Senior doctors await promotions amid controversy in KP MTIs

PESHAWAR: Despite a change in leadership in Khyber Pakhtunkhwa, numerous senior doctors are eagerly anticipating long-overdue promotions within medical teaching institutions (MTIs), primarily at Lady Reading Hospital (LRH).

They are facing undue pressure to sign bonds, forcing them to shift their private clinics to the hospital during evening hours.“This is not only a violation of the Khyber Pakhtunkhwa Medical Institution Rules 2001 but also against fundamental human rights to deny due rights to faculty members and compel them to work under specific terms and conditions,” said a senior faculty member at LRH.

In 2015, the Pakistan Tehreek-e-Insaf government introduced health reforms, designating 10 tertiary care hospitals as medical teaching institutes (MTIs), granting them financial and administrative autonomy. Dr Nausherwan Burki, the architect of these reforms, implemented a new set of standards for doctor promotions, deviating from the criteria set by the Pakistan Medical and Dental Council (PM&DC).

Dr Burki’s changes created discontent among existing MTI doctors, as he recruited fresh FCPS doctors as assistant professors instead of senior registrars. Junior doctors were elevated to department heads, leaving senior staff to work under them, and, in some instances, even reporting to their former trainees.

Before the MTI Act, many doctors served as civil servants and institutional employees, not engaging in institution-based private practice. The MTI law aimed to generate revenue locally, reducing dependence on the government.Under the new promotion criteria, faculty members with less than eight years but more than four years of experience require a 70% score. If their experience exceeds eight years, they must apply for promotion, with a six-month grace period to achieve the required score. Failure to qualify may result in termination by the hospital administration.

Although no terminations have occurred, fear persists among doctors about potential termination if they fail to meet the promotion criteria.

The LRH working environment became restrictive due to the strict implementation of Dr. Burki’s rules. The new chairman of the Board of Governors, Prof Dr Zubair Khan, aims to restore faith in the system. He has replaced the Installation Promotion Committee with more senior and sensible members, including senior gynaecologist Prof Dr Rukh as its head, Prof Dr Waqar Alam Jan, Prof Sarhad Khan, Dr Aneela Basit and Dr Zafar Mahmood as members of the committee.

Three senior doctors including Dr Farooq Azam, neurosurgeon, Dr Zafar Iqbal, pulmonologist, Dr Zahid, neurosurgeon, and Dr Inam Khan, nephrologist, applied for promotion. Interestingly, all of them were asked to submit bonds with the hospital administration for joining IBP following their promotions from associate professor to professor.

In January 2023, Dr. Burki, as chairman of the Policy Board, unilaterally instituted a rule requiring institutional employees to submit a bond to join IBP after promotion. The decision was made without consulting other Policy Board members. Dr. Inam, among four recently promoted doctors, challenged the IBP condition in court.

The bond would treat doctors post-promotion as new recruits in the MTI, negating their previous experience. The court ruled in favour of Dr. Inam Khan, potentially encouraging 45 other senior doctors to apply for overdue promotions, some dating back eight years. Three additional doctors recently applied for promotion, urging the Policy Board to revoke the previous chairman’s mandatory bond decision.

“Approximately, 45 senior doctors may not meet MTI promotion criteria. The faculty’s sole request to the Policy Board chairman is to nullify Dr. Burki’s January 2023 decision linking promotions to bond agreements.,” one of the senior faculty members suggested.

When reached, Prof Dr Zubair Khan, Chairman BoG LRH, told The News that promotions for employees overdue for the past few years had commenced.“I will facilitate employees, resolve their problems to enhance patient service. This is why I replaced the IPC to ensure promotions, particularly for faculty members.