PMDC gets dissolved. PMC gets established. PMC gets dissolved. PMC is nowhere. PMDC is non-functional. That’s quite a confusion the government has gotten itself and the people into. Arsalan Haider finds out how things with monitoring and oversight of medical and dental education in Pakistan are.

he future of thousands of medical students, and possibly the entire healthcare sector, has been put at stake following the dissolution of Pakistan Medical Commission (PMC) by an order of the Islamabad High Court (IHC). With the government already announcing the dissolution of Pakistan medical And Dental Council (PMDC) in October last year and having replaced it with PMC under a presidential ordinance, the decision by IHC has muddied the water even further. There is much confusion prevalent in the medical education circles as there is no medical licensing authority currently in operation in the country. The confusion over the status of the regulatory body of medical education institutions has also led to a halt in new admissions at medical colleges and universities.

Historic Troubles 

The issue of an able body that regularizes medical institutions and practitioners in Pakistan is almost as old as the country itself and has seen several dissolutions and reformations. A regulatory body was initially established in 1948 under the name of Pakistan Medical Council, and worked under the British Indian Medical Council Act 1933. The council was formed on the recommendations of Pakistan Health Conference 1947.Soon after in 1951, Pakistan Medical Council Act was implemented according to which each province had to have its own medical council that regularized medical institutions and dealt with the licensing of doctors. After a few years, the Sindh Medical Council and Punjab Medical Council were merged and a new council named West Pakistan Medical Council came into being in 1957.

With the government already announcing the dissolution of PMDC in October last year and having replaced it with PMC under a presidential ordinance, the decision by IHC has muddied the water even further

In 1962, another ordinance was passed, Pakistan Medical Council Ordinance 1962, which dissolved all existing provincial councils and led to the creation of Pakistan Medical and Dental Council (PMDC). The ordinance amended thrice in 1973, 1999 and 2012. The 2012 amendments passed by the Pakistan Muslim League-Nawaz (PMLN) government made up the foundations of the recently formed and dissolved Pakistan Medical Commission (PMC).

Things did not go much in favor of PMDC in 2013, as reports of irregularities emerged, leading to a judicial commission being set up to inquire into allegations. In 2015, a new amendment was made to the PMDC ordinance while in April 2016, the PMDC Ordinance 2015 was also dissolved.The council again hit troubled waters in 2018, when then chief justice of Pakistan Saqib Nisar dissolved the PMDC. The court also constituted an interim committee to look after the affairs of PMDC in supervision of former SC judge Justice Shakirullah Jan. 

Finally in October, 2019, President of Pakistan Dr Arif Alvi dissolved the PMDC through an ordinance that also suggested a new body to look after medical and dental education, as well as related affairs, in the country.Following the promulgation of the ordinance, Pakistan Medical Commission (PMC) came into being and the Ministry of National Health Services took possession of the PMDC building in Islamabad. However, the move was immediately challenged in IHC, which eventually held the dissolution of PMDC null and void. 

 

State Of Confusion

The developments in over the last few months has created much confusion, for existing and prospective students, and for other stakeholders of the medical sector like doctors, educationists and even college and university administrations. At present, there exists no apparent body to regulate medical institutions in the country or to offer new licenses and renew older ones of doctors practicing across Pakistan.

At present, there exists no apparent body to regulate medical institutions in the country or to offer new licenses and renew older ones of doctors practicing the profession.

Talking to Academia Magazine, Pakistan Medical Association (PMA) Lahore Chapter Secretary General Dr Shahid Malik was of the view that negligence and hasty decisions of the present regime had created yet another crisis in the country, as thousands of doctors were awaiting renewal of their licenses, one of the basic responsibilities of PMDC. Similarly, the recently held exams for admission to medical institutions have also been put to question after the IHC ordered the dissolution, PMC, the body that oversaw these exams.

He said that government should immediately restore the PMDC and appoint members to make the body functional. “PMDC should be made functional as soon as possible as this would save the future of thousands of students as well as doctors. Otherwise the situation could turn into a chaos,” he added. Young Doctors Association (YDA) Secretary General Dr Salman Kazmi said the government’s steps were entirely illegal. He said the people around Prime Minister Imran Khan belonged to the private sector and literally “don’t know the issues of the public sector”.“These people are working to promote the interests of the private sector, not deliberately, but because they are unaware of the issues being faced in the public sector healthcare. That’s why they are pushing things into a wrong direction and creating an utter mess,” the YDA official said.

The absence of a regulatory body can affect not only how medicine is taught in the country, but also how health services are delivered.

Dr Salman was of the view that YDA would file a writ petitions in all four high courts, and would also file cases with the Federal Investigation Agency (FIA) and National Accountability Bureau (NAB). He said individual inquiries should be initiated to find out why a centralized admission policy for medical colleges had been abolished, why had the cap on the fees of medical colleges been ended and why was the private sector being benefited.To a question regarding the future of doctors, he said the current state of confusion had created problems for Pakistani doctors working all across the world, as they were facing issues with licensing. “We are receiving complaints from all across the world about how doctors are facing problems in getting their licenses renewed,” he added. Disregarding the politics involved behind the creation of PMC, or the influence of private players to gain favors from the government, the issue of the absence of a regulatory body to oversee medical education and practice in Pakistan is quite a serious one and is likely to affect not only how medicine is taught in the country but also how health services are delivered. Before further delays, the government must either put the necessary structures in place to sustain the operation of its stipulated PMC or sit down with the PMDC to figure out how it can be made more efficient and in line with the government’s plans to reform the regulation of medical sector in Pakistan.Without a pragmatic approach, things are only expected to head towards a catastrophe. And that is something nobody wants, or can afford. 

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