Doctor-in-law syndrome makes MBBS degree new dowry

Over 2,200 doctors, nurses, and technicians have already gone into self-isolation and dozens of doctors and paramedics have laid down their lives facing the coronavirus. Yet Pakistan also faces a different kind of predicament: there are about 85,000 “missing” doctor-in-law in Pakistan. An MBBS degree has become a new form of dowry. COVID-19 has brought the issue to the fore.

The coronavirus is exacting a heavy toll on global health systems and medical personnel. In Pakistan, the medical community is at forefront of this unprecedented global challenge but it is already overstretched with fears that the worst is yet to come.

Doctor-in-law syndrome

These 85,000 female doctors have completed their medical education at the expense of the state or privately, but they are not part of the medical workforce in Pakistan.

Most of them are victims of the “trophy wife” phenomenon, the brain drain to developed countries, and some have simply chosen not to practice medicine. Some years ago, the Pakistan Medical and Dental Council (PMDC) declared that if only 50 percent of these doctors were mobilized, 70 percent of health issues of people in low-income communities in Pakistan could be resolved.

Unfortunately, this is an issue that has not found a voice in the COVID-19 predicament, which is criminal negligence of our media and intellectuals. This is an ongoing saga and our medical pipeline is bleeding profusely.

Applying a tourniquet quickly is the first step in rehabilitating our medical system, which will be under tremendous stress and short of professionals in the struggle against Covid-19.

The issue exists on multiple levels and the solution space will have to be fluid and sensitive to these layers.

MBBS degree is the new dowry

At the core of the issues are the trophy wife phenomena – a degree dowry signifying status, and a cache of brains in addition to beauty.

The task of juggling in-law and children’s expectations with the demanding commitments to the medical profession becomes an onerous task and eventually, many women choose to leave the medical profession – 85,000 to be exact.

The solution here lies in addressing the societal pressures and heightened expectations towards working female physicians and health workers. Also, women (whether mother-in-law’s or medical graduates) will have to change their attitudes as well.

Many professors at medical institutes have lamented that there are female students who enter medical school only to get good proposals and are never serious about their professions.

The whole of society, including feminists and postmodernists, will have to rise beyond gender bias to address this smoldering issue, and initiate a dialogue, so that a doctor remains a doctor, even after becoming a bride.

Medical practitioners flee abroad

At another layer, is the issue of medical brain drain (both male and female) to greener pastures, with resource abundance and greater growth opportunity. There are medical schools in Pakistan that cater specifically to the developed country markets, and hardly any graduate practices their profession in Pakistan.

Pakistan Army doctors and paramedics are providing first aid and medicines to the victims https://t.co/h1aVFx6F98

— Dawn.com (@dawn_com) March 3, 2019

With the harsh realities of the COVID-19 pandemic hitting medical communities and with doctors in short supply, developed countries like the US and UK could turn to countries like Pakistan to close the supply-demand gap.

But this will leave countries like Pakistan with their own substantial shortage of dwindling medical professionals. This is an issue of the near future, which needs to be attended while we still have some breathing space.

Policy measures can help reduce the doctor-in-law syndrome

Administrative initiatives will also have to be brought to the table as part of the solution space. Many countries have a “pay it back if you don’t come back” program to encourage students to continue with their medical profession for an allocated time period.

This way only well-intended students will be able to avail government subsidies, and more money will be available for students who wish to continue their practice, or for investments in health-care infrastructure.

Some geographical quotas also need to be in place for graduates from rural areas, which often have the greatest shortages. It is hoped that by broadening the geographical and socioeconomic talent base the likelihood of students returning to their practice in their local communities, will increase.

A 50% quota system for female doctors has long been debated to no avail; it is time some harsh and concrete decisions need to be made in this regard, for our teetering medical system.

From a medical practitioner’s point of view, there is a need for empathy with the out-of-profession female doctors. It is amateurish to assume that these amateurs can be brazenly thrown into the blaze of the Corona pandemic frontline. Traditional patients are having a hard time being provided medical facilities and these doctors could be used to treat non-Corona patients.

Leveraging technology – the quickest solution to COVID-19

There exist technological solutions where these practitioners can have useful contributions. Telehealth is perhaps going to be the lasting legacy of COVID-19 on health systems worldwide.

Sustained adoption of telehealth will change how many of our medical services can be delivered outside of traditional healthcare facilities. The thousands of out-of-profession female doctors can be mobilized to serve these patients through telemedicine.

This would not only lower disease burden but would also save thousands of lives in the country. Sehat Kahani, Covid-19 Telehealth Portal, DoctHers, Elaj Plus and the Corona Relief Tiger Force are a few good examples, but the continued sustainability of a volunteer-based model and the resources required for virtual platforms, need to be thought about.

Also, issues of access to technology-deprived and low-income patients need to be sorted out, as telehealth has long been accused of leaving behind the ones who need it the most.

The harsh realities of the Covid-19 pandemic have exposed many shortcomings in our healthcare system. But COVID-19 has also has created an unprecedented opportunity to better align healthcare to creatively solve some of the most pressing health issues of Pakistan.

The writer is a futurist based at the Centre for Policy Studies, COMSATS University Islamabad. He is the blog editor of the Journal of Futures Studies. The views expressed in this article are the author’s own and do not necessarily reflect Global Village Space’s editorial policy.

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Doctor-in-law syndrome makes MBBS degree new dowry

The whole of society, including feminists and postmodernists, will have to rise beyond gender bias to address this burning issue, and initiate a dialogue, so that a doctor remains a doctor, even after becoming a bride.