..

• MINUTES OF THE 194TH SESSION OF COUNCIL HELD ON 20TH APRIL, 2019 AT

PM&DC OFFICE, ISLAMABAD

Honorable President PM&DC Prof. Dr. Tariq Iqbal Bhutta, opened the
house on 20th April, 2019 at PM&DC Secretariat Islamabad for proceedings of the
Session.
Following attended the meeting.
1. Prof. Dr. Tariq Iqbal Bhutta President
2. Prof. Dr. Aamer Zaman Khan Vice President
3. Prof. Syed Shoaib Hussain Shah Member
4. Mr. Muhammad Ali Raza Member
5. Prof. Dr. Amer Bilal Member
6. Prof. Dr. Khalid Usman Member
7. Prof. Dr. Umer Farooq Member
8. Prof. Dr. Saeed Sadiq Hamid Member
9. Prof, Dr. Sulman Jaffar Member
10. Prof. Dr. Muslim Khan Member
11. Maj. Gen. Prof. Saleem Ahmed Khan, HI (M) Member
12. Prof. Dr. Shabir Ahmed Lehri, Member
13. Prof. Dr. Shehla Baqi Member
14. Prof. Dr. Kartar Dawani Member
15. Prof. Dr. Mirza Khan Tareen Member
16. Prof. Dr. Nadeem Samad Member
17. Dr. Sitara Hassan Acting Registrar

Meeting started with the recitation of verses from the Holy Quran.
President allowed deliberation on agenda detailed as under:

ITEM 01: MINUTES OF THE 193RD SESSION OF PM&DC HELD ON 25TH

MARCH, 2019 AT PM&DC, HEAD OFFICE ISLAMABAD:

The Council perused minutes of 193rd Session of PM&DC held on 25th

March, 2019 at PM&DC Secretariat and unanimously approved the same.

ITEM 02: MINUTES OF THE MEETING OF INTERNATIONAL CO-ORDINATION

AND AFFILIATION COMMITTEE HELD ON 1ST APRIL, 2019 AT
PM&DC SECRETARIAT ISLAMABAD AND PRESENTATION BY THE
HONORABLE VICE PRESIDENT PM&DC:

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 1/32
----~-~~---.l
The Council approved the minutes of International Co-ordination and
•
Affiliation Committee of its meeting held on 1st April, 2019 at PM&DC Secretariat
Islamabad.
The Council deliberated on arrangements for the visit of WFME Inspection
team. Aga Khan Medical College, Karachi and affiliated clinical training sites, CMH
Lahore Medical College, Lahore and affiliated clinical training sites, Army Medical
College, Rawalpindi and affiliated clinical training sites and/ or any public sector college
like King Edward Medical college and its affiliated clinical training site were identified as
potential sites. The Council agreed to the proposal of Committee and desired that any of
the medical colleges be finalized for the inspection of the WFME team.
Detailed discussion was held with regards to accreditation criteria for
assessment! inspection of proposed medical/ dental college. It was agreed that the new
accreditation / recognition criteria/ standards 2019 to be prepared / approved by the
Council and will take considerable time for its implementation. Considering that all
colleges have been previously inspected on 2012 criteria and the 2018 criteria is being
revised, the assessment! inspection to the extent of WFME visit will be done on 2012
criteria.
In principle the decision of Council to inspect all existing and new colleges
on revised standards/criteria 2019 shall stand.

ITEM 03: COUNTRYWIDE STANDARDIZED UNIFORM ADMISSION TEST FOR

MEDICAL & DENTAL STUDENTS - PRESENTATION OF PROF. DR.
SYED SHOAlS HUSSAIN SHAH:

Prof. Dr. Shoaib Hussain Shah presented the over view of the uniform
standards for undergraduate admissions. He stressed on the need of uniform central
admission while highlighting its background. He explained that the entry point into a
medical college is the most crucial as it eventually determines the quality of graduates.
The criteria for admission was solely based on academic performance in Higher
Secondary School Certificate (HSSC)/ Secondary School Certificate Examinations (SSC,
or similar exams). "Extra" marks are earmarked for specific categories like Hafiz-e-Quran
-A practice that continues to this day. Eventually different provinces started their own
admission tests which formed a component of the total score that was considered as
merit for admission into medical colleges. This lead to the origin of 'coaching' academies
and eventual 'leaks' within the system leading to paper being available prior to the
assessment.

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 2/32
• Current practice and its drawbacks were explained. Dr. Shoaib Shah
expressed his concern over current practice and drawbacks. No uniform standards for
admission tests with regards to content and scoring, number of tests a student takes,
determinants of an admission test and the merit list being a fiasco.
He highlighted the value of a good admission test and gave examples of
International parameters like United States of America, United Kingdom and India. He
further referred to Standard 4.1.1 of WFME Guidelines "Formulate & implement an
admission policy based on principles of objectivity including a clear statement on the
process of selection of students" and Standard 8.1 of PM&DC guidelines "The medical/
dental college must follow the admission policy devised by the affiliating university in
congruence with the national regulations/ guidelines of central induction policy"
Proposed Strategy was elaborated at length and consisted of:

Raise pass percentage requirement at HSSC level to 70% (60%

Baluchistan).
Single Admission test under the auspices of the PMOC with a cut off merit
(dependent on number of seats available (14825 MBBS; 3115 BOS). The
National MOCAT to cater for both eligibility and entrance to medical
colleges across Pakistan.
Admission by Universities based solely on the National merit (composite
of MOCAT, HSSC! A-Level & SSG! O-Level)
Students have the right to see the merit list and may file complaints with
the PMOC if merit is not followed
As Admission will be done by Universities based on merit and student
preference, there is no need for Upgradation of medical students within or
across the Universities.

Proposed Strategy with regards to ensunng merit and admission

Procedure was also elaborated at length. The admission and MO-CAT timelines were
also provided.
He explained that since PM&DC lacked resources, universities of the
provinces were assigned the responsibility of central admissions although PM&DC being
the regUlator. Sh~UI.dtake thisrbility either on its own or by outsoursing to a third
party with stnct vigilance. \~j-
/1fJ~~
~
.~\V\
..
I
Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.
Page 3/32
 The Council commended the idea of national centralized entrance
•
examination proposed by Dr. Shoaib Shah and further appreciated the detailed insight
on the introduction of a national level centralized entrance examination to medical and
dental programs which would seek to ensure merit across the board while catering for
the weaknesses in the education system in different areas of Pakistan so as to avoid
putting students at a disadvantage for reasons beyond their control and finding the best
future doctors from across Pakistan and resolved to entrust the matter with the Medical
Education Committee to consider on an urgent basis and work out the details for
implementation strategy and particularly any proposed change In composite
aggregate. Dr. Shoaib Shah and his team be co-opted for the meeting. Meanwhile the
Council has also directed the Admission Board to initiate work on improving the central
induction program introduced for the first time this year to avoid the problems faced in its
first year.

Dr. Kartar Dawani e)S:pressedhis concern over conducting country wide

examination on the same day highlighting the media usage by people to malign the
system or perhaps a genuine complain of leakage should also be kept in view. He
concerned that conducting a countrywide exam could be expensive and challenging.

It was agreed in principle that the road map is to be made available to the
Admitting Universities and the students well in time.

