Medical Education In Pakistan Research Articles

The current status and challenges of bioethics education in undergraduate medical education in Karachi, Pakistan

BackgroundThe importance of including bioethics in the medical curricula has been recognized globally. Certain countries including Pakistan continue to lag behind although some developments have occurred recently.ObjectivesThe research aimed to provide a snapshot of bioethics education in undergraduate medical colleges in Karachi, Pakistan. The secondary objectives included identifying factors promoting or inhibiting integration of bioethics into the curriculum.MethodsA two-pronged strategy was used to collect data including a website review of medical colleges, in existence for more than ten years, recognized by the Pakistan Medical and Dental Council (PMDC), the regulating body for undergraduate medical education in Pakistan. The other arm employed in-depth interviews with medical educationists in colleges fulfilling inclusion criteria. Data from the website was analyzed and presented as frequencies. Qualitative data was analyzed using content analysis method which involved coding of transcripts, multiple readings and arriving at subthemes and themes iteratively.ResultsThirteen medical colleges were included for the website review, of which four were from public sector. Three medical colleges used the word “ethics” in their vision and mission statement and four had provided a detailed curriculum for ethics on their website.Thematic framework included four broad themes: 1) Need for Bioethics Education, 2) Current Status of Bioethics Education 3) Challenges in integration of bioethics in medical curriculum and 4) Recommendations for integration of bioethics in the Curriculum. Participants were in agreement that bioethics was important in development of future physicians. Participants identified various challenges, foremost being shortage of trained faculty, lack of institutional buy-in and overcrowded curriculum.ConclusionThe study identified sporadic inclusion of bioethics in undergraduate medical curricula, left to the discretion of individual institutions. Since Karachi is a cosmopolitan city, the findings may reasonably reflect the situation in other parts of the country. While bioethics is recognized as an important field, it will continue to remain an orphan subject in the curricula unless the regulatory and accreditation bodies make it compulsory for institutions to include ethics in their curricula.

Equity, diversity, and inclusion in medical education in Pakistan: Navigating a complex landscape.

Pakistan, a South-Asian developing country with a population exceeding 230 million and a rich cultural diversity faces considerable social and cultural disparities. This article sheds light on the pressing need for equity, diversity, and inclusion (EDI) within its medical education system. Undergraduate medical education in Pakistan faces multifaceted challenges, exacerbated by a digital divide that disadvantages students from underserved regions. The urban-rural divide is further perpetuated during the admissions process, disadvantaging rural applicants. Many medical colleges are ill-equipped to accommodate students with special needs, while cultural diversity often leads to misunderstandings and biases, hindering students' sense of belonging. Postgraduate medical education (PGME) in Pakistan, offered in public and private institutions across the country, lacks standard central induction, rendering it susceptible to provincial biases and favouritism. PGME training predominantly favours urban-centric experiences, with limited availability in rural settings. Public institutions, managing larger patient volumes, provide a broader experience base but often compromise the quality of training due to overwhelming workloads. Female medical graduates face different challenges, leading to a significant dropout rate from postgraduate training and the workforce. Undergraduate and postgraduate nursing education also faces unique challenges such as gender disparity with a mere 10% of nursing students being male. Despite this, only 28% of seats in nursing programs are allocated for male students. The rural-urban divide combined with societal norms and a lack of trained nursing educators compounds the challenges, with most faculty lacking postgraduate or educational training. In light of these disparities and challenges, this article emphasizes the need for a comprehensive, EDI-focused approach requiring unified measures and reforms considering the unique aspects of each segment within health profession education. Achieving equity, diversity, and inclusion is not only vital for the quality of education but also for building a more just and representative healthcare workforce in Pakistan.

