Medical colleges admission test in Punjab, Pakistan

Nearly 18,000 candidates securing 60% and above marks in Higher Secondary School Certificate [HSSC] examination contest for admission in Medical Colleges, in Punjab, Pakistan by sitting in the Medical College Admission Test [MCAT] each summer. This cross-sectional study was conducted to identify patterns related to demographic, economic and educational backgrounds, over a two-year-period, in this population, and how HSSC and MCAT marks predict future performance of the selected candidates. Marks obtained by candidates in HSSC, MCAT, and 1st Professional MBBS [Part-I] Examinations over two years 2008-2009, were analysed using parametric tests in SPSS. Total 18,090 candidates in 2008 and 18,486 in 2009 sat in the MCAT. National HSSC candidates scored higher marks in HSSC and MCAT but lower marks than their foreign qualified HSSC counterparts [e.g., Advanced-Levels from Cambridge University, UK] in Part-I overall and in all its subcomponents individually [p<0.05]. Female students scored higher marks than males in HSSC [p>0.05], MCAT [p>0.05] and Part-I theory, practical, viva voce, continuous assessment and Objective-Structured Performance Evaluation [OSPE] components [p<0.05]. In both years, students from the Dera Ghazi Khan District scored the highest marks in the HSSC Examinations [p<0.05] but least marks in MCAT in 2008 [p<0.05] and in Part-I in 2008 and 2009 [p<0.05]. Students from 'tougher' Boards like Rawalpindi in 2008 and the Federal Board in 2009 who scored least marks in HSSC scored highest marks in MCAT, and in Part-I Examinations [p<0.05]. Linear regression on Part-I by taking HSSC and MCAT marks as independent variables showed that the MCAT marks exerted the greatest positive influence consistently at 0.104 [2008] and 0.106 [2009]. In 2009 HSSC marks were shown to exert a negative influence [-0.08] on Part-I. There is need to standardise HSSC education and examination across all Intermediate Boards. MCAT is a better predictor of Medical Students' future performance

Evaluation techniques in Punjab, Pakistan: eight years of reforms in health professional education

Pakistan, the most populated country in the WHO Eastern Mediterranean region has a population of over 170 million, spread over five provinces and four federally administered areas. It has a growth rate of 1.9%. Punjab is the most populous and developed province with an estimated population in 2010 of 81 million. In 2008, Punjab's development index of 0.60 and a literacy rate of 80% were the highest in the country. In Pakistan, the number of doctors and nurses has risen from 48 to 71 per 100,000 and from 16 to 30 per 100,000, respectively between 1990 and 2003. The major challenge, still, is the imbalance of the population to health-care workers ratio. At the time of creation of Pakistan, King Edward Medical College was the only fully functioning medical college. Over the years, as a result of health reform initiatives, a number of government medical colleges were established in the country. University of Health Sciences, Lahore was established in 2002, having sole jurisdiction over all medical, dental and allied health institutes in the province with the aim of moving medical education towards an outcome-based patient and community oriented competency-driven system. This paper attempts to clarify how initiatives and reforms in the evaluation process have helped the UHS realise its aims. Evaluation in all branches of higher education has long been taken as a means to an end. The focus of UHS on teacher-training, introduction of behavioural sciences as a compulsory subject and setting up an outcome-based evaluation process, has established a knowledge-acquisition medical education atmosphere. The challenges in the future relate to sustainability through capacity-building and staying abreast with the Best Evidence Medical Education practices worldwide, implementing them to fit our local needs and resources

Postgraduate medical training in Pakistan: Observations and recommendations

An appraisal of postgraduate training under the aegis of the Higher Education Commission in 2006-2007 showed strong input of supervisors and enthusiasm of trainees. Problems were evident however, beginning with the virtual absence of training for family doctors. Early moves in provision of this training are applauded. Greater undergraduate contact with primary care may help to raise its status but a trained workforce is necessary to make student placements practicable. Some uncertainties about specialist qualifications need to be resolved. Trainees concerns focussed on the absence of stipend for many; inadequate supervision due in part to insufficient faculty; the poor condition and maintenance of some teaching hospitals; difficulties with aspects of College of Physicians and Surgeons processes; and the lack of career paths. All trainees should receive payment for their clinical duties and responsibilities; there should be a national review of faculty numbers; the management and suitability of hospital facilities should be examined. It is pleasing to know that problems at the College are being addressed; and the provision of career paths including post-fellowship experience should be a priority matter. Medical workforce planning is addressed and a call made for better data. Overcoming deficiencies will mean an increased budget for health, presently among the lowest in the region