Author: Sheheryar Kabraji
Position: Medical Student
Institution: Oxford Medical School
E-mail: sheheryar.kabraji@medschool.ox.ac.uk
Additional Authors: Dr Yureeda Qazi, John Moran Eye Center, University of Utah, UT, USA
Submitted Date: June 07, 2008
Published Date: June 10, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Aly and Taj(1) have added a substantial amount of analysis to the growing body of work that aims to understand the emigration of Pakistani medical graduates to the West.(2) Unfortunately, there is little evidence that the described schemes for repatriation, which could ameliorate the physician shortage in Pakistan, remain anything more than pipe dreams.(1) As previously reported (2) only about 4% (40 of 900) of Aga Khan University (AKU) graduates have returned to Pakistan from specialty training in the West. This is over a period of some 20 years, given that the AKU Medical College was founded in 1983.(3) In that time there has seemingly been no attempt by AKU graduates to establish formal mentorship and exchange programmes between their host institutions in the West and those in Pakistan.(1, 2) Given that ideas of physician exchange and cross-appointments are hardly new, the absence of such initiatives so far does not augur well for future attempts to promote the repatriation of Pakistani medical graduates.

There is no doubting the enormity of the challenge. Implementing such mentorship schemes requires vision, dedication and more than a little finesse as physicians navigate multiple bureaucratic obstacles to establish the free international exchange of medical talent. However, there is an immense resource of well-placed, influential and talented AKU graduates at centres of medical excellence across North America and Europe. They must take the lead and use their positions of medical privilege to set up lasting systems of talent exchange that will benefit both Pakistan and their host countries. One can only hope that upcoming generations of Pakistani medical students will act on these challenges rather than cerebrating in their offices or quadrangles for another 20 years.

(1) Aly Z, Taj F (2008) Why Pakistani Medical Graduates Must Remain Free to Emigrate. PLoS Med 5(1): e2 doi:10.1371/journal.pmed.0050002
(2) Shafqat S, Zaidi AK (2007) Pakistani physicians and the repatriation equation. N Engl J Med 356: 442–443.
(3) http://aku.edu/medicalcol...