An Overview of Private Medical Education in Pakistan

The study's primary purpose was to investigate the challenges and prospects of Private Medical Education (PME) in Pakistan. Private Medical Education in Pakistan has grown significantly in recent decades, and the Punjab province has been at the vanguard of this trend. The desk research was used to gather information and data from books, journals, reports, databases, and online resources, including relevant websites related to private medical education in Pakistan. The author selected several papers, a few from PubMed and many from Google Scholars, to gain insights into the challenges and prospects of the sector to develop thought for the paper. Private Medical Education in Pakistan is an integral part of the Asian Medical Education (ME) landscape, proliferating in response to the increasing demand for medical education. As a result, PME in Pakistan has bright prospects to contribute significantly to the continent's development in terms of ME and economy. The Pakistan Medical Commission (PMC) is Pakistan's medical education and training regulatory authority. It is responsible for ensuring that medical colleges and universities in the country meet the required standards for the quality education and training of medical professionals. However, ME in Pakistan faces several challenges: high tuition fees, limited funding, shortage of MBBS doctors, lack of government support and insufficient medical infrastructure in rural areas, and concerns about quality and standards. Of course, these challenges are not unique to Pakistan but also to many developing countries in Asia, but they are significant. They require the immediate attention of the Pakistan Government to address the issues. Keywords: Growth, Challenges, Prospects, Private Medical Education, Pakistan

Ethical and Moral Issues in Undergraduate Medical Education: An Exploratory Study

Background: Ethical and moral values form the basis of the environment in any academic institution. Objectives: This study aimed to explore the ethical and moral issues faced by medical students during their undergraduate medical education in Pakistan. Methods: This qualitative exploratory study was conducted at ABWA Medical College, Faisalabad. It included thirteen semi-structured, one-to-one interviews of volunteering undergraduate medical students of Punjab, Pakistan, from September 2021 to February 2022. The interview invitation was sent electronically to social media groups. Member checking of transcribed interviews was done, and data were analyzed thematically using Atlas-ti software by two independent researchers. Results: Thematic data analysis led to the formation of 28 codes, 13 subthemes, and 3 main themes. Based on the social constructive approach, three main themes were categorized into ethical issues in (1) academic, (2) social, and (3) clinical contexts. Conclusions: The results showed that undergraduate medical students face a myriad of ethical and moral disruptions during their undergraduate study period at medical college. Much awareness about identifying and dealing with such issues is recommended to bring more quality to the program.

Gender Perspective in Motivation to Study Medicine and Option of Future Practice; A Cross-Sectional Survey in Two Medical Colleges of Karachi, Pakistan

Objective: To access the reasons that are the driving force for joining the medical field, whether willingly, by parents' wish, or because clinicians are the role models and the career choice of the medical students, Methods: This cross-sectional questionnaire-based study was conducted at Jinnah Medical & Dental College and Dow University, Karachi, from May 2018 to November 2018. All the undergraduate medical (MBBS) students were randomly selected, choosing 40 students from each class in an equal number according to gender (20 female students and 20 male students), first to final years from both of the colleges. Consent to participation was obtained verbally from all of the individuals. A questioner was structured regarding demographic information along with reasons for choosing the medical profession and specialty choice for a future career. All the information was collected by using the questioner based self-made study proforma. Results: A total of 400 students were studied. The majority of the students 59.6% were aged 20–22 years, while 40.5% were 23–26 years old. According to the reasons for choosing the medical profession, 37.0% were due to personal interest and parental wishes, 6.8% said their parents are doctors and they are following them, 28.5% students choose the medical profession to serve humanity, 10.5% chose it for high income, 10.3% followed it as a role model, and 7.0% had multiple other reasons. Most common career choices were 26.5% medicine, 30.0% surgery, 5.3% gynaecology, and 7.5% public health, while 8.0% of students still had not decided. Reasons for choosing the medical profession were statistically significant according to age and gender (p = 0.001). Conclusion: The choice of medical education in Pakistan is still affected by stereotypes thoughts with typical eastern influences. Parental wish is a strong and prevailing factor, followed by to serve humanity. Lack of career counselling and guidelines results in the health industry losing many future doctors every year, as well as loss of potential resources for their training. Keywords: Factors, medical profession, gender, career choice

Comparison of Quality of Life of Medical Students in Annual and Modular System in Public Sector Medical Colleges in Karachi, Pakistan

