International Issues: Neurology training in Pakistan

Abstract

Pakistan is a developing country rich in ethnic and cultural diversity in its four provinces. It ranks sixth on the World Health Organization (WHO) list of high disease burden countries. The present national infrastructure of health facilities is equipped with 945 hospitals, 4,755 dispensaries, 562 rural health centers, and 5,349 basic health units.1 There are 1,452 patients for every available bed, which is far behind the country requirements.1 Although the total number of registered doctors in Pakistan has increased considerably from 83,682 in 1998 to 127,859 in 2007, there is still only one doctor available for every 1,254 patients and one nurse available for every 2,671 patients, which is below the international recommended ratio.1 The adult literacy rate in Pakistan is 52%.2 The current number of trained neurologists in the country is particularly low. There are only an estimated 85 consultant neurologists3 in a population of 150 million. Nevertheless, this figure reflects a significant growth in neurology in the past few decades. Neurology has grown rapidly from an almost nonexistent discipline approximately 50 years ago.3 In some ways, this rate of progress is akin to the way in which neurology gained its roots in the United States, where it lagged almost a century behind other disciplines in the 1860s.4 Figure Aga Khan University Hospital Reprinted with permission. Dr. Munawwar Hayat established the first department of clinical neurology in Pakistan at King Edward Medical College and Mayo Hospital in Lahore in the late 1960s. In the early 1970s, Dr. Akhtar Ahmed and Dr. Zaki Hussain jointly established departments of neurology in Karachi at Civil Hospital and Jinnah Postgraduate Medical Centre.3 Within the subsequent two decades, neurology flourished across the country. Currently there are at least 16 academic neurology departments throughout Pakistan.3 There …