremely important that the lead horses in the front, institution heads are selected on merit. They then should make sure that the faculty members are all selected, appointed on merit and their further promotions are also based on merit and their accomplishments in the academic field. Not only that, it is also important that the faculty is provided pleasant, comfortable, secure working environment. The faculty members get due respect and recognition, they have easy access to the head of the institution if and when needed instead of waiting to seek appointment. Communication between the faculty, administration and head of the institution should be exemplary. Government should ensure adequate funding while the administration must ensure the judicious use of available financial and human resources. The postgraduates should also have easy access to their supervisors, work in a friendly environment, they must be keen to learn and the faculty, supervisors interested in teaching and training. Do we have all this available at our institutions, he asked?
For the health planners and policy makers, health remains a very low priority, hence how can one expect some improvements in the present state of affairs in our medical institutions? While we must impress upon the authorities to look after the needs of these institutions, we all must also do our duties honestly. However, when the selections’ and appointments of faculty members and other staff is made, it is usually based on other considerations rather than merit. Hence, even those who are keen to work get frustrated and demoralized. If we have failed or our performance in the field of postgraduate medical education is not so good, we all are also responsible for all this, he remarked.”
The above was an honest analysis of the current state of affairs in most of our medical institutions. There is no denying the fact that over the years, lot of deadwood has got accumulated in our medical institutions. It calls for a major surgery to chop off this deadwood ,of course painlessly, make sure that merit is upheld at all levels and at every stage. We must have a system of awards, rewards and punishment, monitoring and accountability of all, if we are sincere to improve the working of our medical institutions.{jcomments on}

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