ITEM 04: APPROVAL OF INSPECTORS FOR INSPECTION OF EXAMINATION:

The Council considered the request received from Prof. Dr. Shoaib
Hussain Shah, Member Council regarding matter of approval of inspectors for inspection
of undergraduate professional examinations. It was highlighted that the PM&DC is
empowered to inspect examinations held by Medical/ Dental colleges as per Ordinance,
1962 and 2019, however, it is not in practice at the moment. The Council deliberated on
the need for examination inspection and stressed that the same is required to be
initiated. However, the fact the fact that this can be misused should be kept in view. He
opined that PM&DC should only act on specific complaints since universities are
responsible to maintain standards of examination. Considering that the
standards/guidelines for recognition of colleges is being reviewed by the Council,
initiation of examination inspection shall be taken in account. Once after the standards/
guidelines for recognition are finalized by the Council

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 4/32
• ITEM 05: CONSIDERATION OF POINT HIGHLIGHTED BY HONOURABLE
MEMBERS PM&DC REGARDING TEACHING REGULATIONS-2018,
PUBLICATIONS REQUIRED FOR ELIGIBILITY OF ASSISTANT
PROFESSORS, ASSOCIATE PROFESSORS AND PROFESSORS AND
SELECTION & PROMOTION CRITERIA REGULATIONS FOR
ASSISTANT PROFESSORS, ASSOCIATE PROFESSORS AND
PROFESSORS LRH-MTI PESHAWAR:

The Council considered the matter regarding Selection & Promotion

Criteria Regulations for Assistant Professors, Associate Professors and Professors of
LRH-MTI Peshawar. Dr. Amer Bilal apprised the house that these criteria were designed
by Dr Nosherwan Burki for putting into practice in Lady Reading Hospital and have
changed the academic culture and atmosphere. He highlighted salient features of the
criteria including its entry point being mandatory which requires 6 papers as first or
corresponding author in the post, CPSP/ HEC recognized Supervisor, fulfilling minimum
PMDC required experience in the post. He elaborated that as a result of these
mandatory entry point criteria anyone who is not a Supervisor i.e. a Non-Teacher is
excluded and is not considered eligible for promotion. Secondly as only first or
corresponding author are to be considered with documented evidence of their
contribution to the publication, previous practice of inserting/ adding names in list of
authors out of fear or favor for someone is totally curtailed. Dr. Amer Bilal explained that
only after passing these criteria a person can be considered for promotion. After passing
these initial gates, candidate has to score on a scoring index. Required score depends
on the time spent in the post and is as follows:

1. Minimum PMDC time period required in the post i.e. 3 years, required
score is 80% and above. At 5 years required score drops to 70% and at 8
years it comes to 60%. Thus, brilliant candidates/ star performers go up
the ladder faster at 3 years than average performers at 5 years and the
slow plodders at 8 years. This scoring is multifactorial but 30% marks are
for publications. Previously PMDC just required 3 publications in a PMDC
recognized journal and a publication in the LANCET and Gomal Medical
College, for example, carried equal marks, which was ridiculous, to say
the least. Now the publications are given marks according to the quality of
the journal in which they are published, thus distinguishing between the
brilliant and the mediocre. To publish in good quality journals better
planned, prospective and more authentic/ scientific research is required

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 5/32
 than to publish a retrospective experience/ audit in a PMDC recognized
•
journal. This has been a game changer in the quality of research/
publications coming from LRH faculty now.
2. Secondly marks have to be scored on CME, on Excellence as a teacher
and Excellence as a clinician. Again, this marking is not arbitrary
but objectively itemized and thus transparent Faculty are now actually
planning and striving to get these marks, which has resulted in both better
academics and better patient care.

According to Dr Burki's pyramid the teaching pyramid would now be as:

1. Trainees undergoing a recognized training program, under a recognized

Supervisor, in a recognized unit of a recognized Teaching Hospital.
2. Trainee Registrars ie those trainees who have completed their training
program but not yet passed their exit exams.
3. Specialist Registrars who have passed their exit exams, but not yet
completed the Post Fellowship two years' experience required to become
Asst. Profs.
4. Asst. Profs recruited with Level 3 qualification and two-year post
Fellowship experience in the specialty.
5. Associate Profs who have been promoted from Asst. Profs, after fulfilling
the 3 mandatory promotion criteria and scoring appropriately on the
Promotion scoring index.
6. Professors who have been promoted from Associate after fulfilling the 3
mandatory criteria and scoring appropriately on the promotion scoring
index.
Thus entry point to the teaching cadre will become Asst. Prof, instead of
Senior Registrars, a position which has been done away with by PMDC,
existing Senior Registrars can be re designated as Asst. Profs upon
completion of two years Post Fellowship experience. This will be a re
designation and not a promotion as both SR and AP are Grade 18 posts.
There is precedence of this in KPK when 39 Senior Registrars were re
designated as Asst. Profs in 1998, as the govt. wanted to convert SR from
a teaching to a non-teaching post.
7 Associate and Profs may also be recruited directly, in exceptional cases,
where a new skill is brought by the incumbent to the service, or a new

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 6/32
• service IS started and in that case a position commensurate with the
experience of the Innovative clinician coming with a new skill or starting a
new service, would be created either at Associate or Prof level. Apart from
improving academics and patient care, one other major advantage of the
new proposed criteria is reduced litigation. Prior to Dec 2016, when old
PMDC criteria were in vogue in LRH the number of selection/
promotion cases in court was 273. Ever since new rules came into play
from Dec 2016, only 2 fresh cases are in court. The reason for this is that
the scoring index is displayed on the website. The whole process is open
and transparent and mathematically objective. Any candidate can do a
self-appraisal and calculate his score himself before moving for
promotion.

The Council held deliberation on MTI LRH selection and promotion criteria
as implemented in LRH. The Council observed that the criteria are in the process of
notification in the rest of KPK. It was agreed in principle that the bar on standards is
to be raised and the whole country can benefit from this criterion. PM&DC being
regulator should set minimum standards for a broader framework. After thorough
discussion the Council agreed in principle with the criteria however considering that
the timelines and implementation strategy is to be decided cautiously the Council
resolved to entrust the matter to following sub Committee:

1. Prof. Dr. Saeed Sadiq Hamid

2. Prof. Dr. Kartar Dawani
3. Prof. Dr. Amer Bilal
4. Mr. Muhammad Ali Raza
5. Prof. Dr. Muslim Khan

The Council also decided to hold a seminar and consultative meeting with
the Provincial Health Commissions to focus on the issues of quality of services and
systems at hospitals regulated by the Commissions and initiating a consultative process
with the stakeholders on developing a more robust and merit-based promotion and
~ appointment criteria for faculty at teaching hospitals

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 7/32
ITEM 06: CONSIDERATION OF POINT HIGHLIGHTED REGARDING SENIOR
•
REGISTRARS BY THE PROF. DR. JAVED AKRAM, VICE
CHANCELLOR, UHS, LAHORE AND PROF. DR. MASOOD-UR-RAUF
KHAN HIRAJ, PRESIDENT PAKISTAN MEDICAL ASSOCIATION
(PMA) MULTAN:

Status of Senior Registrars for teaching expenence under PM&DC

Teaching Regulations 20'18 was discussed at length. It was pointed out by Dr. Kartar
Dawani that as per PM&DC Regulations for The Appointment / Promotions of Faculty /
Teaching Staff / Examiners / Principals / Deans / Vice Chancellors in Undergraduate and
Postgraduate Medical & Dental Institutions / Medical Universities of Pakistan 2018 post
of senior registrar is abolished.
The Council felt that the Senior Registrars in various clinical specialties
not only do clinical procedures but are also actively engaged in undergraduate and
postgraduate teaching. After detailed discussion it was decided that the Senior
Registrars be recognized as teaching trainees/trainers and be given due 50% credit of
teaching experience, as was the practice in the past. It is antithetical to exclude those
from teaching cadre, who are actively involved in teaching and clinical work in public
Institutions. Also, the post of Senior Registrar will be added in the regulations along with
the post of Specialist Registrar to ensure including of both nomenclatures Specialist
Registrar/ Senior Registrar being used currently for the same defined post. The Council
accorded approval to amend the regulations accordingly. The Law, Regulatory and
Compliance Committee shall review these amendments.

