This week You! takes a look at the recently introduced telehealth education & training project ‘eDoctor’ initiated for the home-based female doctors in Pakistan...
Let us take the example of women in the field of medicine. Many female medical students accept that a medical degree is an extremely hot ticket in the marriage market. According to a report by BBC, the government body that regulates the medical profession, the Pakistan Medical and Dental Council (PMDC), says more than 70 per cent of medical students are women. Competition to get into these medical colleges is tough - at one college they receive 10,000 applications for a 100 places. In the prestigious colleges, students must get 90 per cent grades or more in order to be considered. The vice-chancellor of a local medical university in Islamabad shares that girls are more focused on excelling academically than boys. At the same time, he accepts that some female students are keener on catching a husband than on pursuing a career. “It’s much easier for girls to get married once they are doctors and many girls don’t really intend to work as professional doctors,” he says. “I know of hundreds of female students who have qualified as a doctor or a dentist but they have never touched a patient,” he adds.In a society like ours, it is difficult for young girls to pursue a career and continue with it after marriage. This happens due to the double standards of people who let their daughters opt for a professional degree but don’t let them pursue a career. Normally, girls are only expected to acquire education so they can find a suitable match rather than stand on their feet. Unfortunately, this further promotes the mentality that getting married is the ultimate goal of a woman’s life.
But the story doesn’t end here. There are many girls who really wish to pursue their career even after they are married but somehow are unable to do so. Usually, they do not practice because their husbands or in-laws do not allow them. Eventually, they have to choose family over their careers. This is a situation that prevails in most of the Pakistani households or we can say ‘traditional’ households just to sugar-coat.
As a matter of fact, the government of Pakistan spends substantial amount on getting a single doctor graduate (Rs 5.0 million per doctor for five year education and house job). Since past few years, the intake of female students by the public and private medical institutions in Pakistan has been more than 70 per cent. Sadly after passing out, 80 per cent of these female doctors leave medical profession due to their domestic issues and family priorities, causing huge gap in demand of female medical officer in the country and also a great loss to government in form of the cost born to get them educated. A rough study by the independent surveyors indicated that in 1989 quota system was abolished for male/female admission in medical institutions resulted in more female students. However, it was noted that around 35,000 female doctors who were educated to serve the profession of medicine, did not opt to work after marriage. This amount was a national loss of Rs 175,000 million. Earlier, it was not possible to get these people back in the medical profession but with the advent of social media and its usage, with lowering the cost of high speed broadband, access to smart phones and possibility of global affordable connectivity, it is now possible to get these out of work doctors updated with the latest knowledge of healthcare in their respective specialised fields, and also train them with latest ICT tools like Telemedicine and Mobile Health enabling them to provide basic healthcare advisory even from their homes.
The government of Pakistan spends substantial amount on getting a single doctor graduate (Rs 5.0 million per doctor for five year education and house job). Since past few years, the intake of female students by the public and private medical institutions in Pakistan has been more than 70%. Sadly after passing out, 80% of these female doctors leave medical profession due to their domestic issues and family priorities, causing huge gap in demand of female medical officer in the country and also a great loss to government in form of the cost borne to get them educated.
It is interesting to know that there are a few institutions who have taken the responsibility of addressing thiswidespread issue in our country. An innovative telehealth education and training project by the name of ‘eDoctor’ is launched in Pakistan under private public partnership mode. Dow University of Health Sciences (DUHS) partnering with a leading virtual training and telehealth platform ‘Educast’ started this initiative in 2018. This project before its launch has been already endorsed and supported by Federal Health Ministry, Government of Sindh MNCH Program, Pakistan Medical Association, and leading healthcare providing organisations.
eDoctor is a women led medical virtual education project for the empowerment of lady doctors currently sitting idle. The project is headed by Prof Dr Zarnaz Wahid, Pro-Vice- Chancellor DUHS and Principal Dow International Medical College, with Prof Dr Jehan Ara Hassan, Head of Obstetrics & Gyne -DUHS, Dr Anam Arshad Beg as project Family Medicine Incharge and Dr Sanam Imtiaz as the Academic Coordinator. From Educast, it is spearhead by Sania Butt a Clinical Phycologist by profession.
