The Plight of a Young Doctor in Pakistan

I come from a family of doctors so becoming another one was no shocker. I was destined for it although I am not denying the hard work and effort I put in. I am sure all of you doctors can relate to the struggle - of getting good marks in SSC/GCSE, Fsc/GCE and then MCAT, of joining multiple academies in the hope of outshining and securing a place in the public sector (those who seek admission in the private sector have to go through additional ordeals of applying everywhere, giving tests and interviews and paying a hefty sum annually).

My point is - no one has it easy. We come after facing a lot of obstacles considering the tough competition, the financial burden and most importantly: the mental stress. But this journey has just begun. As soon as we step into a medical school, our main aim is to thrive. Whatever sense of accomplishment we have is reduced to nil as we realize how close failure is, literally following us like a shadow that we have to run away from. I'm sure the humongous syllabus, the pressure to excel and the overwhelming fear of failure has gotten the better of all of us at some point in time (some more than the others) to the extent of mental breakdown, depression and alienation from all the things we love to do. Yet, we sacrifice it all because we know how demanding this profession is that how after God, we are the ones who get to save lives.

Now, let's look at the mindset of an average Pakistani who believes whatever he hears and is highly influenced by the media. He sees or chooses to see the image of doctors going on strikes, 'risking' the lives of patients and being selfish and heartless in general.

But does anyone ever think why doctors are acting the way they are? Well, let me tell you. After five glorious years of their live working their asses off, doctors are required to do one year of residency or 'housejob' which usually includes ward weeks (practically living in the hospital 24/7) in addition to night calls and emergencies extending up to 36/48 hours.

A doctor who hasn't slept properly for the past 3 days is expected to perform well in hospitals having huge patient turnovers and obsolete medical facilities. If they do their housejob in their own institute they'll get paid, but if they decide to work somewhere else (whatever their reasons may be), they do it on an "honorary" basis which means they don't get paid for working in a sleep deprived, mentally and physically exhausted state for ONE year.

You think that’s all? Haha. The joke's clearly on you. What little remains of them after housejob (because by now they clearly don't have a personal life) is consumed in post grad exams like FCPS and the MLEs. But since I'm talking specifically about the Pakistani scenario where the majority opt for FCPS, let me shed light on a very interesting detail.

Whilst clearing the FCPS exam itself is a task on its own, it's definitely not the end of their problems. Our oh so ‘prestigious’ government has further introduced CIP (Central Induction Policy) where doctors are given PGships in different hospitals according to a certain "merit". And don't assume this merit is based on marks only. No. If someone has done their MBBS from a private medical college, their marks will be deducted no matter how brilliant a student they were. Similarly, if they haven't done housejob from their parent institute, their marks will be deducted irrespective of how good and dutiful an HO they have been all year round. And even during their training, their pay is not guaranteed if the paid slots are full.

So basically, half of their life they provide service with an underwhelming or in certain circumstances, nil pay which is not even sufficient to meet their family's needs (and by this time, most of them have started a new life on a personal front with kids in the picture). So when they ask for a hike, not only are they labeled as selfish gold diggers but also beaten up black and blue for this audacity.

My message to the government (and to the public in general) is that doctors are not unwilling to work. Hell, they have been working their entire lives. They have worked with inadequate medical equipment, uncooperative patients and their attendants who threaten to kill, with the immense pressure to perform in critical situations. They are looking after the health and well-being of every Pakistani.

So my question is: can you not look after their health and well-being?

Is that too much to ask for?

- Aliza Latif Aftab (Class of 2019)