ITEM 07: MINUTES OF THE MEETING OF HR COMMITTEE HELD ON 31ST

MARCH, 2019 AT PM&DC, HEAD OFFICE ISLAMABAD:

The Council unanimously approved the minutes of HR Committee of its

meeting held on 31sr March, 2019. The Council considered and approved the
organogram shared by the HR Committee. While approving the new management
organogram of PM&DC, Council authorized the HR Committee to formulate the
necessary criteria for the heads of each department and advertise these at the earliest in
line with the new Service Rules which were sent to the Legal & Regulatory Committee to
finalize for approval of the Council on an immediate basis. The Council also approved
immediately advertising for the posts of Registrar, Director Finance and an External
Auditor.

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 8/32
• ITEM 08: CRITERION FOR THE POST OF REGISTRAR PM&DC:

The proposed criterion for the post of Registrar PM&OC as received from
the Law, Regulatory Committee and Compliance Committee of PM&OC was discussed
by the HR Committee in its meeting held on 31-03-2019 and was referred to the Council
for further discussion/ consideration. It was discussed and agreed that as per 2019 Law,
Registrar is the Chief Executive Officer, and Principal Accounting Officer, responsible for
facilitating and carrying out all the administrative affairs and functions as directed by the
Council. The Council is looking for leader, manager and executor and hence should not
restrict applicants with management skills to apply for the post of Registrar merely on the
basis of not having an MBBS/ BOS degree. For a managerial post such as Registrar any
professional and/or technical expert with management skills is what the organization is in
need of. The Council deliberated on the eligibility criteria and resolved as:

a. Experience: Minimum 20 years

b. Experience in senior management position

c. Experience in Health sector will be given preference

d. Minimum Qualification Masters or above from an institution recognized by

HEC. Preferably M8BS / 80S and qualification in Public Administration or
Public Health.
The Council directed the HR Committee to proceed accordingly.

ITEM 09: ESTABLISHMENT OF PM&DC REGIONAL OFFICE IN SOUTH

PUNJAB:

The Council considered the request of Prof. Dr. Khalid Usman, honorable
member of the Council regarding proposal of establishment of PM&OC Regional Office
in South Punjab in addition to four other PM&OC regional offices and deferred the matter
until IT reforms are initiated and department wise utility of existing staff is identified.

ITEM 10: MINUTES OF THE MEETING OF THE LAW & REGULATORY

COMMITTEE HELD ON 08TH APRIL, 2019 AT PM&DC SECRETARIAT,
ISLAMABAD:

The Council unanimously approved the minutes of meeting of the Law &
Regulatory Committee of PM&OC was held on osth April, 2019 at PM&OC Secretariat,
Islamabad.

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 9/32
 The Council further decided that with regards to pending litigation of OSD,
•
Dr. Ahmed Nadeem Akbar our counsel Adv. Shoaib Shaheen will file a representation
before the High Court for request to refer the matter to PM&DC to decide its fate.

ITEM 11: REVISED SERVICE RULES OF PM&DC:

Prof. Dr. Umer Farooq, Chairman of HR Committee apprised that

revision of Service Rules of the PM&DC are initiated by the HR Committee and are
being forwarded to the Law, Regulatory and Compliance Committee for its input Once
finalized will be tabled before Council for consideration.

ITEM 12: MINUTES OF THE MEETING OF THE STANDING RECOGNITION

COMMITTEE (DENTAL) HELD ON 10TH APRIL, 2019 AT PM&DC HEAD
OFFICE, ISLAMABAD:

The Council considered and approved the minutes of Standing

Recognition Committee (Dental) of PM&DC held on 10th April, 2019 at PM&DC
Secretariat Islamabad.
The Council directed that matters be disposed of accordingly"

ITEM 13: CONSIDERATION OF THE REQUEST OF CHANGE OF AFFILIATION

STATUS FOR DIPLOMA IN OPHTHALMIC MEDICINE AND SURGERY
(DOMS) OF PAKISTAN INSTITUTE OF OPHTHALMOLOGY ( PIO) AL-
SHIFA TRUST EYE HOSPITAL, RAWALPINDI QUAID-E-AZAM
UNIVERSITY, ISLAMABAD TO UNIVERSITY OF HEALTH SCIENCES,
LAHORE:

The Council considered the request received from Dean, Pakistan

Institute of Ophthalmology (PIO), AI-Shifa Trust Eye Hospital, Rawalpindi regarding
change of affiliation of postgraduate program from Quaid-e-Azam University Islamabad
to University of Health Sciences, Lahore. The Council was informed that the Pakistan
Institute of Ophthalmology (PIO) AI-Shifa Trust Eye Hospital, Rawalpindi was inspected
on 21st October, 2014 and was notified by the Ministry on 22nd January, 2019.
The Council was further apprised that Pakistan Institute of Ophthalmology
(PIO) AI-Shifa Trust Eye Hospital, Rawalpindi was directed by PM&DC vide letter dated
2nd August, 2015 to change its affiliation with a recognized medical University.
-;)' \"\ Considering that the program was first recognized in 2014, the existing
standards of the program need to be assessed by a fresh inspection therefore it was
decided that a two membered inspection team shall be sent to assess the program
before formal approval of change of affiliation is granted by the Council.

Minutes of the 194tl1 Session of the Council held on 20-04-2019 at Islamabad.

Page 10/32
.'

• ()
ITEM 14: RE-CONSIDERATION OF INSPECTION REPORT OF
POSTGRADUATE PROGRAMS OF FAISALABAD MEDICAL
UNIVERSITY (PUNJAB MEDICAL COLLEGE, ALLIED & DHQ
HOSPITAL) FAISALABAD:
The Council reconsidered the matter of Postgraduate Programs of
Faisalabad Medical University (Punjab Medical College, Allied & DHQ Hospital)
Faisalabad, inspected on 151 January 2019 for the recognition of postgraduate programs
of MS Neurosurgery, MS Urology and DOMS to be granted by the University of Health
Sciences, Lahore.
The Council was apprised that in compliance of the decision of Executive
Committee in its meeting held on 2nd January, 2019 Faisalabad Medical University was
informed that it cannot be considered as a training site. Punjab Medical College being
the training site shall have to be affiliated with the UHS. The response received from
Faisalabad Medical University vide letter dated 22nd March 2019 along with affiliation
letter of UHS was perused by the Council.
After detailed discussion the Council unanimously approved the
recommendations of the inspectors for the recognition of postgraduate programs are as
under:
Name of PG Programs Recommendations Annually

M.S Neurosurgery 04 Students

DOMS 05 Students
M.S Urology 06 Students

The Council directed that recommendations to the Mlo NHSR&C be sent

accordingly for inclusion of the aforementioned postgraduate programs in the third
schedule of PM&DC Ordinance 2019 under Section 17.

ITEM 15: QUERY REGARDING RECOGNITION STATUS OF MASTER IN

HEALTH PROFESSION EDUCATION (MHPE) THROUGH SHIFA
TAMEER-E-MILLAT UNIVERSITY ISLAMABAD:
The Council considered the application dated 18th March 2019 received
from Dr. Ali Tayyab, Professor & Head department of Ophthalmology, Islamabad Medical
& Dental College, Islamabad, wherein he raised query regarding recognition status of
Master in Health Profession Education (MHPE) offered by Shifa Tameer-e-Millat
University, Islamabad He stated that he was enrolled in the MHPE session 2015-17 of
the Shifa Tameer-e-Millat University and the course concluded in 2017. At the time of the
start of the course it was assured that the program will have due recognition by the time

Minutes of the 194tl1 Session of the Council held on 20-04-2019 at Islamabad.

Page 11/32
course is completed (2017). In the meantime, a second batch of students (session 2016-
•
2018 was inducted and they are also yet to complete the program. He sought
clarification of the status of Shifa Tameer-e-Millat University, with regards to starting
Master's programs. That if the University is not authorized to start programs, why and
how was it able to do so advertising it openly and induction students and the fate of the
students who have completed the course work assignments and thesis and could not
complete the program.

