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Dearth of specialist doctors

Khyber Pukhtunkhwa government is preparing a plan to overcome the dearth of specialist doctors in five specialties in government teaching hospitals. A short term course in pathology, radiology and anesthesia is also being introduced in addition to offering double salary package to the newly graduated specialist doctors of these specialties. The young doctors who hold MBBS degrees prefer specialization in the specialties like cardiothoracic and cardiovascular surgery, ENT, ophthalmology, oncology, nephrology, neurology, neurosurgery general surgery and orthopedic surgery as the doctors of these specialties are in great demand in Saudi Arabia and Gulf States.

The topsy-turvy health policy formulated by the previous provincial government and the likely amendments therein will also accentuate flight of both specialist and young general cadre doctors. Before the implementation of PTI government health policy the general cadre and specialist doctors were recruited on regular basis through selection process of Khyber Pukhtunkhwa Public Service Commission. Now the appointments of all categories are made on adhoc basis rendering the future career of doctors bleak. The promotion prospects are also slim. That is why the newly graduated doctors opt for taking Plab-1 and USMLE examinations and seek their career in Britton, Ireland and the United States. To add injury to insult, Pakistan Medical and Dental Council (PMDC) is acting like a crush machine in the registration of young doctors who hold MBBS and MD degrees from Germany, Russia, other West European countries, Malaysia and China. The young doctors with degrees from foreign universities are now less inclined to jump into the quagmire of PMDC multiple examinations and prefer for PLAB and USMLE examinations which give them an easy and straightforward outlet for the pursuit of better career abroad.

Another major reason for the shortage of specialist doctors in the government hospitals is the grim prospects of promotion of senior specialist doctors who then take long leave and get employment in other countries while keeping their lien intact in the hospitals in the province. According to a prominent news story in a leading Urdu Daily, almost 1000 specialist doctors go on long leave for 2-4 years every year and the leave vacancies are filled in then on adhoc basis which certainly impact the delivery of health service. In the current year approval of the competent authority will be sought for the adhoc appointment of specialist doctors.

The finance department had sent a memorandum to the health department last month for curtailing 237 posts of trainee medical officers in different specialties reducing their sanctioned strength to 515. This will decrease the number of specialist doctors in future. There is rising trend among the young doctors to abandon the medical profession and try their luck in the competitive examinations for landing in the occupational groups of federal and provincial civil services because of the shrink job market of their profession.

Ironically the history of the country tell a bitter truth that in the pre-partition era government hospitals were built by the British government and after impendence most of the hospitals and units of primary healthcare were built in the non-elected governments. The political leaders specially the ministers did one thing that is to rename the already built hospitals. Two hospitals that were built in General Musharraf government in Peshawar were renamed by the PPP and ANP ministers. They should have at least expanded the health infrastructure in these two hospitals before renaming it. The former health secretary made a mistake in good faith by suggesting for a plan of four new MTI level hospitals for the capital city of Peshawar and immediate expansion in the two category B hospitals of the city. Instead of appreciating the proposal he was transferred by the health minister who is a dental surgeon. The Prime Minster Imran Khan is keen to bring improvement in dismal health facilities indicator but the PTI government in the province is moving in the opposite direction, tall claims notwithstanding.