Educast is a Saudi-Pakistani virtual technology platform which has been looking after health education and health facilities for more than a decade now in various forms by the help of technology based technique of e-learning. They have done a lot of projects with Dow but the most popular is eDoctors which is connecting the doctors sitting at home who couldn’t continue their career for some personal reason such as lack of opportunities or travelling to areas with less facilities. “eDoctor has a lot of students (male and female) but the majority is of female students. I feel that it is an opportunity for the female doctors sitting home to achieve a comprehensive knowledge and encouragement to come back to their profession. The programme gives you a comprehensive knowledge of family medicine which includes little bit of surgery, gynaecology, PAEDS, dermatology, ENT etc,” explains Dr Zarnaz Wahid while talking about the project. Wahid also expresses how female candidates get admission in medical colleges and unfortunately or fortunately they are unable to continue after marriage and kids. She believes that prioritising family life after marriage and attaining degree is a good thing as educated moms (especially doctors) contribute to a better society. However, she encourages all the stay-at-home female doctors to opt for this programme as it is their right to be in the field which they have studied for many years and given their time and energy to.
Currently, eDoctor has successfully completed its first batch and for the second, it is aiming for incorporating hands-on training and Professional Development Centre (PDC) for circumcisions. The assessment will also be better in the second batch because often people get the impression that it’s only a lectures based programme which is not true.
eDoctor will also have interactive sessions from now onwards, where questions by the students will be addressed for the forthcoming lecture. Dr Zarnaz while encouraging the women enthuses, “Once this project achieves success, we can ask the government to come forward and support us in terms of stipends for not only the teaching staff but for the students too.”
The first batch of doctors were given 15 days of virtual/online training at their home by the team of eDoctor, on how to use the application and how to use web portal based access that eDoctor offers. Apart from this, the eDoctor project director and professor of Gyne Obstetrics Dow International Medical College and DUHS, Dr Jehan Ara Hassan informs, “The course outline is provided to the students joining the programme. After lectures, there is a series of practical demonstration via videos which help the students in various methods and systems of examinations. The lectures are given on biweekly basis. After each lecture, students are provided a chance to interact with the faculty members of Dow. In this interactive session, students can raise questions and are provided with suitable answers to their questions so that they can learn more and more about the topic. The recommended books include ‘The Current Medical Diagnosis & Treatment’, ‘The ABC for Dermatology & Ophthalmology’, ‘Ten Teachers in Medicine & Gynaecology’ and ‘Bailey & Love’ for surgery. We request the students to get hold of these books and start reading them so that they will be familiar again and will attain the maximum knowledge out of the lectures delivered.”
eDoctor has virtual training areas for the students along with transmission station, call centre and data centre. Chief Executive Officer of eDoctor, Sania Butt elaborates the process of how the edoctors operate from home, “We have the patients connected from the sensors from where the interface is sent through the application and finally saved in the web server application. The web server records patient’s information in the electronic storage and the doctor receives it while sitting at home and interacts with the patient via live video and call centre.”
Dr Butt tells that eDoctor is currently catering to 300 doctors mostly from Karachi and from UAE. Since the start of this programme last year, eDoctor has registered 550 female doctors from in and outside the country. This means eDoctor has enabled a return of Rs 2.5 billion in the National Healthcare echo system. Apart from sharpening skills and revising knowledge, this programme intends to empowering these women and enabling them to open their own healthcare centres in future. With this, the project aims to create the largest home-based female healthcare network in Pakistan which will also help in bringing back the investments that government has made into medical education.
As far as the objectives of this project are concerned, eDoctor aims at seeking attention from all out of work female doctors who are willing to take a virtual/online certification programme of 6 months enabling them to get updated knowledge in various fields under certification with 30 CME credit hours as ‘Family Medicine Certificate’ (initial programme). Also, it aspires to deliver lectures by the leading faculty assigned by DUHS academic team.
For entering the course, one must be a female MBBS doctor who must have completed house job and a registration with PMDC (even if expired). Also, she must have the knowledge of computers and know-how on basic IT tools and social media apps. Moreover, she should have an average computer/laptop with camera and microphone in working condition.
The first batch has been a success. Dr Adeya Ahmed who is a 2011 MBBS graduate from KMDC Medical College tells, “I am fortunate enough to be a part of eDoctor programme because it has not only refreshed our previous knowledge in a better way, but it has also boosted our confidence that now we are capable of identifying common diseases and managing the patient in an up-to-date manner.
The whole team of eDoctor has been very encouraging and they have accommodated us in every way considering that we are housewives now. I recommend this programme to all those home-based doctors out there, and I am sure this programme will be reaching milestones in the future as well.”
Similarly, Dr Nilofer Arshad, a 1990 medical graduate shares, “I couldn’t continue my practice after getting married and I was looking for avenues to get back to my profession. Meanwhile, I got to know about this programme and immediately I got myself enrolled in it. I found this to be extremely useful for me because I could study from home at my own convenience with the best professors and education level. The most appealing part is that I can ask questions and interact with the teachers. I had the chance to learn from the telehealth service and had mock calls which also gave me confidence. Now, I can work in any possible way be it online or being physically on practice at a clinic. Also, I am now able to start working with the help of up-to-date course outline and hands-on experience.”