The Council was apprised that the Masters in Heath Profession Education
(MHPE) from Shifa Tameer-e-Millat University, Islamabad is not recognized under
section 17 of PM&DC Ordinance 2019. Further that the PM&DC had issued public
notices from time to time to inform the doctors to not take admission in any unrecognized
postgraduate program which is not included in the Third Schedule of PM&DC Ordinance
1962 through amendment Act 2012 and that any unrecognized postgraduate diploma or
degree shall not be registered by the Council. The Ministry of National Health Services
Regulation & Coordination, Islamabad forwarded the application for the recognition of
aforementioned postgraduate program vide letter dated 8th September, 2018 but the
programs stand unrecognized under Section 17 of PM&DC Ordinance 2019. On a query
from Prof. Dr. Sulman Jaffar, it was clarified that the university had admitted students
prior to applying to the PM&DC through Mlo NHSR&C for recognition.
Considering the fact that the University started an un recognized program
and it not only charged tuition fee from students but also wasted their precious time, the
Council unanimously agreed that the University is to be fined for such gross violation and
the fine shall include compensationlre imbursement to the students.
It was decided that a hearing will be given to the University to explain the
violation of law committed and so as why an appropriate penalty under section 31 of
PM&DC Ordinance 2019 be not imposed on the University.

ITEM 16: WRIT PETITON OF DR. FAIZAN MUHAMMAD VIS FOP & OTHER IN
ISLAMABAD HIGH COURT FOR REMARKS ON LSMF
REGISTRATION CERTIFICATE:
The Council considered the writ Petition of Dr. Faizan Muhammad VIS
Fop & Other filed in Islamabad High Court for Remarks on LSMF Registration Certificate.
The Council perused the order of Islamabad High Court wherein the court
declared that a person registered under the Ordinance of 1962 becomes entitled to the
rights and privileges explicitly mentioned in section 29 ibid. Moreover, the Council is not
vested with the power and jurisdiction to deny to a registered person the said rights and

Minutes of the 194tl1 Session of the Council held on 20-04-2019 at Islamabad.

Page 12/32
• privileges unless the registration is revoked the registration granted to the petitioner then
before doing so, it would ensure that the mandatory requirements of due process
guaranteed under Article 10-A of the Constitution are complied with.
The Council further perused the decision of NEB Committee of its meeting
th
held on 17 November, 2016 approved by the Council in its 148th Session held on 15th
December 2016 wherein regarding holder of eligibility for NEB examination for LSMF the
Council unanimously decided that LSMF may be registered after NEB, as such for
applicant who have already been issued its eligibility and it shall not be equated to MBBS
(Pak). Further that the matter of remarks on LSMF holder certificates was placed before
the Council in the session on 25th February 2018 wherein it was decided that after 25th
February 2018 eligibility certificate shall not be issued. LSMF shall not be converted to
MBBS at all. However, till 25th February 2018 having LSMF eligibility will only be
registered as equivalent to LSMF after passing NEB exam.
The Council observed that as per law limitation to privileges cannot be
decided once a practitioner's name has been put on the register and the honorable
Islamabad High Court has rightly observed so.
The Council further observed that LSMF is an obsolete/redundant
qualification now and only its nomenclature, albeit wrongly, is being used for MBBS/ MD
degree holders from abroad with issues with their F.Sc /Intermediate (less than 60 % or
overlapping due to improvement etc.). The Council observed that as per order of Lahore
High Court in W/P No 1755 of 2017 titled Muhammad Junaid Alam vs Federation of
Pakistan the court has declared regulation No. 48 and 60 as unlawful and hence there is
no ambiguity in allowing holders of less than 60 % FSc/lntermediate marks or those who
improved their marks of FSc/ Intermediate during their study period as long as they hold
basic/undergraduate qualification recognized in its own country of origin and listed in
WHO World Directory and have qualified the NEB exam irrespective of marks scored in
FSc or any overlapping period etc
The Council agreed that discrimination of limitation to practice shall not be
~ allowed. LSMF is no longer a recognized category or qualification with immediate effect
The applicants who proceed abroad and qualify MBBS/MD from abroad and have
passed the NEB Exam shall be registered by the Council on provisional basis as
equivalent to MBBS and will be allowed one-year house job/ internship to acquire full/
permanent registration as allowed by the Council as in case of local graduates The
Council directed to dispose of all such matters accordingly

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 13/32
 The Council further directed that a detail of certificates of LSMF issued
•
and eligibilities to appear in NEB for LSMF be provided to the Council.

ITEM 17: CONSIDERATION OF REVISED PM&DC CODE OF ETHICS AND

PROFESSIONALISM (CODE OF CONDUCT) REGULATIONS, 2018 IN
THE LIGHT OF PROMULGATION OF PM&DC ORDINANCE 2019:

The Council considered the matter regarding revised PM&DC Code of

Ethics and Professionalism (Code of Conduct) Regulations, 2018 in the light of
promulgation of PM&DC Ordinance 2019. The Council in 189lh Session meeting of
PM&DC held on 03rd December 2018 considered the Final draft of Code of Ethics and
Professionalism (code of conduct) Regulations, 2018 and in compliance of the decision
PM&DC sent "Code of Ethics and Professionalism (code of conduct) Regulations, 2018"
to The Ministry of National Health Services Regulations & Coordination, Islamabad for
Notification/Gazette under section 33 (e) of PM&DC Ordinance 1962, dated: 10th January
2019. As per letter NoJ.6-12/2015-PMDC/NHSR&C dated: 4th March 2019, received
from Dr. Farrah Mazhar, Deputy Director (PM&DC) Ministry of National Health Services
Regulations & Coordination, Islamabad, the views/comments of the new Council are
needed regarding the subject matter after promulgation of PM&DC Ordinance 2019.
The Council resolved to principally agree with the draft and enforce it until
revised/ reviewed by the Council. The Code of Ethics and Professionalism (code of
conduct) Regulations, 2018 be uploaded on website and referred to Medical Education
Committee for review.

ITEM 18: REGISTRATION OF MBBS GRADAUTE (MR. MUHAMMAD

JAHANGEER S/O SYED MATI U ZAMAN) OF BAQAI MEDICAL
COLLEGE, KARACHI:

The Council was informed that Mr. Muhammad Jahangeer S/o Syed Mati-
medical graduate of Baqai Medical College, Karachi applied for issuance of
provisional registration certificate for house job purpose. He was admitted in Muhammad
Medical College, Mirpurkhas in Session 2002-2003 in 1st year and registered with
PM&DC vide registration No. 0242/M/MMC and is now graduated from Baqai Medical
College, Karachi in 2018. As per documents submitted by the student/graduate he was
admitted in Muhammad Medical College, Mirpurkhas in 1st year in session 2002-2003
and passed his First Professional Part-II examination in 2005. He was migrated to Baqai
Medical College, Karachi in 3rd year in 2014 after a gap of almost 08 years but
permission letter from PM&DC was not obtained for re-continuation of his study

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 14/32
• The College was asked to submit copy of NOC for migration issued by
PM&DC and also submit the permission letter issued by PM&DC to re-continue his
studies after a gap of almost 8 years. In response to this office letter, the Principal, Baqai
Medical College, Karachi vide letter No. Nil dated 25th February, 2019 informed that at
the time of transfer, he had been directed clearly to contact PM&DC for permission letter
of study gap as well NOC. He was only admitted after his verbal affirmation that he
would obtain the same before his graduation but failed to comply with. He further
requested that the candidate may kindly be registered on sympathetic and humanitarian
grounds.
The Council was apprised of the rules regarding study gap in vogue at
that time. After detailed discussion it was resolved that there should be no bar on
maximum study gap and a student at any stage be allowed to re initiate his/her study
program. The applicant shall however have to re take the last professional
examination, if the study gap is of two years or more. The Council accorded approval
for amendment in original text of regulations to this effect and referred to Law,
Regulatory and Compliance Committee for necessary amendment in the regulations.
In the instant matter the applicant shall be registered.
The College and the University shall be issued a show cause notice for
allowing migration without prior permission and permitting study gap of more than 5
years in violation of Council regulations.