Background: Curriculum structure in medical education in Pakistan includes an annual system which is based on subject wise learning and clinical rotations, and a modular system, with the basic and clinical sciences taught cohesively. The effect of curriculum designs in the quality of life (QoL) of medical students has not been assessed in Pakistan. We aimed to compare these two curriculum structures focused on QoL. Methods: Cross-sectional study of medical students from three different medical schools in Karachi, Pakistan, comparing QoL based on their curriculums. QoL was measured using the WHOQOL-BREF questionnaire. Through random sampling students from each year (1st-5th year) in each institution were selected. Kruskal Wallis test and Mann-Whitney U test were used to compare scores among different years of medical training and between curricular systems. Results: Response rate was 85%. Out of 404 participants, 81.3% were females, and age average was 21±1 years. According to the year of study, significant differences were observed in physical health and overall QoL domain, with 3rd-year students having the highest scores. Overall QoL of students in clinical years was found to be significantly higher than those in preclinical years. The modular system was found to have a better but not significantly higher QoL when compared to the annual system (mean 83.34±11.41 vs. 82.32±10.27, respectively). Conclusion: Overall QoL in the modular system was slightly higher than the annual system, but a significant difference was noted only in the environmental domain. QoL of students in clinical years was higher than preclinical years.

Professionalism - The Ignored Competence of Medical Education in Pakistan

Professionalism - The Ignored Competence of Medical Education in Pakistan

Why do we fail to fail Undergraduate Medical Students? A Perception of Ophthalmology Faculty

Objective of study: To evaluate the ophthalmology faculty perspective on why they fail to fail undergraduate medical students. Place and duration: Medical colleges and universities of both public and private sectors, duration was three (3) months Study design: It was a cross sectional survey. Non-probability conventional non interventional sample was used. The data was analyzed by SPSS-25. Methods: Total 134 university examiners for undergraduate medical students from ophthalmology faculty were identified from the websites of both private and public sector medical universities and colleges of the Punjab, Pakistan. The ophthalmology faculty members with more than five years of experience as a faculty were included in the study. An online survey questionnaire was sent out through Google forms. The faculty members were given reminder twice. The responses are analyzed with SPSS-25. Results: Out of 134 ophthalmology examiners, 98 (73.13%) examiners responded to the questionnaire. Among the respondents, only 80 faculty members, 58 (72.5%) males and 22 (27.5%) females, with teaching experience of more than five years, are included in the data analysis. Fifty-four (55.10%) participants declared teaching experience of more than ten years while 26 (26.53%) had experience between five to ten years. Twenty-seven (33.75%) respondents had additional qualification in the field of medical education like certification, diploma, or master’s degree (CHPE or MHPE). Fifty-five respondents (68.75%) opted that a few unmerited students passed fourth professional medical university exam. Further, 47 (58.75%) respondents also agreed that they were failed to fail a few ineligible and inefficient undergraduate 4th year medical student while marking a viva voce interactive session, a mandatory section in practical examination, as an internal or external examiner, whereas 33 (41.25%) respondents disagreed with this statement. The top five reasons behind failure to fail, as identified by the respondents were poor assessment methods (50%), lenient examiners (37.5%), commendation by colleagues or administration (22.5%), irrelevant syllabus (12.5%) and pressure from college administration (10%). Mixed opinion regarding the standards of medical education in Pakistan was emerged, according to 45% participants “it is improving”, while 55% had opinion “it is deteriorating”. The top four suggestions opted by the participants regarding improvement in medical students’ assessment to avoid fail to fail phenomena, were “teachers should be more experienced” (60%), “strictly following the criteria of 75% mandatory attendance set by university while sending students admission for university exam” (50%), “revision of admission criteria while selecting first year medical students” (25%) and “adoption of honest policy by administration while selecting students for admission in medical college” (10%). About 60 (75%) examiners felt the need to revise ophthalmology syllabus for under graduates. Conclusion: Being a medical teacher and an examiner is considered as an honour as well as a great responsibility because their students are going to be the future serving doctors, dealing with human life. An unsafe physician or surgeons is neither desirable for doctors’ community nor for the society. Examiners should be more trained, more experienced, and able to assess the failing student if he or she is inadequate, deficient, or not meeting the required standard without any bias. The formative assessment should be dependable, reliable, and rigid as compared to summative assessment and failing a student should be considered as providing them a second chance for their improvement rather than producing an inadequate or incompetent doctor. The standardized admission criteria and merit policies need to be followed. The ophthalmology syllabus should be revised as it needs to be more community oriented and precise. Key Word: Medical student, medical teacher, ophthalmology, examiner, fail.

