ISLAMABAD: While students and associations of private medical and dental colleges have been critical of Pakistan Medical Commission (PMC), the Ministry of National Health Services (NHS) in a performance report claimed that the commission has been performing well.

The report said PMC was formed in September 2020 to standardise medical education. In a short span of time, the regulatory body took several steps to set standards that will help improve the healthcare system.

The ministry claimed that Pakistan Medical and Dental Council (PMDC), which was dissolved and replaced with the PMC, had failed to check mushrooming of private medical and dental colleges, fix the inefficient licensing system, outdated curriculum and dwindling standards of healthcare delivery.

“To find a lasting solution to these problems, the PMDC 1962 Act was amended in 2012 and again in 2014. Unfortunately, these efforts were in vain. Moreover, it was becoming extremely challenging for medical graduates to also prove themselves to be competitive abroad.”

Says NLE, MDCAT and revised inspection standards aimed at improving quality of healthcare education

The Educational Commission for Foreign Medical Graduates (ECFMG) assesses the readiness of international medical graduates to enter residency or fellowship programmes in the United States. If Pakistan is not recognised by the ECFMG in 2024, graduates will not be hired as a doctor in the US. PMDC was given 10 years to meet the standards of ECFMG but it made no progress to improve quality.

“PMC is taking urgent measures to ensure they meet the standards of ECFMG and can apply for accreditation. The conduct of the National Licensing Exam (NLE), Medical and Dental Colleges Admission Test (MDCAT) and revised inspection standards are just some of the steps taken to improve the quality of healthcare education in Pakistan,” the report claimed.

“Before the PMC was created, each province administered MDCAT individually, which created a rift in national merit since each province had adopted different provincial syllabi. Various boards competing with each other started awarding higher marks to their students, so more students from their board were accepted into medical colleges. To provide every student an equal opportunity to pursue medicine, it was necessary to set a uniform standard. Hence, PMC mandated a standard MDCAT exam across Pakistan to ensure that only competent students got into medical colleges. For the first time in 2021, MDCAT was held in 25 centres in Pakistan and at six international centres in North America, Europe and the Middle East. A record number of 194,133 students took the MDCAT from August 30, 2021, to October 2, 2021- 68,680 students passed the exam resulting in a national pass percentage of 35.4,” it stated.

“PMC also introduced a computer-based testing system to enhance transparency and allow all students to compete on a level playing field. The system also allowed students to prepare for the exam through sample questions, practice tests and specially designed drills. A record number of students registered for the first computer-based MDCAT examination across 21 cities and five international locations.”

Ministry of NHS’ spokesperson Sajid Shah told Dawn that once students graduated from a medical school, there wasn’t a standard criterion of assessment for foreign and local medical graduates to get licensed to practice medicine in Pakistan legally.

“In the presence of ever-growing private medical colleges and declining education standards, it was more important than ever that licences were only issued to graduates who could prove that they could provide safe care and function independently. A large number of students who were unable to meet the minimum admission criteria in Pakistan sought admission in medical colleges abroad. In some instances, graduates from these foreign medical colleges were not allowed to practice in their host countries.

The PMC addressed this medical malpractice by evaluating the standards of medical education imparted in foreign medical colleges and enforcing restrictions. To practice medicine in Pakistan, foreign medical graduates now must hold a medical licence accepted by their host country. PMC also mandated that foreign students pass the NLE in Pakistan before they can practice to confirm that they are at par with local graduates,” he said.

“In December 2021, 8,069 graduates from national medical colleges sat the examination, out of which 7,233 passed the NLE step 1 (medical) exam, resulting in a pass percentage of 89.64. Moreover, 3,437 graduates from foreign medical colleges sat the examination, out of which 1,137 passed the NLE step 1 (medical) with a pass percentage of 33.08.

The results of the 2021 NLE exam proved that it is a fair indicator and much-needed barometer to gauge the basic competency of medical students from foreign and local medical colleges,” Mr Shah said.

Published in Dawn, January 16th, 2022