Dr. Kartar observed that medical study is different than other university
programs. I doubt any other country allows this. A student cannot be allowed to graduate
as per his will. If a student gets admission, passes his first year and joins another
program in other university; comes back after 3 years and so on and so forth, then
medical education will become laughing stock. In LRC meeting we had discussed this
earlier and it was proposed that if a student does not pass within 7 years his admission
may be cancelled. Present suggestion of no time bar is mindboggling for me. He
proposed that study be done in the context of practice in other countries including our
neighbor countries and the Council may revisit this accordingly.

ITEM 19: REGISTRATION OF MBBS GRADAUTE (Mr. GHAZANFAR

MASHKOOR S/O MASHKOOR SIDDIQUI) OF HAMDARD COLLEGE
OF MEDICINE AND DENTISTRY, KARACHI:

The Council was informed that Mr. Ghazanfar Mashkoor Sio Mashkoor
Siddiqui, medical graduate of Hamdard College of Medicine and Dentistry, Karachi

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 15/32
 applied for issuance of Provisional Registration Certificate for house job purpose. He
•
passed his MBBS Examination from Hamdard College of Medicine and Dentistry,
Karachi. He was admitted in Hamdard College of Medicine and Dentistry, Karachi in 1st
year in 1994 and passed his MBBS exam in 2012 (after 18 years).
The Council was further apprised that the Principal, Hamdard College of
Medicine and Dentistry, Karachi has verified his MBBS provisional certificate and
informed that he was admitted in Hamdard College of Medicine and Dentistry, Karachi in
1994. He passed 1st professional exam in 1997 in 4th attempt, passed 2nd Professional
MBBS examination in 1999 in 3rd attempt, passed 3rd Professional MBBS examination in
rd
3 attempt in 2001, after eight years absence from studies i.e. 2002 to 2009, he retook
third Professional MBBS Exam and passed in 4th attempt in 2010-2011, He passed final
professional MBBS examination 2012 in 2nd attempt.
As per PM&DC rules in vogue at that time a maximum period of 5 years
was to be permitted for continuation of MBBS and BDS classes after discontinuation of
studies by any student for any reason. The College was asked to clarify that how Mr.
Ghazanfar Mashkoor was allowed to appear in the exam after a gap of 08 years against
the PM&DC rules. In response to our query, College informed that the case of Mr.
Ghazanfar Mashkoor S/o Mr. Mashkoor Siddique, enrolment No. 694016 was
appropriately comprehended and further requested to kindly exonerate the human
mistake and entertain his case on humanitarian ground.
The Council was informed that in compliance of the decision of Executive
Committee in its meeting held on 7th June, 2018 wherein it was directed to present the
case with complete details of record since 2002 in respect of students who have not
been allowed to continue their studies after a gap of 5 years. Upon scrutiny of student
registration record and upon inquiry from Council Section, only one precedence related
to student who was declined to continue his study after a gap of 5 years has been found.
However, on the basis of Court order the Council later on in its 160th Session held on 6th
February, 2018 allowed this student. The precedence related to students allowed by the
Council to continue their studies after a gap of 5 years were also perused.
~ / The Council was apprised of the rules regarding study gap in vogue at
! \,\
that time. After detailed discussion it was resolved that there should be no bar on
, maximum study gap and a student at any stage be allowed to re initiate his/her study
program The applicant shall however have to re take last professional, if the study gap
is of two years or more. The Council accorded approval for amendment in original text of

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 16/32
• regulations to this effect and referred the matter to Law, Regulatory and Compliance
Committee for necessary amendment in the regulations. In the instant matter the
applicant shall be registered.
The College and the University shall be issued a show cause notice for
allowing migration without prior permission and permitting study gap of more than 5
years in violation of Council regulations.

Dr. Kartar recorded his observation as referred in agenda point No. 19

ITEM 20: SINGLE TIME AMNESTY FOR THE OVER ADMITTED STUDENTS OF
NISHTAR MEDICAL UNIVERSITY, MULTAN:

The Council considered the matter regarding single time amnesty for the
over admitted students of Nishtar Medical University, Multan on request received from
Prof. Dr. Khalid Usman, member of PM&DC. The Council was apprised that seat
allocation of recognized Medical/Dental College from Inspection/Council Section is 250
MBBS students however the college is over admitting students since 2012-13 as per
directive of provincial government.
Details of students over admitted by the College were perused. The
Council was apprised that reparation of over admitted students as per decision of 142nd
Session of the Council is being charged from the College.
The Council showed concerned over the violation by the College with
regards to admissions beyond the allowed/ permitted seats. It was also decided that a
public directive as well as a directive to provincial governments will be issued to ensure
compliance of Council regulations by all public sector colleges with regards to seat
allocation pursuant to any form of Executive directives or quotas.
The College shall pay reparation of over admitted students as equivalent
to five years tuition fee of each over admission.

ITEM 21: MINUTES OF THE MEETING OF INFORMATION TECHNOLOGY

COMMITTEE HELD ON OSTH APRIL, 2019 AT PM&DC, HEAD OFFICE
ISLAMABAD:
~'0I
~
'I The Council approved the minutes of the Information Technology
Committee of PM&DC held on osth April, 2019 at PM&DC, Head Office Islamabad. Mr. Ali
Raza, Chairman IT Committee informed the Council that National Institute of Technology
board (NITS), arm of the Ministry of IT, having services from consultancy and
deployment works in conjunction with the National Technology Council (NTC) that
provides databases and connectivity. The NITS having broad range of technical

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 17/32
guidance and consultancy services has been requested to provide facilitation has been
•
requested vide letter dated 17th April, 2019 for provision of services in following areas, in
addition to advisory consulting service:

1. E-Office Implementation.
2. Resurvey of Infrastructure for E-Office Implementation.
3. Case Tracking Systems Deployment in PM&DC
4. Digitalization of Record
5. Students! Practitioners and Institutions ID's.
Mr. Ali Raza informed the house that the NITS has offered us to provide
free of cost services through which they will give us an assessment plan, design strategy
and services required for E-enablement. Within 15 days they will bring us online with E-
Office, secure and digital management system. The entire structure needs to be
converted to digital platform and the staff will be trained on E- Office. In addition, the
NITS has financial, ERP and Procurement modules etc, with which the PM&DC can be
benefitted. Moreover, the NITS team will help us design solutions for registration
systems and reform the existing static website. He informed the house that once after
the evaluation is done a lot of equipment like computers, scanners need to be
procurement.

The Council granted permission to sign an agreement! MOU with the

NITS and once after financial assessment approval of equipment procurement may be
sought from the Council by circulation, in case urgently required.

ITEM 22: MINUTES OF THE MEETING OF DISCIPLINARY COMMITTEE HELD

ON 30TH MARCH, 2019 AT PM&DC, HEAD OFFICE ISLAMABAD:

The Council considered and approved the minutes of the Disciplinary

Committee of PM&DC held on 30th March, 2019 at PM&DC, Head Office Islamabad.
The Council deliberated on the directives to be issued to administrative
heads with regards to management and decided that in cases where there is a question
of management issue, serious directive is required to be issued to the management. The
Council approved the issuance of advisory notes to hospitals on account of failure of
systems and management. These advisories will also be communicated to the relevant
Provincial Health Commissions for further inquiry. As part of the disciplinary proceedings
it was noted with concern that the process of recording all actions, taken, especially
counselling, is not strictly adhered to and it must be followed by all hospitals and doctors

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 18/32
..
• specially recording and providing to patients or their families in writing the medical advice
as part of consultations.