Reforming Medical Education in Pakistan through strengthening Departments of Medical Education

Early medical education departments, notably in the United States, were well-known for their origins as medical education research institutions. Objectives: According to this study, Pakistan's medical education may be improved by creating new departments of medical education and training. Methods: The Punjab Health Department conducted this cross-sectional survey from August 2021 to November 2021. Participation in the research was open to people from all areas of life. The study included all the city's medical schools that were approved by the PMDC and situated inside the city's boundaries. Responses were from medical college faculty members who had been solicited to participate in the survey, such as department chairmen. Results: In the study, 200 people are participating, and their data was acquired from that group. Every single person who has been nominated for the position was interviewed. Students' assessments (72.2 %) came in second, followed by faculty development (70.7 %), curriculum development (70.7 %), and educational research (66.6 %). Conclusion: For the last argument, it is claimed that DMEs with a long history of success can play a key role in strengthening medical education. Policy, governance, and regulatory challenges should be addressed by the Ministry of Planning and Development, and medical universities in Pakistan, as well as technical capabilities in these areas at medical and dental schools across Pakistan

Medical Education in Pakistan: Challenges & Way Forward

There have been many conceptual and practical drawbacks in how the medical education has been developed in Pakistan. Though there has been expansion in the medical education sector since the creation of this country, the doctors available for the existing population are not sufficient thus affecting the overall quality of medical care. To understand this particular issue, associated factors are required to be analyzed. Medical education in Pakistan is affected by the growth of the private medical colleges, mal-distribution of resources, traditional curricula that focus on theoretical knowledge more than the practical training and absence of uniform admission processes in the public and the private sectors. To keep pace with socio-economic development and the quality of medical education, there is a need for re-evaluation of every facet at each and every level: creation of strong and efficient accreditation system; promotion of equality in the distribution of resources; curriculum redesigning with stricter implementation of guidelines provided by Pakistan Medical Commission (PMC) and improvement in the teaching and assessment methodologies for graduates in the medical profession; thus providing optimum healthcare delivery ensuring competence concomitantly and bringing positive change in the system.

Problems of Medical Education in Pakistan

Background and Aim: As the new millennium dawned, there were numerous difficulties to overcome, particularly in the field of health education. As the first line of defence against many diseases, oral health was given prime consideration. The study's primary goal is to identify the challenges faced by Pakistan's medical education system. Study Design: Descriptive cross sectional study Place and Duration: Department of Medical Education CMH Institute of Medical Sciences, Bahawalpur during from September 2020 to Jan 2021. Methodology: The data was collected from 200 participants of different age groups from FSc to Ist year of medical colleges. We wish to examine the difficulties that students and their families faced at the beginning and during their medical education in Pakistan. Results: A total of 200 people were surveyed. Interviews were performed with each and every one of the individuals who had been shortlisted. We then come across the following issues that students and their families faced while pursuing medical degrees in Pakistan. The mainstay of education at the undergraduate and graduate levels is the standardisation of instruction. Lectures are considered to be the most efficient method of delivering information to students, as they need minimal engagement from the students. Conclusion: Medical educationists, teachers, administrators, and policymakers in poor nations should endeavour to transform the adversary of difficulties into a chance to construct excellent learning programmes. Perhaps it will lead to new pathways of lear. Keywords: Medical Education, Teaching Methodology, Problems

Reforming Medical Education in Pakistan through strengthening Departments of Medical Education

Introduction: Early medical education departments originated as medical education research offices, primarily in the United States of America (USA). Objectives: The main objective of the study is to analyse the reforming medical education in Pakistan through strengthening departments of medical education. Material and methods: This cross sectional study was conducted in Quaide Azam Medical College Bahawalpur in duration of Jan 2021-Sep 2021. The survey includes all of the city's PMDC-recognized medical schools. Respondents were medical school faculty members who were knowledgeable about the subject matter of the survey. Results: A total of 200 people took part in the study. All of the participants were interviewed by us. Education research (66.6 percent), faculty development (70.7 percent), and curriculum development (77.7 percent) were the top four tasks. Conclusion: This study concludes that well-established and effectively operating DMEs can play an effective role in increasing medical education quality. Medical and dental institutions should be supported in Pakistan by the Pakistani government's Ministry of Health & Family Welfare (PM&DC), the Higher Education Commission (HEC), as well as Pakistan's leading medical and dental universities in policy, governance, and regulatory matters. Keywords: Medical Education, Faculty Development, Lack of Resources, Infrastructure

Medical Students' Academic Achievement Differences in Annual and Semester-Based Examination Systems: Anatomy Subject Scores As an Example.

