The doctor brides

[Argus Panoptes]

Is another skilled profession in which we used to excel is in decline?

The doctor glut - DAWN.COM

The doctor glut
RAFIA ZAKARIA

2013-07-19 15:31:26

It used to be that there were just a few medical colleges in the country. The majority were state run institutions and a handful were private establishments that required hefty fees. Admission to the public medical schools was highly competitive. Students crammed for months, especially those who by the misfortunes of ethnicity were left to fight for the small numbers of spots that were reserved for candidates applying purely on the basis of academic merit. The day the admission list was posted on the bulletin board outside the colleges was one where the futures of many were deigned. In the mathematics of meager opportunity that is the fate of those pushing to get ahead, many thousands competed for a few hundred and those left off the lists faced a dead end.

Then the market responded. Egged on by more lenient rules and the possibility of large profits, the numbers of medical schools increased exponentially. If you couldn’t get into a competitive public medical school, there were suddenly scores of private ones where you could also get a medical education. The quality of the education was of course another matter, but the result in all cases was supposed to be the same; a degree that made you a doctor and set you on the path of riches.

While the number of medical schools increased furiously, and enabled lesser students to obtain a medical education the market for Pakistani doctors declined. In the past few years, a number of global factors have colluded to create a particular sort of crisis. The United States, often the first choice for Pakistani doctors seeking a return on their investment, has implemented a number of security regulations that make it difficult for Pakistani medical graduates to obtain visas with the same ease and speed as medical graduates in India or China or Eastern Europe. This has negatively impacted their ability to compete for residency spots in that country. Similarly, in the United Kingdom, with an economy barely recovering from recession and an influx of doctors from Poland (now benefiting from EU labor regulations), has significantly reduced training and employment opportunities for Pakistani medical graduates in that country. If all this wasn’t bad enough, Saudi Arabia, the longtime importer of Pakistani doctors has in recent years also changed its iqama or work visa regulations with the intention of training Saudi nationals for skilled jobs in medicine. This represents yet another closed door to the Pakistani doctor.

Of course, there is always Pakistan, and serving one’s own country is a noble goal indeed. However, according to statements made by various members of the Pakistan Medical Association and other representative bodies, the number of training spots available for medical graduates is far too small compared to the numbers of doctors that are being churned out. That is, of course, only half of the dismal problem. Month after month, television channels and newspapers report situations where doctors have not been paid any stipends. The low morale, unprofessionalism, and apathy of these vast numbers of unpaid and untrained doctors inflicts the sum of its wrath on those more hapless than they – the patients. Recent months and years have revealed case after case of wrong limbs amputated, incorrect medicines administered, as well as the misdiagnosis of illnesses. In the mad mix of all these problems the Federal Investigation Agency revealed last week, that a preliminary investigation of documents obtained from the Pakistan Medical Dental Council showed that 19 medical colleges currently operating in the country have fake registrations. In turn, 40 doctors have fake registrations and 150 have registrations currently under investigations. Those are of course, just the ones that have been caught.

For everyone else, the message is simple. The middle class mantra of becoming a doctor as a means to a better life, or a tolerable life is no longer supported by facts. Unless gullible and shortsighted parents stop pushing their offspring into medical schools based on old equations of supply and demand, the country will continue to produce more and more jobless doctors. While glib suggestions of serving Pakistan’s poor (which are indeed lacking in even the most basic healthcare) may sound comforting, they are unlikely to untie the knots in the system which imagines trained doctors serving them without being paid a wage on which they can survive. There are many things Pakistan needs, more doctors is simply not one of them.

 

[third eye]

There is a glut in almost everything - Engineers , MBAs ..

Quality & skills are a different matter..