ITEM 23: HOUSE JOB ROTATION (RECEIVED FROM PROF. DR. TARIQ IQBAL
BHUTTA, HON. PRESIDENT PM&DC):

The Council considered the matter regarding original system of having

house job (a) six month in medicine or allied and surgical and allied or (b) straight one
year in medicine or surgical specialties. The Council was apprised of previous system of
rotation of house job wherein six months of modules of Medicine and Allied six months
Modules of Surgery and Allied was being followed however the existing system consists
of 4 modules of three months each.
The Council deliberated on both the systems and their pros and cons. It
was agreed that although subspecialties have taken over in place of Gen. Medicine and
Gen. Surgery, a house officer cannot work independently and require adequate
supervision. International requirements were also kept in account, where rotation in
subspecialties is mandatory.
The Council considered the proposal of keeping both the systems in place
on the basis of preference from next year onwards.
It was directed that a letter be issued to recognized institutions offering
house job to clearly mention /specify allied subject modules in house job certificates.

ITEM 24: RECOGNITION/ STUDENT REGISTRATION OF DOW DENTAL

COLLEGE, KARACHI - CONSIDERATION OF:

The Council was informed that Dow Dental College, Karachi applied for
recognition in 2012. Inspection was convened on 15th November, 2012, whereby the
college obtained 650/750 marks and was recommended for recognition to train 50 80S
students by the Executive Committee in its meeting held on 10th December, 2012
however it was never notified by the Mlo NHSR&C, which is a mandatory requirement for
recognition as per law.
The Council was further informed that the College was later inspected on
14th November, 2018 whereby it scored 680/1000 marks and as per decision of
nd
Executive Committee of its meeting held on 2 January 2019, subsequently approved by
nd
the Council in its 191st Session held on 02 January, 2019, the College was not
recommended for recognition and it was decided that the college will be re- inspected as
and when it applies to the Council, once after rectification of deficiencies pointed out by
the inspection team. The decision of Executive Committee and Council was

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 19/32
communicated to the college vide PM&DC letter NoPF.12-F-2018(lnsp.)/1246 dated 11th
•
January, 2019.
The Council perused the order of High Court of Sindh, Karachi in
C.P.No.D-507 of 2019 dated ih March, 2019.Recommendations received from Law &
Regulatory Committee were perused. It was established the matter is pending with the
PM&DC for inspection and hence appeal in the said matter does not need to be filed. It
was further resolved to order inspection of the College on direction of the Court. With
regards to criterial proforma for assessment it was decided that the College will be
assessedl inspected on existing criteria i-e 2018, the criteria on which the College was
lastly assessed.

ITEM 25: CHANGE OF UNIVERSITY AFFILIATION OF MUHAMMAD MEDICAL

COLLEGE, MIRPURKHAS, SINDH - RE-CONSIDERATION OF:
The Council considered the matter of change of affiliation of Muhammad
Medical College from University of Sindh to Liaquat University of medical & Health
Sciences, Jamshoro. The Council was informed that the Principal vide letter No. MMC
1202 dated 2th March, 2019 has requested for change of university affiliation of
Muhammad Medical College, Mirpurkhas with Liaquat University of Medical & Health
Sciences, Jamshoro wherein he has referred to the directions of PM&DC regarding
colleges that are affiliated with non-medical university to affiliate them with a medical
university. He has informed that in compliance to the directions of PM&DC after due
inspection by Liaquat University of Medical & Health Sciences, Jamshoro affiliated
Muhammad Medical College vide No.Doc./LUMHS/lC/8410/13 dated 10-03-2015. They
requested that change affiliation with Liaquat University of Medical & Health Sciences,
Jamshoro may be considered at earliest since the batch 2014-15 is in Final Year MBBS
at present
The Council after detailed deliberation directed that two inspectors be
sent to the College to verify the change of affiliation. Once verified the matter be placed
before the Council.

COURT CASE REGARDING CONSIDERATION OF APPLICATION OF

MR. MUHAMMAD FAROOQ SIO MUHAMMAD SALIM KHAN
REGARDING ISSUANCE OF PERMISSION LETTER FOR APPEARING
IN NEB EXAMINATION:

The Council considered the application of Mr Muhammad Farooq slo Mr.

Muhammad Salim regarding issuance of permission letter to appear in the NEB
Examination. The Council was informed that a case of overlapping of IBCC equivalence

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 20/32
'.
• certificate with MD duration in respect of Dr. Habib Nawaz Khan S/o Mazhar Nawaz
Khan who passed NEB exam vide roll no.112-0315 having MD degree from Moscow
State University, Russia in 2002 and IBCC equivalence certificate of SSC & HSSC (pre-
medical) with the duration 1994-2009 and 1994-2010 was placed before the Executive
Committee meeting held on 4th December, 2014 and Executive Committee decided to
issue him registration for one year house job
In the instant matter, applicant Mr. Muhammad Farooq S/o Muhammad
Salim Khan applied for issuance of permission letter for NEB Exam of PM&DC He was
regretted as there was overlapping between his FSc and MBBS (He got admission in
MBBS in September, 2012 and pass supplementary Exam of Intermediate 2012 held in
Oct/November, 2012) and result was declared on 4th December, 2012). Mr. Muhammad
Farooq S/o Muhammad Salim Khan approached Islamabad Honorable High Court,
Islamabad for issuance of permission letter for NEB Exam.
The Council was further informed Permission letters are being issued to
applicants having foreign basic medical/dental qualification with less than 60% marks in
FSc as per the Honorable Lahore High Court Orders and that students who improved
FSc or got A level from abroad during their MBBS/MD/BDS program with more than 60%
marks seek eligibility to appear in the NEB Examination and therefore a generic decision
regarding issuance of permission letter in cases where there is overlapping of FSc with
MBBS/MD/BDS program is required to be made.
The Council observed that the Lahore High Court in w/p No. 1775 of 2017
titled Muhammad Junaid Alam vs Federation of Pakistan has declared impugned
regulation No. 48 and 60 of Pakistan Registration Regulations for Practitioners, 2008
illegal, unlawful and ultra vires of Section 15 read with Section 33 of PM&DC Ordinance
1962 hence there is no ambiguity in allowing holders of less than 60 % FSc/lntermediate
marks or those who improved their marks of FSc/ Intermediate during their study period
as long as they hold basic/undergraduate qualification recognized in its own country of
origin and listed in WHO World Directory irrespective of marks scored in FSc or any
overlapping period etc.
\,/
i'lJvW\J" The Council directed to ensure that compliance of order is being done
,1tom 9 th
Oct, 2018 (date of order of the Lahore High Court) and issue a circular to the
NEB Section to comply with the court order in true letter and spirit and that no applicant
tS denied eligibility to appear in the NEB and registration after the NEB on the basis of
less than 60 % marks in FSc/lntermediate

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 21/32
 The Council discussed to reframe the regulations and come up with a
•
methodology which is not in violation of the order of Lahore High Court. It was agreed
that our own standard of examination should improve with checks and balances but the
instant matter needs to be discussed at length keeping in view different modalities.

ITEM 27: MINUTES OF THE FIRST AND SECOND MEETING OF EVALUATION

COMMITTEE HELD ON 1ST & 6TH APRIL, 2019.

