Doctors have to eat too

Published: April 4, 2011

Physicians are often paid less than support staff

As a medical student, I have witnessed the doctor verus government tussle from the get go. Firstly,  let me clarify that this is not a protest – this is a breaking point.

Doctors have been protesting for years and the government paid little, if any, attention. The facts leading up to this month’s events are actually understandable to anybody who has been to a hospital ward.

Serving humanity or bank accounts?

The first question in a medical student’s life is where he will work after MBBS. This is no joke. An estimated 1,500 doctors leave Pakistan every year to work abroad. This year 5,000 post-graduate trainees are likely to leave the country. These are the top doctors who are attracted to different countries including the Gulf, US, UK and Australia.

These doctors do not return.

The few who do, are appointed professors and start private practice which are frequented by the elite. These doctors  are parasites who have no intentions of “helping humanity”.

But what about the doctors who work for decades in government hospitals? They are unlikely to be appointed professors and hence not that lucrative private practice either.

What are we studying for?

In these tough times, it is the junior doctors who suffer the most. There are about 30-40 house officers in every ward among which only eight are paid and the rest are unpaid.

These doctors have studied for five years and now earn Rs18,000 as house officers, – that’s if they are lucky enough to get paid at all.

After a year long house job, doctor’s start their fellowships for which they have to appear in two exams. The first, is  FCPS part I (Fellowship of the College of Physicians and Surgeons). About 12,000 graduates appear in all disciplines in FCPS-I and 250 are declared successful. These 250 then apply to the hospitals for fellowships. At a given time, 10 or more post-graduate trainees are to be present in a ward. Among these only eight are paid at Rs16-22,000.

After  four years of training, they are supposed to leave the hospital and appear in FCPS part II which is the toughest exam in the medical field. The few who manage to pass it and have solid recommendations are hired as Registrars in government hospitals with a salary of Rs30,000. Now, their pay increases on increments and their seniority increases on political backing.

My driver earns more than me

So, a doctor of the age of 35 (if he aces every exam in the first attempt), earns about Rs30,000. With that money, he has to run a family. During the past 15 years, he has spent his days and nights serving patients. As a house officer he has worked non-stop shifts of 36 hours.

Meanwhile, a matric-pass driver is earning Rs35,000 in a government office.

The bank the doctor goes to to collect his pay has a security guard earning more than the doctor.

If he goes to get a car on lease, the bank tells him his monthly salary needs to be at least Rs40,000.

If you do not understand the injustice here, there is no point of carrying on.

Unfair solutions

Towards the end of the strike, the government agreed to increase the salaries of the young doctors (house officers and trainees) to Rs28,000 and Rs 44,000. This was an injustice to the senior doctors who would then be earning about as much as house officers and less than the trainees! This was obviously unacceptable to the doctors and hence they refused.

The future

Yes, doctors have handed over their resignations. There is no point in compromising because they have better options elsewhere (even as a driver or a police constable). They can now look for alternative jobs in private hospitals. Others may apply abroad where their talent is appreciated (in the US, a trainee earns about Rs300,000).

While shifting blame from government to doctors, the people suffer. It is easy to blame the doctors but then you would be denying them a basic human right – the right to work or resign.

If the government is not able to give attractive packages to the doctors while enjoying themselves in luxurious mansions, then doctors cannot be blamed for looking for a way to make ends meet.

They have compromised for years, blackmailed emotionally not to do anything lest patients will suffer. But now they have reached breaking point – they can’t save lives if their own aren’t secure.


Ahmad Malik

A medical student based in Lahore who tweets @Ahmad_Malik
