Amin A. Muhammad Gadit ( Memorial University of Newfoundland, St. John's, A1B 3V6, Canada. )
Medical doctors are currently increasing in number because of the coming up of a number of medical collegesin the private sector. This number is though not sufficient for the needs of the population of Pakistan for the reasons of lack of career structure for doctors, brain drain, unstable political situation and concentration of doctors in the major cities. There is a huge investment on doctors either by government or by parents seeking medical education from private sectors and the reward of full accomplishment is not assured only by graduate studies. In this era of competition and sub-specialties, survival is somewhat possible by acquiring postgraduate qualifications. The path for pursuing post graduation is tedious in Pakistan in terms of time,finding approved training slots and remuneration while intraining.1On the other hand, the doors in UK are shut for young doctors aspiring to gain higher qualifications with the introduction of new visa systems, revamp of the education system and the foundation year training requirement. 2 The US option is full of uncertainties, either in terms of selection or the grant of visas from Pakistan. The USsystem has a number of minor specialties that they would offer to the international medical graduates but gaining arotational post in a major discipline is a rarity. Canada is not looking for residents because of self sufficiency as only few can get foot hold if they are either permanent residents or citizens and remain successful in local qualifying exams.Placement in Australia and New Zealand is not smooth as multiple requirements are to be met before getting aposition. There is a limited scope for returning postgraduates in Pakistan as the slots are limited and payscales do not match the monetary benefits abroad. Irony ofthe fact is the living expenses in Pakistan have sky-rocketed and it has become extremely difficult to maintain a societal position that is required of from a medical specialist. This scenario has been a cause of perpetual frustration and doctors are opting for alternate career options. The trend for acquiring an M.B.Aand getting a foothold in pharmaceutical industry has been a popularoption and a number of young medical graduates were absorbed in the Pharma industry. As mall chunk of doctorswent into the business and civil services while completely abandoning the medical career. The blame goes to the policy makers, health care custodians and finance departments ofthe government but no significant forward movement has so far been observed. Some blame is to be taken by the doctors who despite their best desire to serve the country are compelled to leave or opt for alternate career plans in the face of social pressures and financial needs. Interestingly,the electronic media has become very popular in Pakistan and has been found effective in dissemination of health related messages. Doctors are now frequently appearing on TVchannels and the radio apart from writing for print media. Once in a while, TVappearances are observed but of late, there is a trend for doctors joining the private TVchannels.3Radio FM is not a very attractive option for the medicos.A number of doctors have joined some channels as full time workers and are involved in different productions.Some are also directing plays. There is a glamour associated with media besides high monetary incentives and the flare of being a 'celebrity in offing'. According to a personal communication, there are sixteen medical doctors working with GEO TV in different capacities.4There are obvious advantages of being able to reach the masses at a faster paceas according to a report the viewership of GEO is about 10million which indicates that other channels too may behaving a reasonable viewership. Visual items have a deeper and quicker impact than any other mode of communication.There is obvious monetary benefit for the doctors and achance for further progress. The disadvantage is for the health system of the country which does not get the benefitof a qualified medical professional who could have played apart in strengthening the already fragile system. However,the current health system scenario gives a 'helpless' picture with limited slots for postgraduate studies, no proper career structure for doctors and hence the government is facilitating migration at a microscopic level.5With media,the prospective candidates who in this case a doctor could develop artistic skills and bring forth a 'hidden' talent. The government has established a 'VirtualUniversity' which is Pakistan's first university basedcompletely on modern information and communication technologies with a clear mission to provide extremely affordable world class education to aspiring students allover the country. It uses free-to-air satellite television broadcasts and the internet to broadcast across the country.The doctors can have an effective role in this university. The other set up is NAPA(National Academy of Performing Arts) which is a teaching institution, first of its kind inPakistan, based at Karachi is an avenue for media education in all spheres.6There is every like lihood that career switch by medicos can take place by joining this academy in orderto pursue an academic career in the media.For those medical doctors who do not desire to change their career but prefer to appear on the media from time to time and make presentations, there are some guidelines by the Royal College of Psychiatrists which are helpful in maintaining a sound professional role in the latter capacity.7The Pakistan Medical and Dental Council(PMDC) have not formulated any advice or guidelines which of course is the need of the time under the current circumstances. There is a particular word of caution for the medicos participating in medical education programs to keep themselves abreast with authentic and latest medical information as wrong dissemination of information can bedangerous. The medical information can be valid locally insome circumstances which are akin to medical licensing which is relevant for one country or region and hencedeclaration of its specificity while on air is essential9. The medics in media can face suspicion of motives and jealousy from fellow professionals.8The glamour of media is likely to fade away over time but the glow and respect of being a medical professional lasts permanently. Monetary issues can bead dressed by supplementing with private practice income.There is no ceiling to medical income but a ceiling to mediain come, the current gloomy picture of health services willchange and medicos will find plenty of space. Having saidthis, a part time career option of belonging to media may help the health system in terms of awareness and need based redressal of medical problems by the medical doctors as medicine allows many doctors to work flexibly which compliments the type of media work.9In the era of multipronged approach, will the medico-media bonding bring the desired results in terms of population welfare, policy improvements, career planning and individual personal satisfaction?
1.Patel S., Gadit, AM. Psychiatric training; Acomparison between Canada andPakistan: Is there a common ground? J Pak Med Assoc 2007;57:267-71.
2.Gadit AM. Dilemma facing IMGs from Pakistan. BMJ Career Focus 2006;333:179.
3.Ashmore P. Medics in the spotlight. BMJ Career Focus 2006; 333:232-3.
4.Awan, A. Personal communication; Geo Television, 14th March, 2007.
5.Gadit AM. International migration of doctors: Need to follow thecommonwealth code. Accepted for publication in Journal of Medical Ethics(BMJ Group of Journals)
6.www.napa.org.pk 'Academic Program', National Academy of PerformingArts. Date accessed: 14th March, 2007.
7.The Royal College of Psychiatrists. Practical advice on working with themedia, Public Education Handbook; 2005, p: 1-17.
8.Ashmore P. Medics in spotlight. BMJ Career Focus, 2006; 333:232-3.
9.Easton, G. Working in the media 1: options for doctors. BMJ Career Focus,2004; 328: 127-8.