Reform in medical education

Despite many weaknesses, Pakistan’s education system can take measured pride in its medical education establishment.

There is little doubt that Pakistan needs to focus on educational improvement across all sectors of society, particularly for women, to improve our development indicators. The story last week about burqa-clad Rukhsana Batool, a young mother of two from Daudkhel, who enrolled in primary school with her husband’s support, is heart-warming and a promising sign which suggests that it is never too late to learn. Scores of girls’ schools have reopened in Swat and numerous NGOs are using innovative means such as text messages to improve female literacy in remote parts of the country. Yes, we have a very long way to go, but the journey has begun.

Despite many weaknesses, Pakistan’s education system can take some measured pride in its medical education establishment. Unfortunately, many educational reformers in Pakistan continue a sterile debate over whether to focus on primary schooling or higher education. The reality is, we need both to be developed at the same pace, and should not reduce investment in our existing strengths such as medicine, which provides livelihoods while also saving lives. While our medical colleges might not have all the facilities of a developed country, the quality of medical education in Pakistan deserves some level of commendation, for our medical graduates are highly successful worldwide. In the United States, the highest per capita demographic of foreign trained doctors come from Pakistan (Indian doctors outnumber Pakistani doctors by two to one, but Pakistan’s population is one-sixth of India’s and hence our per capita contribution is much higher).

Some may consider this ‘brain drain’ to be negative, but often expatriate doctors can be an asset in terms of foreign remittances to families back home, and in helping with seasonal training programmes and other means of epistemic exchange. Furthermore, Pakistan’s medical demographic, domestically, is also decent for a developing country. We have about 74 doctors per 100,000 people, which is more than the statistic for countries such as Malaysia (70), India (60), Egypt (50), Thailand (37), Bangladesh (36) and Indonesia (17). Incidentally, Cuba has the highest number worldwide, around 500, while the United States is middle-of-the-road with around 230.

However, we cannot be complacent about our medical professionals. Sadly, they too have been victims of terrorism in a perfidious way and it is high time that religious parties unequivocally condemn the killing of doctors for sectarian purposes, which has historically been pervasive in Karachi. The Taliban have a nefarious record of killing educated professionals as well. As we lament targeted killings, let us not forget the cold-blooded murder of Dr Farooq Khan in Mardan by two Taliban assailants in October 2010. This noble and fearless professional was killed simply because he had tried to set up a vocational school as an alternative to radicalised madrassas in the region and was going to be appointed as vice-chancellor of the new Islamic University of Swat.

Bridging primary and higher education requires greater investment in vocational training academies. An important cadre for embarking on such an effort is our religious seminaries, whose graduates have the most difficulty finding productive careers. The madrassa establishment in Pakistan must realise that well-intentioned Muslims who are trying to provide a vocational avenue for madrassa students should be championed, rather than be considered a threat. Islamic schools should particularly focus on medicine as a neutral and essential field of inquiry and vocational endeavour for their students. Given Muslim norms regarding gender in physical examinations, medicine is also an essential field for women to be involved in. This is in line with the theological mandate of a humanitarian Islamic society as well as being an important professional pursuit. Imagine, if even half the donations collected at mosques could be funnelled into establishing Islamic institutions for training nurses and doctors all over the country, we would have fewer minions ready to waste their time parading streets with vigilantism and more purposeful young practitioners, who would also be serving an important divine purpose of saving lives.

Published in The Express Tribune, January 25^th, 2011.