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Strengthening Healthcare System in Pakistan: Merits and Demerits of the Quota System

Submitted by on October 28, 2014 – 7:52 PM

medical-students-suhail-yusuf-file-photo-670-x-350The Pakistan Medical and Dental council (PM&DC) which is the Statutory and Regulatory Registration Authority for Medical and Dental Education and Practitioners for Pakistan has been striving hard for the improvement of medical education and healthcare system in Pakistan but has been facing a lot of challenges since its birth. One of the major problems is the lack of doctors in the country as there are very few doctors  (1 doctor/ 1250 people) when compared to the growing population in the country. Out of these few students who get the chance to become doctors more than 70% are females in most of the medical colleges. Although they get in to these colleges on pure merit most of them are somehow unable to pursue there profession in future due to various reasons as some are not allowed to work after their marriages while others find it hard to cope with their household responsibilities and medical profession simultaneously.

According to the statistical data provided by Pakistan Medical and Dental council as on 30 June 2014, there are 142017 registered MBBS doctors with basic degree. Out of these 54% (77551) are males and 46% (64466) are females. Whereas in Dental section there are a total of 13479 doctors with basic degree out of whom 40% (5369) are males and 60% (8110) are females. Similarly there are only 30272 working as registered specialist doctors in MBBS section with males 73% (22087) and females 23% (8185) and 1115 registered dental doctors as specialist out of whom 72% (801) are males and 18% (314) are females.

This data clearly shows that despite more than 70% females getting admission in various medical colleges very few are able to continue practising their profession resulting in less number of doctors working. As for the rest of the male doctors most of them try to work outside the country for a better livelihood. Now the challenge for PM&DC is to overcome the shortage of doctors which is seriously affecting the health care system in the country.

Recently PM&DC came up with the idea of implementing quote system which will give 50% seats to males and 50% to females. The rationale behind this is that by increasing the number of male doctors, the working force will increase resulting in much needed relief to the shortage of doctors. However the question which arises is, will this step strengthen the healthcare system? This decision has met with mixed response as some hailed it while other seriously objected it. Now let’s see the two sides of the coin.

Those who support this decision feel that this step will strengthen the working force bringing much relief to the patients who have been suffering for a long time due to the lack of doctors especially in the rural areas. They also feel that some females just choose this profession for their personal interest rather than practising it.

However some see this decision as controversial as they feel that this decision will not bear any fruitful result unless certain necessary steps are taken at the grass roots level as now males with lower merit will get a chance to become doctors which carries a danger of producing inefficient doctors that can lead to harm to the society rather than benefiting them. And those who are efficient enough, may not stay in the country or go to the rural areas where doctors are needed the most.  Many females and human right activists are also against this decision as they feel this decision will deny them the chance to compete side by side with males depriving them of their education so women should be given equal opportunity to carry out their education.
Here are some of the steps which in my view could be taken before implementing the quota system.

•       While implementing the quota system separate female medical colleges should be opened in order to accommodate females who will be deprived of admissions due to males occupying 50% seats. In this way females will not be deprived of their right to succeed.
•        According to the World Bank the average spending as percent of GDP on health in Pakistan from 1995 to 2012 was 3.21 percent with a minimum of 2.82 percent in 2004 and a maximum of 3.72 percent in 1999. This should be increased and more and more hospitals should be built across the country especially in rural areas possibly with a better pay structure given to doctors.
•       All doctors should be advised to at least work for 2-3 years in the country, more so in the rural areas before their medical degree is recognized.
•       Those doctors who do not practice their profession for more than five years should have their medical license suspended.

These steps will hopefully solve most of the problems as the numbers of practising doctors will increase while preserving the rights of women to study. Also females would not want to waste their degrees and practising females will provide a healthy environment thus maintaining good standard of medical education.





About the Author: Taha Nafees is a final year student of Karachi Medical And Dental College which is affiliated with the University of Karachi. He has a keen interest in research and blog writing and has presented his research at Aga Khan University in AEME conference 2013 and 16th AKU symposium. Taha can be reached at [email protected]

About this article: This article is competing for the JPMS International Medical Writing Contest 2014.

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