The Council earlier its 193rd Session held on 25th March, 2019 had
resolved that the Inspection criteria and its processes require to be thoroughly reviewed
by the Evaluation and Legal Committees before start of any inspection. Until such review
is presented for approval of Council, no new inspections shall be carried out. In
compliance of aforementioned decision of Council, meetings of Evaluation Committed
were held on 1st April, 2019, 6th April, 2019 and 19th April 2019.
Dr. Amer Bilal, Chairman Evaluation Committee briefed the house about
the accreditation framework and revised standards/ criteria formulated by the Evaluation
Committee. He explained that the idea for revision of standards/ criteria to make it more
transparent and objective, focused more on processes, quality and outcomes rather than
on infrastructure and least prone to litigation. He informed the house that the evaluations
will be of two types. One for initial evaluation and the other for continuation of evaluation
of existing accredited colleges that the exercise of revised standards/criteria 2019 is
being done keeping in view all the fallacies that existed in the 2012 proforma, 2018
proforma and international guidelines of Joint Commission for Inspection and
Accreditation (JCI) and World Federation of Medical Education (WFME). The revised
standards/ criteria is more or less in line with the WFME criteria but is contextual to
needs of our own country.
While revising the standards/criteria requirements of the 21 st century
students have been kept in view which includes but is not limited to access to digital
library, access to online journals, access to free Wi-Fi in the campus (both the college
and the hospital) and access to resource network centers.
He presented the standards, evaluation framework and processes and
explained that the evaluation tools are a being devised by the Evaluation Committee and
~)all be finalized by the end of next week
While elaborating evaluation framework he highlighted on process of
improvement in quality of education of existing recognized colleges With regards to
inspection tools, he elaborated that the inspector will be not be aware as to what marks

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 22/32
'.
• each component carnes. It will be more of yes/ no check box and the marks will be
collated/ translated by a computer matrix. The inspectors will be given smart tablets,
evaluation will be done there and then and the data will be transferred to the PM&DC so
there's no tampering afterwards. To further ensure that the results are not tampered, the
convener will give an initial report to the convener and will get the Dean/ Head of the
institute to sign that report
Once the evaluation tools are devised by the Evaluation Committee and
approved by the Council representatives of all medical/ dental schools in Pakistan will be
called for a one-day symposium to educate them on the proformCl Clndto provide them
guide books on how to fill the proforma. The proforma will be shared with all medical!
dental schools for self-evaluation within a month. A quality assurance cell in PM&DC will
be established for evaluation of the data submitted and initial scoring which will then be
shared with the colleges to enlighten them about their strengths and weaknesses. Three
months' time will be given to colleges to adapt to the laid down standards without any
penalty. After three months inspections will be carried.
With regards to inspection processes, it was stressed that the inspection
proformas are subjectively exploited and therefore inspectors training is a must to
standardize the process. The proforma will not only have a yes/no format of questions
but will also have some trick questions to eliminate the element of favoring. The
inspectors will be engineer and architects to look at the infrastructure, a Finance expert,
a management expert to look at the management and governance and subject
specialists one each for evaluation of basic and clinical science facilities.
While explaining the process of inspection he proposed that instead of
part time inspectors, volunteering for inspection the Council may look into hiring of pool
of inspectors, full time employees of Council specifically trained for this job. Discussion
on appointment of in-house inspectors was held in depth. It was agreed that there should
be checks and balances and test methodologies are available. A permanent inspector
could be a subject expert, Associate professor and above with 10 years of teaching. It
was also discussed that JCIA accredited surveyors are there in Pakistan who can be
Ired for carrying out surveys .
.\\! Dr Amer Bilal then gave an overview of the 12 standards (essential
I '.'

standards that are mandatory and quality standards which each college should be
aiming for) In line with the WFME standards. He explained that few of the standards like

jvJinutes of the 194r:, Session of the Council held on 20-04-2019 at Islamabad.

Page 23/32
 Curricular organization, educational content, curricular management and assessment are
•
awaiting feedback from the Medical Education Committee.
Evaluation Framework along with the pre requisites for initial inspection
and for ongoing continuation of recognition to be evaluated were discussed at length. It
was explained that the recognition evaluation will be a mandatory initial evaluation
carried out for college applying for the first time. Performance evaluation will be
continuous evaluation carried out on a recurring basis at a frequency determined by the
category of college. Light was shed on the new concept of categorization/ ranking of
colleges and explained various categories of colleges along with the incentives and
penalties for not upgrading their category. The incentives like no fee caps and limit of
number of students is being given to institutions to strive for upgrading them for better
categories. On a query it was clarified that the same will be validated with a pilot project
testing.
It was clarified that the revised standards are based on both the purple
and the orange proforma. The orange and the purple proforma are already shared with
the colleges and if there aren't any vast differences it won't be great deal of difficulty in
making the institutions adhere to the revised standards/ criteria. It was clarified that the
difference is mainly with regards to the revised proforma being focused on safe and
adequate teaching facilities including fire exits, infection control, lighting, ventilation etc.
to be assessed by an ArchitecUEngineer. The team shall further include professionals
like health profession's expert, and a health institution management apart from the
subject experts. The role of universities, students and faculty has also been defined in
the revised standards/ criteria. The proforma will be focused more on patient turnover
rather than bed occupancy and on number of procedures rather than number of beds.
With regards to internal assessment it was explained that the same is being reduced to
10-20 % as being exploited by the colleges.
The Council commended the effort of Evaluation Committee, particularly
the input of Mr. Taimur, Shah Director Quality Assurance Shifa International Hospital and
approved the minutes of Evaluation Committee of its meetings held on 1sl April 2019, 6th
April 2019 and 14th April, 2019. The council directed that the presentation be shared with
all the members

~ The Council approved the structure of new evaluation criteria for medical
\~nd dental colleges which entails In addition to initial recognition cntena a penodlcal
performance evaluation of colleges and their corresponding rating in categories which

Minutes of the 194rl1 Session of the Council held on 20-04-2019 at Islamabad.

Page 24/32
• ()
would be publicly available for students also to make their decisions as to
preferences Colleges in the lower categories would have a fixed period of one to two
years to improve their performance and be promoted to the higher category failing which
they will face penal action including suspension of admissions and thereafter, de-
recognition The revised standards/ criteria 2019 will be followed in true letter and spirit.
The Council noted with concern that quantity without quality is a
dangerous trend which needs to be curbed therefore, the Council decided that all public
colleges will also be evaluated for performance and rated so as to enable the Provincial
Governments and Universities responsible for these public colleges focus on
improvement. The evaluations done so forth shall be made public.
Colleges which would improve performance would also receive incentives
including the right to increase their allocated seats subject to proper enhancement of
facilities. The inspections would be carried out using an online reporting system to avoid
any latter interference. The detailed tools, proforma and guidelines for the inspection will
be finalized and approved within the next two weeks to enable the Council to start many
pending inspections and set down a schedule of performance evaluation of all existing
colleges. Colleges will be provided the new criteria in advance for enable to do a self-
evaluation after having introduced them to it through detailed workshops and seminars to
be held by PM&DC.
ITEM 28: PERMISSION TO CONTINUE STUDIES OF 8DS AFTER FOUR
CHANCES:

The Council considered the application received from Brig. Asad Raza,
father of Tatheer Fatima Raza, student of Multan Medical & Dental College, Multan
stated that her daughter is studying in MMDC in 2nd Year BDS program. She was unable
to clear her Anatomy paper of 15t year BDS in four chances due to her illness and
psychological pressure on her as he was involved in war on terror at FATA. However,
she was successful in clearing her Anatomy paper in 5th attempt on interim order of
Honorable Lahore High Court She has also been permitted by LHC to appear in 2nd year
Annual Exam however, her result will be subject to final outcome of the petition
~#\\~ The Council was informed that as per PM&DC rules she is not eligible to
"'ontinue her medical studies as she exhausted her four chances for the first
professional
The Council perused the interim order of Honorable Lahore High Court,
Lahore dated 23-11-2018 in WPNo 250703/2018 titled Miss Tatheer Fatima Raza Vs
University of Health Sciences, Lahore whereby the petitioner was provisionally allowed

Minutes of the 194'11 Session of the Council held on 20-04-2019 at Islamabad.

Page 25/32
to appear in Anatomy paper (First year) and in the annual examination of the Second
•
year BD However, the result of said paper / examination will be subject to final outcome
of this petition.
The Council observed that since the matter is sub judice in the High Court
therefore it would be appropriate to allow the court to decide the matter on merits.

