Pakistan Medical Commission (PMC) declared a mandatory National Licensure Exam (NLE) for newly graduating medical doctors (MBBS & BDS) before they start to practice medicine in the country.
NLE has a theory component and a Clinical Skills Evaluation exam (CSE). The pass percentage is set at 70% for each component. Upon successful completion of the theory, the candidate has 5 years during which he/she must clear the CSE.
PMC has been generous in allowing 3 attempts at CSE. Additionally, candidates can complete their house jobs prior to passing the exams. House job is part of a structured educational program and offers the opportunity to apply theoretical knowledge to real patients under the supervision of experienced faculty members.
Sad and shocking is the news from Lahore about a recent conflict between police and young doctors with regards to NLE. Police had to baton charge and pepper spray young doctors who tried to disrupt an NLE exam proceedings. On top of this, some members of a Young Doctor’s Association (YDA) have threatened to jam outpatient clinics and emergency departments to press for their demand to abolish NLE.
— AqsaMumtaz (@AqsaMumtaz) August 27, 2021
PMC: Supporting young medical graduates in Pakistan
A review of the progressive trends in Pakistan in relation to medical education show tremendous changes. In 1947, King Edward Medical College and Dow medical college were the only 2 institutions imparting medical education in the country. Currently, there are 176 medical colleges, 62 of which are public and 114 private.
Medicine has always been a regulated profession in Pakistan. The reverse chronology of events shows that PMC came into existence on 16th September 2020, as a successor of the Pakistan Medical and Dental Council (PMDC) which was founded in 1962. PMDC was in fact a continuum of the Pakistan Medical Council which adopted recommendations of the 1947 Pakistan health conference to ensure standard medical education in the country.
So, since the inception of Pakistan provision of quality medical education was a concern and objective. The above-mentioned regulatory authorities have supported Pakistani medical graduates for more than 7 decades. Whenever a Pakistani-trained doctor vows to work abroad, a primary source verification is conducted by international agencies like ECFMG, EPIC, etc. It is the PMC that bears the responsibility of verifying the education and basic training of these doctors.
To facilitate this further, authorities have to comply with directives of International Medical Education Directories. The World Federation of Medical Education is an organization that shares the minimum standards of medical education and training to be met in all member countries. Pakistan had to keep in line with those regulations and the timeline provided was 2023.
Medical councils in Europe and America took similar steps of testing their local as well as foreign medical graduates more than 3 decades ago. Nobody can enter the residency programs or training slots without first clearing the national collaborative clinical skill exam and theory components.
Why is NLE important for young Pakistani medics?
Introducing NLE will enable young medics from Pakistan to better understand the process they need to follow in case they desire to get advanced training at centers of excellence in the developed world.
Interacting with real patients is different than interviewing a role player and being ready to quickly ask for other relevant investigations from the examiner during a short span of time and then coming up with a management plan. PMC is actually trying to sharpen the reflexes of our new generation of medics.
In my humble opinion, social media in Pakistan can play a positive role by inviting all stakeholders including policymakers from PMC, young medical graduates, and senior Pakistani doctors who had to undergo the source verifications and a series of exams before they could practice medicine in any other part of the world.
This will help clear the misunderstanding and frustration in the minds of young doctors. They might then be able to appreciate the vision of PMC!
The author has done MBBS, MCPS, FCPS, MCCEE, and is a consultant Obstetrician & Gynecologist at Mega Medical Complex. The views expressed in the article are the author’s own and do not necessarily reflect the editorial policy of Global Village Space.