Universities to regulate medical colleges, no cap on fee & feared NLE

PAKISTAN MEDICAL COMMISSION ORDINANCE’19

ISLAMABAD: The advent of 'Pakistan Medical Commission Ordinance, 2019' has given private medical and dental colleges’ unlimited autonomy. As per the new ordinance, which took the medical and dental fraternity by storm with its shocking takeover on a Sunday, colleges will now be able to appoint faculty members on the directions of universities they are affiliated with, rather than standard directives of the new commission. Colleges are at liberty to charge tuition fee as per their wish, without fearing interference from a regulatory authority. The new ordinance also allows them to give marks or points for additional tests.

The new ordinance has been promulgated by President Dr Arif Alvi, which has left the Pakistan Medical and Dental Council (PMDC) dissolved and paved way for the establishment of a new body: Pakistan Medical Commission (PMC). The Ministry of National Health Services (NHS) has sealed the PMDC building. Services of the registrar and around 220 other employees of the PMDC have been terminated. The new nominees include an Economist, a Lawyer and an Accountant Nominated in PMC along with CPSP, Surgeon General, 3 doctors from private sector including Shaukat Khanum and a general dentist will now look after the affairs of the new commission.

Talking to Medical News, a member of PMA who preferred not to be named, said that soon Engineers and others will also be included to run the affairs of the healthcare in Pakistan. It is almost like washing your dirty linen in public.

Special Assistant to the Prime Minister on Health, Dr Zafar Mirza, however, said that the new ordinance was the need of the hour, and it would address all issues related to medical education. He remarked that the PMDC was promulgated when there were only ten medical colleges in the country, and now there are over 150. To ensure their smooth running and address their concerned issues, it was time for drastic measures and major changes, which the new PMC will cater to. According to a copy of the ordinance, the ordinance aims to improve the standard of medical education in the country.

Section 19 of the ordinance states that all candidates will have to clear the Medical and Dental College Admission Test (MDCAT) to get admission to medical or dental colleges, and only a single admission test would be held across the country. Sub-Section 3 of Section 19 further states that admission to medical or dental programs conducted by public colleges would be regulated as per the policy of provincial governments. However, admission to a private college would be per the criteria and requirements stipulated by the private college at least a year before the admission, including any additional entrance test as may be conducted by a private college.

After March 2020, students after clearing their Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Dental Surgery (BDS) programs will have to clear the National Licensing Exam (NLE) to obtain provisional and full license to start house job. Earlier, that requirement was only applicable to foreign graduates. Pakistan Medical Assoiation showed their distaste over this decision, saying that this shows that there is a lack of trust in our medical education system despite the passing of this new ordinance. The other problem that will arise with this decision will be the growth of coaching centers in the country. In the name of preparing the students for Exit Exams, they will charge a hefty fee from already overburdened parents. Another subsection says that Pakistan Armed Forces cadets upon clearing their undergraduate program and pre-requisite military training will be given a provisional license, which will allow them to practice. Many are viewing this as an act of discrimination between civilians and army associates.

It is stated that the major controlling authority of the college will be the university with which it is affiliated. The document explains that a university would have the autonomy to decide the number of faculty members in a college. Earlier, the PMDC used to push colleges to have a certain number of faculty members. Moreover, in case of any violation of rules, the university would take action against the college. These situations call for conflict of interest as universities get the funding from colleges, and in several cases, universities own these colleges.

Another shocking news for aspiring medical candidates and their parents was the statement under subsection 7 of section 20: medical colleges can now charge fees as per their choice, but they would have to mention their fee structure in an advertisement, which should be given three months before admission.

 

Shortly after, another ordinance called the Medical Tribunal Ordinance 2019 was promulgated. The Tribunal will consist of a Chairman (High Court Judge) and at least four members, all selected by the Prime Minister of Pakistan. The Tribunal will be responsible for dealing with complains against the health providers.

The President Pakistan Dental Association Dr Mahmood Shah has also rejected the recently promulgated Pakistan Medical Commission. PDA has labelled the new ordinance as yet another joke with the health of the nation. Only the nomenclature has changed, otherwise the composition of this Commission again consists of nominated persons like the previous Pakistan Medical and Dental Council Ordinance, whereby government-nominated persons were given charge of PMDC. As such, nothing has changed even after the unceremonious lapse of the previous PMDC Ordinance and no lessons have been learnt. Only the Council has been replaced by a more authoritarian Commission, to further enhance governmental authority over autonomous professional bodies. PDA is of the view that this ordinance will also like previous such Ordinances and will die its natural death in 90 days

Commenting on the new ordinance, Senator Abbasi said that there was a judgment of the Supreme Court, which says that there would be no legal justification of the ordinance if the Senate and the National Assembly disapproved of it. He added that government's representatives had invited him in a meeting and sought the support of the opposition for a bill in this regard. "I told them that they should table a bill so that the input of all stakeholders could be included in it.”

Senator Abbasi said he has decided to move a resolution in the house for disapproval of the ordinance. He alleged that the ordinance had been promulgated to please a person who was very close to the prime minister.

PML-N spokesperson, Maryam Aurangzeb, has also criticized the promulgation of the ordinance, informing that her party had rejected it.

Earlier, the Association of University Physicians and Surgeons Pakistan rejecting the Pakistan Medical Commission Ordinance 2019 said that the government covertly unemployed hundreds of employees in the spur of the moment.

The PMDC employees held a protest sit-in outside the council building, demanding the government to withdraw the orders of termination of their services. The ordinance discusses a golden handshake scheme for PMDC employees. According to the scheme, the services of all PMDC employees would be terminated, except those working in grades 1-4. Six-month basic salary would be paid to them as the additional amount, and other dues would be cleared after an audit.