 

[Argus Panoptes]

So here is another social angle on the story posted above:

The doctor brides - DAWN.COM

The doctor brides
RAFIA ZAKARIA

2013-07-26 15:45:57

It used to be that she only needed to be fair, from a good family, charming, and pliable. Now it seems the perfect bride for the darling son of this or that family – must also be a doctor. Gone are the days when too much education was a boon on the backs of the bride-to-be, a consternation that suggested the chance for possible rebellion; the desire to overturn age old traditions. Today, the doctor bride signifies status, not simply the cache of brains in addition to beauty, but rather of the incredible largesse of having the option to work, to make lots of money, and then to forego it all in the path of devoted wifehood and motherhood. In this misogynistic equation a man who can boss a woman around is quite manly, but a man who bosses a doctor around is the manliest.

The doctor brides of Pakistan, bred at medical colleges all over the country, move on to become wives and mothers but give up being doctors. The figures tell the story an Associated Press report published a few months ago asserts that 80-85 per cent of Pakistan’s medical students are women. At Dow Medical College in Karachi, the ratio of female to male students stands at 70 per cent female and 30 per cent male. All these hopeful numbers would be considered indicators of the feminisation of Pakistani medicine and the proliferation of female doctors around the country. Indeed much approbation would be in order for the Pakistan Supreme Court decision that abolished the quota that limited women to only 20 per cent of the seats at medical schools.

All of it could have been were it not for another set of numbers. While no figures are officially kept in Pakistan of the numbers of doctors that are lost to the bridal belt of wife and motherhood, some inkling of the losses can be found in the following. Of 132,988 practicing doctors registered with the Pakistan Medical and Dental Council, 58, 789 are women. Of 28, 686 specialist physicians in the country, a paltry 7, 524 are women. The percentage of female medical students may be high enough, but the bridal market places more urgent demands, promises more stability and social acceptance than the job market.

It is a conundrum of many dimensions and central to it is the question of blame. Does the fault lie with the individual student, who has adequate commitment to the demanding academics of medical education while single, but falters in juggling them when the demands of in-laws and husbands and children are added to the mix? Is it the fault of the Pakistani middle-class culture that has placed value on professional education for girls, but only as an accouterment, a sort of degree dowry whose value does not lie in its actual use? Or indeed, can this waste be pinned to the deeper misogyny in the working world of a patriarchal nation; that begrudgingly tolerates these girls in the halls of learning but is too hostile to allow them to practice without harassment and intimidation in hospitals? Furthermore, wouldn’t reinstating quotas that limit female seats in public medical schools set Pakistani women doctors even farther back than they are today?

These questions are important because they have resource implications. In a poor country, where healthcare is inaccessible to millions, female students, especially those that attend public universities take up already meager resources. When these girls do not practice they take away income generating opportunities from others who would utilise them. On another scale, the lost doctors represent an expenditure on healthcare that produces a net loss in that the benefits of the education are never dispersed into the general population. The problems are not Pakistan’s alone. In post-apartheid South Africa, a country where Indian Muslims present a significant demographic, rumors have been circulating about the application of unofficial quotas that reject applications from female Indian Muslim students because too many of them fail to practice medicine after marriage and motherhood. While administrators of medical schools insist that they do not exist, the issue remains a contentious one even in that country.

In Pakistan, the solution may ultimately rest on what Pakistanis consider the purpose of medical education to be. In an article I wrote last week (posted above - AP), I argued that the decrease in international demand for Pakistani doctors and the absence of local labor market able to absorb them, suggests that Pakistan does not need to be producing more doctors. The article was premised on the assumption that in Pakistan, the choice of becoming a doctor is as much, if not more motivated by aspirations to middle and upper middle class status; than to actually provide healthcare. If this is not the case, then all medical students in the country male or female should welcome the implementation of programs that require two years of obligatory service in underserved areas of Pakistan as part of completing a medical degree anywhere in the country. The failure to complete the two years would incur a fine payable by the student or their guardian and prevent the student from graduating.

