Equity, diversity, and inclusion in medical education in Pakistan: Navigating a complex landscape.

Abstract

Pakistan, a South-Asian developing country with a population exceeding 230 million and a rich cultural diversity faces considerable social and cultural disparities. This article sheds light on the pressing need for equity, diversity, and inclusion (EDI) within its medical education system. Undergraduate medical education in Pakistan faces multifaceted challenges, exacerbated by a digital divide that disadvantages students from underserved regions. The urban-rural divide is further perpetuated during the admissions process, disadvantaging rural applicants. Many medical colleges are ill-equipped to accommodate students with special needs, while cultural diversity often leads to misunderstandings and biases, hindering students' sense of belonging. Postgraduate medical education (PGME) in Pakistan, offered in public and private institutions across the country, lacks standard central induction, rendering it susceptible to provincial biases and favouritism. PGME training predominantly favours urban-centric experiences, with limited availability in rural settings. Public institutions, managing larger patient volumes, provide a broader experience base but often compromise the quality of training due to overwhelming workloads. Female medical graduates face different challenges, leading to a significant dropout rate from postgraduate training and the workforce. Undergraduate and postgraduate nursing education also faces unique challenges such as gender disparity with a mere 10% of nursing students being male. Despite this, only 28% of seats in nursing programs are allocated for male students. The rural-urban divide combined with societal norms and a lack of trained nursing educators compounds the challenges, with most faculty lacking postgraduate or educational training. In light of these disparities and challenges, this article emphasizes the need for a comprehensive, EDI-focused approach requiring unified measures and reforms considering the unique aspects of each segment within health profession education. Achieving equity, diversity, and inclusion is not only vital for the quality of education but also for building a more just and representative healthcare workforce in Pakistan.