By Dr Shershah Syed

WHAT started a few years ago as a favour to some friends has ended up pushing medical education in the country into a deep crisis.

It all began when after seizing power General Pervez Musharraf assigned the task of running the Sindh health department to a retired lieutenant-general. Being a graduate of Liaquat Medical College at Jamshoro, the health minister saw this as an opportunity to revive old friendships.

Thus the idea of establishing the country’s first medical university came to be floated. Apart from the personal interest of the sponsors, the project also sought to promote their political ambitions as it envisaged taking all medical colleges in the province, including, of course, those in Karachi, under its wings.

To make it palatable to all concerned, it was reasoned that the proposed university would organise medical education along scientific lines in the province and, in doing so, it would be able to set an example for the other provinces to follow.

The professors concerned naturally had little realisation of the dynamics of regional politics and power in the country and could not foresee that taking over the entire province would not be the piece of cake which they thought it would be.

Besides, as experience has shown, they had very little understanding of how medical education is conducted in the modern world. The minister should have thought twice, but he was won over by his friends. He did not even bother to learn from the experience of a private medical institution that had already been working independently in the province. The decision was taken in such haste that no baseline feasibility of the project was in place when it was announced.

The Liaquat University of Health and Medical Sciences came into existence by an executive order and the Higher Education Commission (HEC) was made to dish out millions of rupees for the task. The series of events that followed the establishment of LUHMS is as interesting as it is unfortunate.

Immediately after the announcement by the Sindh government, the health minister of Punjab decided to have a medical university in his province. If Sindh could have a medical university, why not Punjab? Thus came into existence the Punjab University of Health Sciences.

Back in Sindh, with the appointment of a new provincial governor, the idea of a medical university in Karachi was floated by the professors of Dow Medical College. Provincial politics being what it is, the establishment of the Dow University of Health Sciences (DUHS) did not take long. Another executive order came around without any proper feasibility report. The HEC was again there to fund the project.

Now with Sindh having two medical universities, there was ground enough to prepare for a similar number in Punjab to restore parity. The famed King Edward Medical College took the lead and was soon converted into a university. The provincial government made the announcement and the HEC rushed ahead with funds. Nobody bothered to pause and see whether a medical university was required at all. No one asked about the performance of the particular medical college that was selected for upgradation, and, more importantly, whether there had been a significant change in any of the three universities established thus far.

With Sindh and Punjab engaging in a war of numbers, it was only a matter of time before the North West Frontier Province and Balochistan started feeling neglected. As the two smaller provinces, they had always been denied their rights, but they were not going to miss out on this score. Khyber Medical College in Peshawar and Bolan Medical College in Quetta soon had themselves elevated to the status of medical universities.

With so many universities across the land, one hoped everybody was satisfied, but that has not been the case. A demand has recently been aired through the national media to grant a similar status to Chandka Medical College in Larkana, and to rename it the Shaheed Benazir Bhutto Medical University.

Given the present political environment, nobody would be too surprised if the proposal gets the official green signal soon. And when that happens, a third such university will also emerge in Punjab where the Nishter Medical College in Multan would be the most likely choice. It is not only among the better medical colleges in the public sector and has a sprawling campus, it is also situated in southern Punjab which is the constituency of the incumbent prime minister and the provincial chief minister. The HEC cash cow will only be too willing to be milked once again.

Indeed, medical education in the country has become a longwinded tale of political expediency and vested interests. To have such a large number of medical universities is beyond comprehension, especially in a country where not a single medical college in the public sector happens to be a fulltime teaching institute.

Even when they were colleges, they were basically producing glorified MBBS quacks in enormous numbers because of the lack of teaching focus and the inexplicable reluctance to update the course content. Instead of upgrading the syllabus, our governments have found it much easier to upgrade colleges to university level.

It is time the new government took serious note of the happenings and reviewed the entire structure of medical education. A system should be there to benefit the patients and students, not to provide perks and privileges, both in cash and kind, to part-time medical faculty.

It is neither practical nor advisable to undo the entire proceedings of the past few years and to initiate investigations regarding money spent on the construction of buildings and the purchase of expensive but useless equipment. But it is, indeed, possible to convert all these medical universities and colleges in both public and private sectors into fulltime teaching institutions, just as they are in the large majority of countries.

Even if we initiate the process today, and make it merit-based, accountable and transparent, it will be a decade later when we may finally have quality medical education system in the country. But that should not deter us from taking the initiative. A beginning has to be made. Why delay it further?