The increased numbers of girls in Pakistan’s medical schools suggests that ideas do change, if only partially, and that inroads can be made. There was of course a time when the co-educational set up of medical colleges and the limiting 20 per cent quota kept women away. The elimination of the quota created enough of a push from intelligent girls to convince their families that they be allowed to attend despite the presence of male students. While post-feminist interpretations of women’s choice may insist that Pakistan’s female medical students should have the option of saying “no” to a medical career if they wish to, such arguments are simply not valid in a country with such limited resources and a society always looking for excuses to keep women out of the workplace. In this sense, the imposition of a service requirement may well be the catalyst needed for the next step in the transformation and a good way to insure that the doctor bride continues to be a doctor long after she is a bride.

 

[Hyde]

The doctor brides

It used to be that she only needed to be fair, from a good family, charming, and pliable. Now it seems the perfect bride for the darling son of this or that family – must also be a doctor. Gone are the days when too much education was a boon on the backs of the bride-to-be, a consternation that suggested the chance for possible rebellion; the desire to overturn age old traditions. Today, the doctor bride signifies status, not simply the cache of brains in addition to beauty, but rather of the incredible largesse of having the option to work, to make lots of money, and then to forego it all in the path of devoted wifehood and motherhood. In this misogynistic equation a man who can boss a woman around is quite manly, but a man who bosses a doctor around is the manliest.

The doctor brides of Pakistan, bred at medical colleges all over the country, move on to become wives and mothers but give up being doctors. The figures tell the story an Associated Press report published a few months ago asserts that 80-85 per cent of Pakistan’s medical students are women. At Dow Medical College in Karachi, the ratio of female to male students stands at 70 per cent female and 30 per cent male. All these hopeful numbers would be considered indicators of the feminisation of Pakistani medicine and the proliferation of female doctors around the country. Indeed much approbation would be in order for the Pakistan Supreme Court decision that abolished the quota that limited women to only 20 per cent of the seats at medical schools.

All of it could have been were it not for another set of numbers. While no figures are officially kept in Pakistan of the numbers of doctors that are lost to the bridal belt of wife and motherhood, some inkling of the losses can be found in the following. Of 132,988 practicing doctors registered with the Pakistan Medical and Dental Council, 58, 789 are women. Of 28, 686 specialist physicians in the country, a paltry 7, 524 are women. The percentage of female medical students may be high enough, but the bridal market places more urgent demands, promises more stability and social acceptance than the job market.

It is a conundrum of many dimensions and central to it is the question of blame. Does the fault lie with the individual student, who has adequate commitment to the demanding academics of medical education while single, but falters in juggling them when the demands of in-laws and husbands and children are added to the mix? Is it the fault of the Pakistani middle-class culture that has placed value on professional education for girls, but only as an accouterment, a sort of degree dowry whose value does not lie in its actual use? Or indeed, can this waste be pinned to the deeper misogyny in the working world of a patriarchal nation; that begrudgingly tolerates these girls in the halls of learning but is too hostile to allow them to practice without harassment and intimidation in hospitals? Furthermore, wouldn’t reinstating quotas that limit female seats in public medical schools set Pakistani women doctors even farther back than they are today?

These questions are important because they have resource implications. In a poor country, where healthcare is inaccessible to millions, female students, especially those that attend public universities take up already meager resources. When these girls do not practice they take away income generating opportunities from others who would utilise them. On another scale, the lost doctors represent an expenditure on healthcare that produces a net loss in that the benefits of the education are never dispersed into the general population. The problems are not Pakistan’s alone. In post-apartheid South Africa, a country where Indian Muslims present a significant demographic, rumors have been circulating about the application of unofficial quotas that reject applications from female Indian Muslim students because too many of them fail to practice medicine after marriage and motherhood. While administrators of medical schools insist that they do not exist, the issue remains a contentious one even in that country.

