The country is again set to lose a number of doctors, many of whom benefitted from millions of rupees in subsidies on their medical education, to more lucrative posts abroad.
Pakistan has become a huge market for Gulf countries looking to get doctors. A Saudi delegation is to conduct interviews for doctors in Lahore on August 31, in Multan on September 5 and in Islamabad on September 9.
An official with the consultants organising the interviews told The Express Tribune that he expected the Saudis to hire some 150 doctors in this year’s recruitment drive. “They never tell us exactly how many doctors they want, but they are expected to hire around 150 this time,” the official said.
The Saudis are looking for consultants, specialists and residents in general medicine, endocrinology, neonatology, general surgery, haematology, obstetrics and gynaecology, orthopaedics, paediatrics, neurosurgery, family medicine, intensive care, anaesthesia, nephrology, emergency medicine, radiology, dermatology, cardiology, urology, ophthalmology and dentistry.
“A doctor with two years of experience gets a salary of 6,000 Saudi riyal (Rs166,205) per month, while a consultant gets 20,000 riyal (Rs554,016) a month at least. Those with more experience get more,” the consultancy official said.
Motives
Dr Ahmad Asghar, who served as medical officer and consultant at Jinnah Hospital, is currently preparing to move into a new job in Saudi Arabia, where he will make 20,000 riyals a month.
Though his salary is to increase ten-fold from what he was making here as a consultant, Dr Asghar said that he was not moving for the extra money, but because he did not get what he felt was a due promotion to senior registrar.
“I was making Rs52,000 a month here and I was happy. But when I was transferred from Jinnah Hospital, where I was needed, for someone with just an MBBS degree, I decided to quit,” he said.
Dr Shahid Imran, who worked at the Punjab Institute of Cardiology and had College of Physicians and Surgeons fellowships in medicine and cardiology, quit eight months ago to take up a job in Qatar with a salary of 32,000 Qatari riyal (Rs911,000) per month.
Senior doctors have been leaving Pakistan too. Professor Mushtaq Haroon of King Edward Medical University (KEMU), author of two books on the MBBS curriculum, went on Ex-Pakistan leave to Saudi Arabia and then mailed in his resignation.
Long leave and vacancies
A representative of the Young Doctors Association (YDA) Punjab said that the exodus of doctors abroad was a major blow, as almost half of the specialist seats at district headquarters hospitals and 40 per cent at teaching hospitals were vacant.
“The gulf countries aren’t establishing any higher medical education institutions. They say they don’t need to as they can just ‘buy’ doctors from countries like Pakistan,” said Dr Amir Bandesha.
He also noted that the government spent a lot of money subsidising medical education and training. “The government spends Rs2.5 million on a student to make him a doctor and an additional Rs10 million to make him a consultant or specialist. During training, doctors are paid Rs44,000 per month, which comes to a total of Rs2.7 million per doctor,” said Dr Bandesha.
Dr Izhar Chaudhry of the Pakistan Medical Association (PMA) said that the Health Department’s decision to not allow government-employed doctors to go on leave abroad for periods longer than 10 days had pushed many doctors to quit. Previously, such doctors would have gone on leave to work abroad for a year or two and then returned to Pakistan.
“Many doctors have made up their mind to resign and go abroad after being denied ex-Pakistan leave,” said Dr Chaudhry. “The Health Department has made no policy to stop this brain-drain. Rather, it seems as if they are teasing government sector doctors to promote private colleges. The four new public medical colleges are still short of faculty. [Their] policies encourage doctors to go to countries like Saudi Arabia,” he said.
He added that many doctors were upset that the Health Department had not done all it had promised to do when it reached a deal with doctors’ associations last year for a new service structure to end a long-running doctors’ strike. “The Health Department announced that it would give an additional allowance to doctors who complete post-graduate degrees, but it still has not done so,” Dr Chaudhry said.
Health Secretary Hassan Iqbal defended the department’s decision to ban doctors from going abroad on long leave. Though these doctors were away, they still officially counted as Health Department employees and so the department could not hire replacements, he said. “This way we were not able to recruit anyone else in their place. By reviewing the policy we have avoided this problem,” he added.
Iqbal acknowledged that the government lost millions of rupees in wasted investments whenever a doctor trained locally decided to move abroad, but they could not be prevented from resigning, especially when much higher salaries were on offer. “We have many intelligent people and we constantly review our policies to see what we can do to retain them,” he said.
He added that the Health Department was implementing the service structure agreement step by step.
Published in The Express Tribune, August 29th, 2013.