By Dr Unsa Athar
(KEMU Class of 2017-18)
The British, while ruling the Sub continent, held science as the key to the novel way of thinking and gave its propagation a top priority.
Punjab held the title of “Sword Arm of India”. It also provided an opportunity for British Empire to boast its scientific achievements to the native elite. With an expanded native army from the newly acquired territories, essential medical cover was required for the native ranks. Hence, in October 1860, Lahore Medical School was established as a third seat of medical education in Indo-Pak Subcontinent. (Calcutta Medical College being the first one, and Grant Medical College in Bombay being the second.) (1)
From here began the journey of 158 years, filled with glory and magnificent success in the field of medical education.
Under the rule of King George, King Edward Memorial Fund was launched in Lahore Medical School. This fund was established by the King in recognition for the need of providing medical treatment to common people, as homage to his parents. His father, King Edward VII, suffered from typhoid as well as pneumonia. His mother suffered from osteosclerosis, a congenital disease. (1)
On December 21, 1911, Lahore Medical College was renamed as King Edward Medical College, in order to celebrate the revolutionary changes brought in the institute due to the memorial fund. The institute achieved another major milestone in 2006, when it became King Edward Medical University (KEMU).
What sets graduates of KEMU apart from others is their yearning to give back to their alma mater. With the advent of American style of training, the smart and competent minds of KEMU were being given red carpet treatment by the US Consulates. Graduates of KEMU worked in the States and changed the face of medical education and research there. Dr Amanullah Khan, graduate of 1963, felt that KEMCOLIANS, spread all over America, should join hands and do something for the institute. And hence, King Edward Medical College Alumni Association of America (KEMCAANA) was formed. From here began a system of constant financial and educational support for the current students of the institute. Providing funds for the new infrastructure, reading rooms, lecture theatres, granting scholarships and loans to brilliant students with financial constraints, arranging annual scientific symposiums, holding research competitions and mentorship programmes, opening their hearts and homes to KEMCOLIANS all over the world; KEMCAANA has proved to be one of the best indicator of KEMU’s success.
From Dr J.B. Scriven to Prof Aamer Zaman Khan, King Edward Medical College/University has seen many principals and vice chancellors. Each man left the institute with a specific touch of his nature and unique leadership persona. Currently presiding the office is Prof Dr Khalid Masud Gondal (Tamgha-e-Imtiaz). Having spent 38 years at this place, he is a pure KEMCOLIAN and a medical educator at heart. His out-of-the-box approach towards collaborations and performance indicators has set him apart from all the previous leaders. Let us take a look at his views for medical education in the new decade.
How do you see the future of medical education in Pakistan as we enter the new decade? Any new fields/domains or modernization that will be a part of your curriculum?
When it comes to medical education, what we need to be clear about is that Pakistan is far ahead than other regional countries; let it be India, Bangladesh or Sri Lanka. Despite that, we still have a long way to go. There are two levels of medical education: undergraduate and postgraduate. The biggest challenge we are facing at the undergraduate level is modifying our curriculum according to international standards. That not only includes introducing the international modular system but also tweaking it according to our regional needs.
With the new decade, we are focusing on shifting our perspectives on undergraduate training. Previously, lectures used to be main instructional method. We are now introducing small group discussions and problem-based learning. Instead of the teacher being the sole tutor, the main driving role is being handed over to the students. Students will have a participatory role in curriculum development and execution while the teachers will be facilitators. That is how we plan on dealing with new era of medical teaching. The student-centered teaching approach will help our medical students learn leadership and responsibility as well as skill from the very beginning.
At the post-graduate level, the biggest challenge is induction system, followed by no authentic accreditation of the training, the variations in training systems, lack of proper monitoring and evaluation.
Medical training at this level began on a system based on apprenticeship. From there we moved on to product or process-based systems. With the new decade, we are moving towards competency and outcome-based teaching systems. We are now introducing a competency based medical training in Pakistan. We have formulated and forwarded guidelines for accreditation, based on accreditation bodies present in the USA and Canada. Induction is becoming more streamlined now, being done twice a year. Curriculum has been revamped now with the involvement of the faculty at KEMU and College of Physicians and Surgeons (CPSP). The issue of variation in training at different institutes is being addressed by introducing and executing training courses for supervisors. It is mandatory for them to meet a minimum eligibility criterion to become a supervisor so that a competency-based training can be carried out by them.
Monitoring is being innovated by introduction of E-Log monitoring system. CPSP has been using this system for more than a decade, which is now also being brought to KEMU. For evaluation, the element of subjectivity at the part of the examiner is being eliminated for the new decade. Instead of simple viva voce along with theory paper, we are now introducing TOACS, OSPE and structured evaluation of short and long cases. We are also working on other modernizations like work-place based or on-site evaluation.
For enhancing the objectivity in examinations, we are also bringing in post-examination analysis. For instance, after an exam based on multiple choice questions, each MCQ will be analyzed and assessed via various indices e.g. discriminatory index, reliability index etc. Based on this analysis, the MCQs will then be either kept in or removed from the bank. We are extremely hopeful that these modernizations will help us meet the current national and international needs.
What would you say is the root cause of brain drain? What can we do to prevent the restlessness and anxiety among the postgraduate trainees in Pakistan?
Oh, lack of incentives! Doctors are flying out of Pakistan like water pours out from a running pipe! We need to sit down and talk about introducing new incentives for our smart minds. Financial incentives will never be enough, trust me on that! We need to go beyond that. Job security, protection at work-place, appreciation and acknowledgement, all this needs to be addressed. What I believe is, and I know many people would disagree, the incentive of being a messiah should be enough. But I know as the times are changing, we cannot rely on merely the goodness of hearts. I do hope that we find a solution soon to deal with this brain drain catastrophe.
What will be the vision of KEMU (particularly King Edward Medical College) for the new decade keeping in mind the socio-economic situation of Pakistan as it affects the healthcare of our people?
As far as the socio-economic situation of Pakistan goes, it is a domain affected by multiple factors. We might not be able to bring a sudden revolution in healthcare, but we can train our future doctors to become more compassionate and skillful. KEMU is now going to focus more on inculcating professional and ethical standards in its students. We want our students to be the embodiment of the oath they take as doctors on their graduation. We will be arranging regular counselling and mentorship sessions for our students. For we want them to have a realistic idea of the ground truths of this profession. We want them to be trained for the harsh grind of the job. KEMU will work on the vision of nurturing leaders who will be able to work against all odds for the greater good of this country.
1.History Book: 158 years of Excellence King Edward Medical University (https://kemu.edu.pk/kemu-book)