In Pakistan, the solution may ultimately rest on what Pakistanis consider the purpose of medical education to be. In an article I wrote last week, I argued that the decrease in international demand for Pakistani doctors and the absence of local labor market able to absorb them, suggests that Pakistan does not need to be producing more doctors. The article was premised on the assumption that in Pakistan, the choice of becoming a doctor is as much, if not more motivated by aspirations to middle and upper middle class status; than to actually provide healthcare. If this is not the case, then all medical students in the country male or female should welcome the implementation of programs that require two years of obligatory service in underserved areas of Pakistan as part of completing a medical degree anywhere in the country. The failure to complete the two years would incur a fine payable by the student or their guardian and prevent the student from graduating.

The increased numbers of girls in Pakistan’s medical schools suggests that ideas do change, if only partially, and that inroads can be made. There was of course a time when the co-educational set up of medical colleges and the limiting 20 per cent quota kept women away. The elimination of the quota created enough of a push from intelligent girls to convince their families that they be allowed to attend despite the presence of male students. While post-feminist interpretations of women’s choice may insist that Pakistan’s female medical students should have the option of saying “no” to a medical career if they wish to, such arguments are simply not valid in a country with such limited resources and a society always looking for excuses to keep women out of the workplace. In this sense, the imposition of a service requirement may well be the catalyst needed for the next step in the transformation and a good way to insure that the doctor bride continues to be a doctor long after she is a bride.

Source: The doctor brides - DAWN.COM

 

[Ayush]

gone are the days when people wanted the bride to be just a housewife to take care of the children.. working housewife is what people are lookin for now a days.. with even the man sharing a bit of the house work.though this mentality is yet to reach the rural places..

 

[Argus Panoptes]

@Zakii Already posted, after another article by the same author:

http://www.defence.pk/forums/social-issues-current-events/265583-doctor-glut.html

 

[Leader]

well now a days we have russia and china made doctors, worst than neem hakeem !

 

[DESERT FIGHTER]

well now a days we have russia and china made doctors, worst than neem hakeem !

Yes... but to practice they have to pass tests held by medical association... in which most of them fail.

 

[Leader]

Yes... but to practice they have to pass tests held by medical association... in which most of them fail.

oh yar koe masla hi nahi hai pass kerna, plus sab say bara issue ethics ka hai, inko profession ki sanctuary ka ehsas hi nahi hai..

 

[Argus Panoptes]

oh yar koe masla hi nahi hai pass kerna, plus sab say bara issue ethics ka hai, inko profession ki sanctuary ka ehsas hi nahi hai..

Overall, Pakistan has a great shortage of doctors and nurses to take care of the increasing population. Any step that increases the numbers is good, including keeping locally trained doctors at home in practice, and even attracting doctors from abroad, if it can be done.

 

[Leader]

Overall, Pakistan has a great shortage of doctors and nurses to take care of the increasing population. Any step that increases the numbers is good, including keeping locally trained doctors at home in practice, and even attracting doctors from abroad, if it can be done.

for approx 1200 people there is one general practitioner.

and yearly 4000 doctors take flight from the country, including professors.

and what happens when ppl go to a clinic, the doctor prescribes 4-6 different medicine products to cure the same problem which they know can be cured with only one product, but hey they got their commission attached to selling these products.

oh without forgetting how they steal organs, twist the baby's position to charge for operation etc etc !!

 

[Argus Panoptes]

for approx 1200 people there is one general practitioner.

and yearly 4000 doctors take flight from the country, including professors.

and what happens when ppl go to a clinic, the doctor prescribes 4-6 different medicine products to cure the same problem which they know can be cured with only one product, but hey they got their commission attached to selling these products.

oh without forgetting how they steal organs, twist the baby's position to charge for operation etc etc !!

I am sure there are plenty of good doctors in Pakistan still. Supposedly some on this forum too. May be they can share their experiences.

 

[Leader]

I am sure there are plenty of good doctors in Pakistan still. Supposedly some on this forum too. May be they can share their experiences.

ofcourse....

 

[Argus Panoptes]

ofcourse....

Well, it is pretty silent so far .........

 

[Leader]

Well, it is pretty silent so far .........

well I guess they didnt notice @S.U.R.B ?