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It may be mentioned at
the very outset that CPSP and its present Council treats its trainees as
the future stakeholders of the College. This College, its entire
infrastructure and more importantly its legacy of developing an
appropriate postgraduate medical education system for this Country and
the Region, belongs to its fellows which also includes its future
fellows (the trainees). Founded in 1962, the Late Gen. W. A. Burki
played his part in establishing and introducing it to the Royal Colleges
in UK. Prof. S. M. Rab, Prof. Hayat Zafar, Prof. Luqman Ali, Prof.
Khawaja Saadiq Hussain, Prof. Ijaz Ahsan, Prof. M. Haq Nawaz and Prof.
M. Sultan Farooqui have all contributed along with their Council members
to bring this institution, where it now is; giving over 85% of the
specialized medical manpower to the Country. It is due to the fact that
all of them have considered this institution as a sacred trust of its
Fellows; of the past, present and the future.
Dr. Muhammad and Dr. Ahmed have rightly pointed out that the College
always played a leading role in getting appropriate stipend for its
Fellowship trainees. It was due to the efforts of the previous Council
that the trainees got their stipend alleviated from Rs. 6,000/- per
month to Rs. 10,000/- per month. Presently, it is due to the untiring
and persistent efforts of Prof Zafar Ullah Chaudhry, its incumbent
President and the Council that the stipend has been raised to Rs.
22,500/- per month. We are fully aware that a large number of College
trainees are yet not able to get the stipend as fixed by the Provincial
Governments; but the trainees must realize that they are part and parcel
of a society which is facing grave economic issues. Thousands of our
postgraduates (MBA, MA, & MSc) are not able to get even this much after
attaining post graduation. This is due to the financial crunch and
lopsided economic policies which are being faced by our society, of
which we all are obliged to be a part.
Coming to the three expectations narrated by these spokesmen of the
trainees, let us discuss them one by one.
They claim that the trainees expected to see reduction in fees of
examination and workshops. They should realize that the examination and
workshop fees have not been increased for the last seven years, although
the dollar rupee parity has gone up from Rs. 60/per dollar in 2006 to Rs.
85/per dollar. This has brought in an unprecedented inflation which is
still running in double digits. The College’s administrative expense,
traveling expenses and even equipment cost has risen by almost 40%
during these years. Based on the inflation cited above, the fees should
have been increased by at least 100%, if not more. Yet the College has
not increased any of the fees.
On the other hand, it’s a matter of record that the Present Council of
the College has made the Computer & Internet Workshop optional for all
those who are already well versed with this technology. The College
introduced a Computer & Internet Exemption Test at a nominal cost of Rs.
1,000/- only. The fee for five days Computer & Internet Workshop has
been reduced to Rs. 6,000/- only.
It is desired that Communication Skills Workshop be dropped. The
trainees should understand that there is a definite, professional
relationship between a specialist and a patient or his attendants, which
has to be learnt and acquired. Our trainees should realize that the
College is perpetually updating its Workshop manuals; the Surgical
Skills manual has recently been updated and revised; and Research
Methodology & biostatistics and Communication Skills manuals are
presently under revision. It costs to the College. We are fully aware
that it financially hurts our trainees; but they must realize that
capacity building is a definite and important aspect of the postgraduate
learning and grooming of a comprehensive personality of a specialist.
And one has to pay for the cost of this capacity building. May I venture
to inform them that ATLS® workshop is being offered by the College at Rs.
20,000/- only while the same is available in Gulf countries at a cost of
$ 450/-
They next discussed the rotations of the General Surgery; presumably for
the year 3rd and 4th. College has already taken notice of the
discrepancy and has now decided that there should be only Six months of
rotations during the Advanced Training in General Surgery in years 3 &
4. The trainees should refer to the new prospectus and the Visual
Display Chart of General Surgery, FCPS-II, for year 3 and 4. However,
those who have already undertaken their training according to the
previous prospectus must abide by it. The changes in the curriculum can
only be prospective and not with retrospective effect.
Next was a discussion about the synopsis and research.
Firstly, the trainees must comprehend as to why the College insists upon
research as a mandatory aspect of the FCPS. The College Fellowship is
equated with PhD and even Kuwait Institute of Medical Sciences (KIMS)
has equated it with PhD. The PM&DC also treats College Fellowship at par
with PhD in clinical sciences. Further, the College Fellowship has now
become prerequisite for being a member of a Faculty. No further
qualification is required by PMDC (except continued research) to attain
the position of a Professor; while in other physical and social
sciences, a PhD degree is a prerequisite to get the position of a
Professor. And to attain a degree equivalent to PhD, the trainees must
strive and undertake research.