Introduction: Various factors including the system of examination affect students’ academic achievement. Annual or semester-based examinations are commonly observed practices. Students like semester system, as their academic performance is significantly higher in this system. Medical education in Pakistan has largely followed the British system of preclinical and clinical years of teaching followed by end-of-year examinations. In the wake of medical education reform, the semester system of examination having objective assessment was recently introduced in medical institutes of Pakistan. There is no empirical evidence regarding the effects of this change on medical students’ academic achievement. This study aimed to assess whether the semester system has made any difference in the academic performance of medical students as compared to the annual system of examination.Method: Anatomy percentage scores of two batches of students who sequentially took annual and semester examinations were collected from a medical university. The data were analyzed for normality and later descriptive and inferential statistical tests were carried.Results: The data of 748 students (semester = 319 and annual = 429) were entered for analysis. The students who took semester-based examination (N = 319, M = 72.30, SD = 8.25) performed better than the students who took annual examination (N = 429, M = 64.36, SD = 10.69). The difference in mean percentage scores was statistically significant (t-test = 11.04, degrees of freedom (df) = 746; p < 0.01; 95% CI, 6.53-9.35).Discussion: The results demonstrated the enhanced scores of students who sat the semester examination. The findings of this research supported the earlier studies that suggested the restructuring of course durations and examination system have enhanced students’ achievement. Also, the objective assessments method showed improved academic performance.Conclusion: The study found that anatomy knowledge assessment scores of students who sat semester examination were significantly higher than students who sat the end-of-year examination. Further studies are needed to understand if this difference is also observed in other basic sciences subjects and continues in the performance clinical years.

Medical education in Pakistan, Where Do we Stand?: Medical Education in Pakistan

Healthcare providers and doctor community is considered very respectable in society. It is not a small task to deal with human lives. This high regard for the community has a big responsibility. This is a very important and sensitive profession where a small mistake can cause disaster. Considering its importance and sensitivity it is required that doctors and healthcare providers should have proper skill, knowledge, ethics and professional attitude to avoid the repercussions and deal the challenges that daily life brings. Medical education system is way to prepare and equip healthcare providers from raw recruits to skillful manpower. Medical education curriculum should be updated with time according to the advancement in science, medical practice and social needs. Many factors play the role in converting and preparing the student of first year in medical college and university into a professional doctor. Some of the factors cannot be controlled like his social activities, financial problems, family and social problems and intellectual acumen. Factors that can be planned and controlled are quality of medical curriculum and standard of teaching. Corona virus pandemic which started from Wuhan has greatly affected the teaching and education. It has brought new challenges in medical education. Students of the whole world have suffered due to the closing of universities and colleges. Medical institutes have shifted from physical classes to the online teaching. New advancements in technology of our time has opened many opportunities for distant learning and exchanging the knowledge and experience worldwide due to the internet connectivity and accessibility. Medical education systems of the world has developed and designed online courses considering the present situation. Developing world has different challenges to shift to online learning from the developed countries .

Rote Memorization & Medical Education In Pakistan

Rote Memorization & Medical Education In Pakistan

Online Medical Education and Examinations during COVID-19: Perspectives of a Teaching Associate.

The novel coronavirus disease 2019 (COVID-19) pandemic has not only challenged global health systems but also social, economic, and educational systems. In this short communication, our focus is on its impact on medical education in Pakistan. We discuss the structure of undergraduate medical education in Pakistan; and how it has evolved in the wake of COVID-19. We describe our role as teaching associates (TAs) at the Aga Khan University (AKU); and how it has enabled us to be a part of the transition to online medical education, with a specific focus on online examinations in medical schools. Key Words: Medical education, Online examinations, COVID-19, Pandemic.

