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The PMC Conundrum

Opening private medical/dental colleges and universities is a lucrative business in Pakistan. Even with their fees capped by the previous PMDC, their growth has been phenomenal. With the new law, they will have an even more lethal ‘licence to kill’.

By Dr. Mehreen Mujtaba | February 2021

PMC-Conundrum

On 20th October 2019, the President of Pakistan signed a new ordinance titled ‘Pakistan Medical Commission Ordinance 2019’ by virtue of which a new era was envisioned to begin with reference to regulations and control of the medical profession by establishing uniform minimum standards of medical education and training and recognition of qualifications in medicine and dentistry.

The Pakistan Medical Commission is a triumvirate body and comprises the Medical Council, National Medical & Dental Academic Board and the National Health Authority. The Medical Council is the apex body of the commission and the other two organizations are to work under the supervision of the apex body.

The basic purpose of PMC is to inspect and formulate recommendations regarding recognition of medical and dental institutions for training of undergraduate and post graduate qualifications, to inspect under and post-graduation examinations for standardization, setting up schemes of reciprocity with other countries and medical and dental regulatory authorities and prescribing the standards of examinations as well as methods of conducting the exams in order to bring conformity in medical education across the country. It is also a mandate of the commission that no member should have any conflict of interest described as ownership interest in a teaching hospital or medical or dental college or university.

However, ever since PMC replaced the Pakistan Medical and Dental Council (PMDC) it has been surrounded by controversies and continues to court contentious issues.

The Ordinance mandates conducting MDCAT examination for admission to medical colleges, be it private or public, which would be centralized at the national level. But strangely enough, private medical colleges have been given liberty in deciding weightage given to marks obtained in the MDCAT.On the other hand, in case of public medical and dental colleges each provincial government has the authority to decide the pass percentage for the MDCAT examination. In such a scenario, private colleges have the conscious volition to adjust their scores according to their whims. Prima facie, giving this liberty to private institutions defeats the whole purpose, as has been seen with the National University of Medical Sciences and the Aga Khan Medical University, where they conduct their own independent entry tests. This has opened a pandora’s box, and other medical collages are demanding the same exemption for their institutions. Hence, in the interest of all concerned, it is imperative that PMC should devise a centralized criterion for admission in public and private medical colleges across the country, without prejudice and bias.

Another controversial aspect of the Ordinance is section 20(7) wherein private medical colleges have been given the authority to fix their own fee structures without any checks. They can also take as many foreign students as they deem fit and decide the fee structure according to their own whims. This raises the concern that the private medical colleges will deliberately take a large number of foreign students and charge them exorbitant fees. Private medical and dental colleges being an extremely lucrative business in the country will mushroom further, as has been seen in the past but will inadvertently affect the parents and children who for some reason couldn’t get admission in the public colleges.

The latest controversy bogging the reputation of the commission came in the form of expanding the syllabus of the MDCAT a month before some 150,000 aspiring medical students from across the country were to sit for their entrance exam. The new syllabus also included out of course topics and subjects and resulted in thousands of students protesting on the streets to protect their rights.

Ironically, the promulgation of the Pakistan Medical Commission ordinance, 2019 by the PTI government gives unlimited autonomy to the private sector medical and dental institutions, which beats the essence of passing a law to ensure uniformity in medical education across the country. The steps taken so far by PMC appear to be aimed at serving the vested interests of private medical and dental colleges. The array of haphazard actions and policies announced by the PMC hints at incapable administrators at the helm of affairs, who don’t actually have in-depth knowhow of how to smoothen out the inadequacies being experienced by the medical fraternity. The freedom given to private medical and dental institutes also raises questions regarding whether it was a wise decision to replace PMDC with PMC, since PMDC had a case against the private medical institutions around the country and was hell-bent on closing down many such institutions which didn’t even have proper laboratory facilities.

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