Dr Ali* is a professional doctor with a degree obtained in 1988. He practices at his private clinic in a compound, where several other doctors have set up their clinics. However, he rarely finds the time to attend any refresher courses for keeping himself up-to-date with advancements in the field of medicine – known as Continuing Medical Education (CME).
CME refers to the refresher courses that help medical professionals across the world to maintain competence and learn about new and developing areas in their field.
Ali, however, is not the only one in this field, but the majority of doctors in the province is general practitioners (GPs), and treats patients suffering from ailments ranging from normal fever to rabies, asthma to hepatitis, even conducting minor surgeries. Most GPs had acquired their professional degrees decades ago.
A recent study reveals that a majority of these GPs, instead of updating themselves through scientific research journals with the new developments in the field of medicine and pharmacy or attending refresher courses, are being introduced to new medicines by the medical representatives of different pharmaceutical companies. Due to this, many patients who come to these GPs have to suffer as the physicians do not know the recent treatment methods applicable for the disease.
Concerned by the trend, the Aga Khan University Hospital (AKUH)’s CME Department has started some introductory courses for adopt such standards at the healthcare institution. As part of the efforts, the department will arrange a forum on CME on December 26 at the AKUH campus.
“CME in the country is in disarray,” Dr Wasim Jafri, AKUH CME Associate Dean told Pakistan Today.
He was of the view that although some healthcare institutions regularly arrange CME courses for their own doctors, but their credibility and general practices during such events remains questionable. He added that CME programmes do not adequately focus on improving clinical performance and patient health outcome. “The emphasis is on measuring acquired knowledge, based on training results and hours, instead of assessing competence and skills.”
In Pakistan, the five-year Bachelor of Medicine, Bachelor of Surgery (MBBS) is followed by a one-year internship before the Pakistan Medical and Dental Council (PMDC) registers a doctor,” Jafri said. “As a result, many doctors employ techniques and prescribe medications based on knowledge which is several years old,” he added.
“In order to avoid such problems, it is important for health specialists to constantly keep up with new research and prescribe the most effective evidence-based medication.”
The associate dean said that in order to provide improved healthcare facilities to patients continuously, while staying up-to-date with new advances in the field, it is imperative for doctors and nurses to take part in CME. “It is the need of the hour to properly accredit the CME programmes for improving the quality and outcome of refresher courses,” Jafri maintained.
The World Health Organisation estimates that over a billion people worldwide lack access to quality health services. The shortage of health workers is compounded by the fact that their skills, competencies, clinical experiences and expectations are often insufficient for the health needs of the population.
According to health experts, approximately half of the knowledge obtained in medical schools becomes obsolete within five years and it is essential that health professionals constantly update their skills.
A paper titled “Continuing Medical Education and Pharmaceutical Industry” jointly authored by AKUH’s Farhan Saeed Vakani, Wasim Jafri, Almas Amin and Mughis Sheerani, points out that the relationship between CME providers (academia) and industries is drawing attention all over the world. “To date, there are no national commercial support guidelines available in Pakistan to properly regulate cooperation between the two distinct entities,” the researchers stated in the paper.
“However, the fact is that the future of all CME depends on pharmaceutical support and the providers are heavily dependent on the pharmaceutical industry to remain in action. It should always be remembered that medical education and profession is regarded as a moral of enterprise based on a blind faith between the physician and the patient,” they added. “The funding support by the industry should not bind or influence physician’s prescription for any reason, so to be trusted, medicine must be free of all such dependency; it should be accountable only to the society it serves and to its own professional standards.”
*Name changed for privacy