Design and evaluation of a blended mental health curriculum for undergraduate medical education in Pakistan

There is a significant shortage of qualified psychiatrists and related service providers in Pakistan; this occurs in the backdrop of burgeoning evidence of a high prevalence of mental health disorders in the country. At the Aga Khan University Medical College, Psychiatry has been taught to the undergraduates as a mandatory one-month clinical rotation since 1987. AKU is the only medical college with a formal psychiatry training at the undergraduate level. In 2017, a team of faculty members reassessed the curriculum, teaching methodology and learning outcomes of the psychiatry rotation. As a result, an outcome-based, blended curriculum was devised that integrated virtual and classroom-based learning with patient skills training. The new curriculum has now been in implementation for one year. At the end of the rotation, a questionnaire was administered to determine students’ experience of online learning. WEBLEI was adapted to measure students’ perceptions across four subscales. Data was gathered from learners’ use of the virtual learning system, participation in facilitator-based sessions and the clinical teaching and learning. Students were also asked to compare didactic face-to-face sessions with blended learning. Blended learning scored higher on all measures such as student engagement, critical thinking, student-led learning and alignment of assessment method with learning outcomes. The analysis of this data has informed future directions regarding the design and implementation of a Pakistan-wide mental health program. This study also highlights the challenges of curriculum design and its implications in the broader context of Pakistan. The results add to the existing literature about the experience, challenges and successful outcomes of designing a blended curriculum for Pakistan.&#x0D; Keywords: Blended learning, Integrated curriculum, Mental health, Learning analytics, PakistanHow to cite this article:Chachar, A.S., Siddiqui, S.A., Saeed, H., Naseem, A. &amp; Mian, A.I. 2020. Design and evaluation of a blended mental health curriculum for undergraduate medical education in Pakistan. Scholarship of Teaching and Learning in the South. 4(2): 100-117. https://doi.org/10.36615/sotls.v4i2.111.This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Views of expatriate Pakistani doctors about quality of medical education in Pakistan

Introduction and objective: Road Survey to evaluate and analyze the views of Pakistani doctors working in various developed countries about the quality of undergraduate and postgraduate medical education they received in Pakistan and how well it prepared them for their role as senior physicians in a multicultural healthcare workforce in many countries and in terms of parity to the medical education in their current country of work.&#x0D; Methodology: A web-based survey consisting of twenty item questions with graded answer choices, was prepared by the authors to include a multidimensional comprehensive questionnaire to collect the views of the target participants. The survey was completed anonymously on a mobile device or a computer with internet access and took 5 to 10 minutes to complete.&#x0D; Results: The results of this qualitative survey indicate that there is generally a broad convergence of opinion regarding the quality of Pakistani medical education, with primary medical education, more consistently considered higher quality, amongst the Pakistani physicians currently working in UK, USA and Middle Eastern countries.&#x0D; Conclusion: Overall the Pakistani education seems to be of a satisfactory level, but cannot be considered to be superior to the counterpart education from these countries, based on this survey results. Areas such as research methodology appear to be particularly weak and there was a divergence of opinion regarding what the top priority should be to address within Pakistani medical education and training environment. Many of these physicians would like to work in Pakistan again, provided that the working conditions are favorable.

Lecture Banking - Quality Learning Transfusions for Health Sciences Students Post-COVID-19

&lt;p&gt;The Coronavirus has changed the dynamics of human interaction around the globe. Medical Education in Pakistan is moving through a state of transition with introduction of the modular education in place of traditional methodologies. The development of Lecture bank can be the source of helpful educational transfusions for student centered self-directed learning in health professional education.&lt;/p&gt;

Challenges of Online Medical Education in Pakistan During COVID-19 Pandemic.

The novel coronavirus (COVID-19) pandemic has adversely affected economy, social life, and educational services all around the globe. Medical colleges and universities are facing challenges to provide quality education to their students during this prolonged period of lockdown. Technologically advanced countries have systems in place for e-learning and online medical education. This is not the case with most of the low-income countries like Pakistan. Here, we describe the challenges being faced by medical faculty members and students in Pakistan while engaging in online medical education during the COVID-19 pandemic. These include lack of faculty training and institutional support, internet connectivity issues, maintaining student engagement, online assessments, and problems with understanding the unique dynamics of online education. A collaborative approach involving all stakeholders, intuitional support, use of free online training resources, and out of box thinking can help overcome these challenges. Key Words: Analysis, E-learning, Coronavirus, Developing countries, Solutions.