11.08.2013 Unhealthy trends
A part of our ‘national fabric’, nepotism is fast replacing merit even in important professional areas
By Syed Mansoor Hussain
One of the more unfortunate facts of life in Pakistan’s medical institutions is the preferential treatment that children of ‘professors and principals’ of medical institutions get as students. A few years ago there were a series of ‘scandals’ in King Edward Medical College (KEMC), one of which even prompted a student strike when children of faculty members got ‘medals and distinctions’ that other students felt were not truly deserved. Though there are many faculty members that are above such shenanigans, over the last thirty odd years this has been a growing trend. And that in its own way is the story of the deterioration of the quality of medical education being provided in many of our public medical institutions.
I realise that favouritism is present in most educational institutions but it is perhaps more obvious in the medical environment, the reason being that children of doctors choose medicine as a profession with greater frequency than other professionals. As the only son of two doctors it was expected that I would become a doctor. Even as a child, my neighbours would call me ‘chotai’ (young) doctor sahib.
Over the five years I was associated with KEMC and then for a year as a house surgeon in Mayo Hospital, all the principals and many of the senior members of the teaching faculty of KE during that time had children that went through KEMC. Yet not one of them became the ‘best graduate’ and only one got a ‘distinction’ and he actually deserved it. He went on to do a PhD in the shortest time possible from a ‘premier’ US university and is now a full professor in a major US Medical School.
I still remember when I started my fourth year in KEMC, what was then called the final professional, one day I was driving with my father on the way to college, my father said to me, son this is going to be hard work and you better concentrate on your studies. So, I made a promise to him that he would not have to ask any of his friends and classmates from medical school, many of whom happened to by my professors and examiners to ‘take care of me’ as I went through my examinations. And I did that, as a matter of fact one of my professors and examiners had literally brought me up as a child, but I made sure that in his subject I would not be found wanting. During the oral examination (viva voce), he kept asking me questions until he ran out of questions to ask. Then he stopped and looked at me and said, Mansoor when do you get time to study? That was the ethos our generation lived by.
More importantly, any of our professors and principals of the college in those days would probably have disowned their children if they had dared to ask their fathers for ‘help’ during the examinations. And, yes I personally knew most of those students quite well since we the doctors’ children were a rather close knit community. And all of them would not have found the courage to ask their fathers for help either. Here I must admit that some of us did get unasked for ‘help’. In my case the most important ‘help’ I got during my final examination in surgery was because I was dressed properly (I still remember the tie I wore that day!) and spoke good English.
But what has changed? It is the brazen disregard for merit that has now become a part of our national behaviour. The thing that strikes me is that this is not a new problem. After all ‘taking care of your own’ is a longstanding tradition that spans all cultures. And no, it is not something that sprang out of ‘nowhere’ in Pakistan.
MA Jinnah in his famous August 11, 1947 speech, that is so often quoted when the question of religious tolerance is raised, also spent a significant part of his speech talking about corruption. Perhaps that part of his speech devoted to the problem of ‘nepotism’ is worth remembering. This is what he said: “Here again it is a legacy which has been passed on to us. Along with many other things, good and bad, has arrived this great evil, the evil of nepotism and jobbery. I want to make it quite clear that I shall never tolerate any kind of jobbery, nepotism or any influence directly or indirectly brought to bear upon me. Whenever I will find that such a practice is in vogue or is continuing anywhere, low or high, I shall certainly not countenance it”. Of course by ‘jobbery’ what he meant is what today we call ‘sifarish’.
So, even if we accept that a certain amount of ‘nepotism’ was always a part of our ‘national fabric’, the one thing that has changed is that even in important professional areas, nepotism is becoming more important than merit.
So let me present three possibilities. First an airline pilot that does not really know how to fly a plane well but gets the job through connections, such a pilot would never fly a plane because his own life will also be at stake. The second possibility is of a lawyer who is not too good at what he does. The worst he or she can do is lose the client, some money and possibly end the client up in jail. The third possibility is of a doctor that is not well educated and trained. Such a doctor can actually cause the death or serious disability of a patient under his or her care.
Is there a ‘saving grace’ in this entire situation? Yes there is and that is that almost every student that ends up in our public medical college is a ‘high achiever’ and has done well in school and pre-med before getting into medical college. Most of our medical students that qualify and end up as practicing physicians go on to learn stuff that they were not taught as students. There are exceptions but not too many and that is why even when our medical graduates go abroad they do quite well.
The main problem is that our medical education system does not do justice to the first rate students that enter our medical colleges. But by making nepotism as one of the major determinant of positions and awards as students and then as the primary criterion for providing the best training positions, we undermine the confidence of the ‘ordinary’ students in the system. And we also set a pattern where these students learn early on in their professional lives that to get ahead they will need to have ‘connections’ and that merit by itself will never be enough. If only we could provide good quality education to all our students, treat them according to merit and make sure that the graduates with the best performance go on to get the best training positions; we could in a matter of few years change the entire complexion of the medical profession.
The writer is former professor and Chairman Department of Cardiac Surgery, KEMU/Mayo Hospital, Lahore: smhmbbs70@yahoo.com