THE governments at both federal and provincial tiers aspire to provide specialist services not only in tertiary care hospitals, but also in all district headquarters (DHQ) hospitals, taluka headquarters (THQ) hospitals and all major healthcare facilities having more than a hundred beds.

A large number of trained consultants are required to achieve such an ambitious target. There is an acute shortage of specialists in all disciplines of medicine, particularly those trained to manage and practice modern techniques.

For postgraduation in medical sciences, a medical graduate has to pass fellowship examination — Fellowship of the College of Physicians and Surgeons (FCPS) — from the College of Physicians and Surgeons, Pakistan (CPSP), an institution of international repute based in Karachi with branches in Lahore and Islamabad.

FCPS comprises parts I and II. FCPS-I is a competitive examination requiring high medical intellect. This is followed by admission to a four-year clinical course at some tertiary care centre in Pakistan.

On their part, medical universities have evolved their own way of conducting such examinations. There are very few seats in the universities and there is also lack of facilities and capacity to train postgraduate students. Besides, there is also a lack of will on the part of the authorities concerned to accommodate the applicants.

Medical graduates who do not get admission to FCPS-II, keep trying till their three-year deadline expires, making their FCPS-I qualification good for nothing.

They then have to reappear in FCPS-I exam after paying an exorbitant CPSP fee. This is a strange cycle beyond the control of the applicants.

To facilitate postgraduate training of FCPS-I candidates, there has to be close coordination among the CPSP, medical universities, provincial governments and the Higher Education Commission (HEC).

Currently, the CPSP is producing FCPS-I qualified candidates every three months — after charging an exorbitant fee, of course. However, it remains totally disconnected with the fate of the successful candidates. The CPSP must play — or be made to play — its part in helping FCPS-I candidates get training opportunities for FCPS-II. Else, it should not invalidate their qualification for at least 10 years.

On their part, the medical universities should increase their capability and capacity to deliver postgraduate training. The HEC should force it on the agenda of medical universities. It can do that by providing funds to the universities in proportion to the number of enrolled postgraduates.

The governments must realise the folly of missing out on the services of qualified medical intellectuals with FCPS-I qualification. At present, there are about 10,000 such candidates looking to somehow get admission to FCPS-II clinical course. The number of such talented postgraduates is increasing and it will keep on increasing if policies are not changed.

In principle, all FCPS-I postgraduates must get admission to FCPS-II training without having to waste their precious time. Had they been not good enough, they would have failed FCPS-I. They are national assets and must be given a stipend of Rs60,000 per month till they get admission, and during this period their services should be utilised on the clinical side for better medical care.

It is an irony that we face shortage of consultants despite having tremendous talent in such large numbers amid us.

Dr Fateh M. Khan
Ex-Director General,
Sindh Health Services
Hyderabad

Published in Dawn, June 17th, 2023