Research has its own parameters. For those who consider synopsis and
dissertation a nightmare; they better choose MCPS where no research is
involved. But then they will not be able to equate to a holder of PhD.
The College, on its part has facilitated by developing Provincial
Headquarter Regional Centres at Hyderabad, Lahore, Islamabad, Peshawar
and Quetta, where the facilities of getting the synopsis checked,
assessed and providing appropriate assistance. Epidemiologists and
Statisticians are available at all these Centres. Besides, the College
encourages the trainees to participate in Research Methodology Workshop,
come with their proposed synopsis and discuss it in the workshop. This
will and can help them develop appropriate synopsis.
As stated above, the research has its parameters, developed
internationally and the sample size is determined accordingly. We cannot
amend or alter the internationally recognized parameters of research;
but in cases of real difficulty, the epidemiologists of the College are
thee to come with a solution.
Concluding, it may be said here that the knowledge is fast expanding and
to acquire the highest degree of clinical sciences in Pakistan, one is
required to put in extra efforts, energy and put the family life at
loss. The College Fellows of the Future must resolve to even further
enhance and improve the bar and parameters, rather than to ask for
lowering it.
* * * *
* * * * * * * *
Another viewpoint from
Trainees from Lahore
We the Postgraduate Trainees from Lahore also wish to respond to the
write-up by Dr. Muhammad and Dr. Ahmed published in PULSE International
of January 15th 2010. We agree on some issues and have right to disagree
on some points which need elaboration. The writers have rightly
mentioned long working hours and financial constraints. There is no
doubt that post graduate residents are the main force providing health
care facilities in all public sector hospital of the country. We expect
federal and provincial Governments for facilitation, duty hours must be
defined and pay package needs to be increased in all four provinces of
the country. As now the western countries are closing the doors of post
graduation to our doctors and number of doctors doing FCPS-I are
increasing day by day but paid slots created few years ago by the
efforts of CPSP authorities and doctors representative are same. As much
we expect and request the authorities to increase number of these seats
in proportion to the number of doctors passing FCPS-I. It is unjust that
doctors after passing a transparent and standardized FCPS-I and getting
registration has to do job on honorary basis.
Now coming to CPSP there are many problems related to postgraduates and
fellows. They have been addressed to some extent for which we are
grateful. However our view point is as follow:
Although the fee of exams and workshops has not been substantially
reduced but it is frozen from 2004 onward, in spite of present high
inflation rate. We appreciate the present council for giving relief in
computer workshop fee up to Rs. 1500 to every one and making it
optional. Re-submission fee of synopsis and Re-registration fee in some
institution has been abolished, research methodology workshop for MCPS
has been made optional, credits must be given for provision of
facilities like, inauguration of new regional Centre in Quetta and
Hyderabad. Extension of the Centers like Lahore Centre and Peshawar
Centre, video-conference facilities at all main centers of CPSP and
signing of the MOU with Saudi-Arabia and other countries. Our doctors
working at the King Fahad Hospital after this MOU are happy and feel
facilitated.
Submission of the synopsis at the regional centers and the entire
synopsis submitted are being responded within the period of two to three
months time as compared to the past when it took around one to two years
to get the synopsis approved. Similarly dissertations are being
processed within the due time of six months. All of us who attend the
workshop feel that they are justified and we learn knowledge and skill.
Computer workshop is already optional. We can appear in the test and
there is no need for the workshop. Regarding the communications skill
workshop this is essential in these days because doctors should know how
to talk with the patients properly and how to satisfy them. If you go
through the feed back of this workshop, 90% of our friends feel that
either the duration should be increased or it should be attended every
year.
We would like to mention here that the present council has created an
environment of facilitation keeping in view the dignity of the college
and prestige of the degree. Relief within the notification rule and
regulation is not delayed, the example is induction of new residents
after implementation of new residence program, continuity of training in
same unit after the transfer of supervisor have resolved important issue
of trainees. The President Prof. Zafar-ul-allah Chaudary and councilor
are available to fellows and trainees especially at Lahore the regional
director himself and controller of examination Dr. Amjad have regular
meetings with the post graduate trainees.
Our expectations are that CPSP will have further collaboration with
international forum. We are waiting for the good news from the Malaysia
, UAE, and UK. Similarly implementation of e-log system and regular feed
back from the trainee regarding their training and supervisors is yet
another step which needs to be commended. Finally we are grateful to you
for your concern about our issue and health care delivery system in the
country.
Dr. Aurangzeb and Dr. Nabila
Postgraduate Trainees in Medicine
391-Neelaw Block,
Allama Iqbal Town, Lahore. |