ITEM 29: MINUTES OF THE MEETINGS OF ADMISSION BOARD HELD ON 01ST

AND 12TH APRIL, 2019 AT PM&DC, HEAD OFFICE ISLAMABAD:

The Council approved the minutes of meetings of Admission Board held

51 th
on 01 , 12 April, 2019 and 141h April, 2019 at PM&DC, Head Office Islamabad. The
Council was apprised that the admission process of UHS has been finalized. NUMS
Examination was held in abeyance as the Board had identified due to some missing
record. NUMS was directed to submit the same in order for the Admission Board to
decide future course of action. NUMS has submitted the desired record and the Board
shall review the same in its meeting scheduled at 7: 00 pm. The Council entrusted the
Admission Board to resolve and decide the matter and fill remaining vacancies
accordingly.

The Council ratified the decisions of the Admissions Board in respect of

finalization' of the UHS admissions and the NUMS admissions and the decision that all
admissions now stand finally closed for the current academic year and any seats left
vacant in any college due to a student electing not to join such college corresponding to
having been given the right on merit shall not be filled at a later stage as admissions
stand closed as otherwise it would become an unending exercise cutting into the
ongoing academic year and present its findings to the Council.

ITEM 30: PUBLIC NOTICE REGARDING HAIR TRANSPLANT AND

LIPOSUCTION:

The Council considered the matter regarding Public Notice for Hair
Transplant and Liposuction. The Council was informed that the petitioner has filed Crl.
Org. No. 84/2019 in W.P.No. 168/2019 before Islamabad High court Islamabad which is
pending. The petitioner Dr. Muhammad Nasir Rashid (Reg No. 28233-P) is a simple
MBBS doctor and Secretary General of Hair Restoration Society of Pakistan. He
challenged the public notice issued by the PM&DC regarding Hair Transplant or
Liposuction whereby all doctors were advised to get their additional qualifications
registered with PM&DC before carrying out the procedures of Hair transplant or
Liposuction on any patient and that no Simple MBBS can do these procedures.

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 26/32
'.
• The Council was further informed that in consequence of the decision of
the Executive Committee meeting held on 30-01-2017 and in light of orders of Honorable
Lahore High Court Lahore in WP/No. 10392/2016 a committee was constituted to
submit its findings on the said matter. Subsequently another subcommittee was
constituted by the Honorable President, In consequence of decision of Executive
Committee dated 30th January 2017, to decide the case.
That the meeting of the subcommittee was held in Medical Directorate
GHQ on 24 May 2018 under the chairmanship of Surgeon General/Director General
Medicine Services (inter services) and subject matter was deliberated in detail. The
committee was of opinion that the input from faculty of the Plastic Surgery and
Dermatology, CPSP, is essential to proceed further in the case. PM&DC was requested
to approach College of physicians & Surgeons 0 Pakistan for detailing representatives
from the facilities of Dermatology and Plastic Surgery facilitate the committee in
formulating its Policy. PM&DC wrote a letter 11th June, 2018 to Registrar, CPSP and
Chief Operating Officer Punjab Health care Commission for the nomination of
representation for formulation of policy regarding Hair Transplant or Liposuction. But
mean while a new W.P.No.168/2019 has been filed by HRSP through its Focal Person
Doctor Rana M.lrfan.in the Islamabad High court, Islamabad with the prayer that the
proceedings of the said Committee may be halted, the PM&DC may kindly be directed to
put on the committee qualified and skilled persons in the field of hair transplantation and
bring this medical branch in to regular and registered system. Furthermore, hair
transplant may be registered as a separate specialty like others. The honorable
Islamabad High Court vide order 17-01-2019 ordered in the subject case to decide the
matter in accordance with law expeditiously preferably within a period of thirty (30) days
from the date of order.
Mr. Ali Raza informed that the court has directed to determine the list of
qualifications accepted for hair transplant and liposuction. The Council deliberated at
length and stressed on the need of limitation to practice In the instant matter Dr. Shabir
Ahmed Lehri was entrusted with the responsibility to provide with nomenclature of
additional qualificationsl certifications for the purpose of hair transplant, liposuction etc.
o the Law, Regulatory and Compliance Committee to respond to the court accordingly.

Minutes of the 194tl1 Session of the Council held on 20-04-2019 at Islamabad.

Page 27/32
 ITEM 31: COURT CASE REGARDING CONSIDERATION OF APPLICATION OF
•
MISS. AZKA ZAHRA RIZVI REGARDING ISSUANCE OF PERMISSION
LETTER FOR APPEARING IN NEB EXAMINATION:

The Council considered the application of Miss. Azka Zahra dlo Syed
Iftikhar Mahmood Rizvi regarding issuance of permission letter for appearing in NEB
Exam. The Council was informed that applicants' approach for issuance of permission
letter with overlapping of their F. Sc./ Intermediate with MBBS/MD/BDS program in
circumstances like improving FSc or A level from abroad during their MBBS/MD/BDS
program to achieve 60% marks.
The Council was informed that Miss. Azka Zahra Rizvi 0/0 Syed Iftikhar
Mahmood Rizvi applied for issuance of permission letter for NEB Exam of PM&DC. She
was regretted as there was an overlapping period between her FSc and MBBS (She got
admission in MBBS in September, 2011 and passed supplementary Exam of
Intermediate 2011 held in Oct/November, 2011) and result was declared on 13th
December, 2011). Later she approached Islamabad High Court.
The Council was apprised that permission letters to appear in the NEB
Examination are being issued to applicants having foreign basic medical/dental
qualification with less than 60% marks in FSC as per order of the Honorable Lahore High
Court in wlp No. 1775 Of 2017 titled Muhammad Junaid versus Federation of Pakistan
The Council observed that the National Examination Board (NEB)
Examination is conducted to assess proficiency of a candidate to be declared eligible to
practice as a doctor. In view of the of the order of Lahore High Court Regulation no 48
and 60 have been declared illegal, unlawful and ultra vires the Section 15 read with
Section 33 of the PM&DC Ordinance. The Council keeping in view the Lahore High
Court order directed that students who have improved their FSc with an overlapping
period in MD/MBBS/BDS be allowed permission letter to appear in NEB Examination
and the NEB Section shall dispose all such matters complying with the court order.

ITEM 32: ICA NO. 25728312018 TITLED DR. SAAD RASHID ETC VIS PM&DC
ETC. IN LAHORE HIGH COURT LAHORE HIGH COURT

.~ The Council considered the matter of representation of Dr. Saad Rashid

d-', etc. vis PM&DC etc. on the direction of Court order dated 2ih March, 2019 and deferred
for next meeting when the petitioner appears for personal hearing

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 28/32
• ITEM 33: DECISIONS AND RECOMMENDATIONS OF THE DISCIPLINARY
COMMITTEE OF PAKISTAN MEDICAL AND DENTAL COUNCIL,
ISLAMABAD:

The Council was apprised that the minutes were to be approved to the
extent of recommendations since due to paucity of time detailed facts of each case could
not be added. The Council accorded approval to incorporate brief facts of the cases in
the minutes and approved the recommendations of Disciplinary Committee of its meeting
held on 141h April, 2019 at CPSP Karachi and directed Complaint section to dispose of
matters accordingly.

The Council deliberated on the directives to be issued to administrative

heads with regards to management and decided that in cases where there is a question
of management issue, serious directive is required to be issued to the management. The
Council approved the issuance of advisory notes to hospitals on account of 'failure of
systems and management. These advisories will also be communicated to the relevant
Provincial Health Commissions for further inquiry. As part of the disciplinary proceedings
it was noted with concern that the process of recording all actions, taken, especially
counselling, is not strictly adhered to and it must be followed by all hospitals and doctors
specially recording and providing to patients or their families in writing the medical advice
as part of consultations.

ADDITIONAL AGENDA POINTS:

1. INSPECTION REPORT OF RAWAL MEDICAL COLLEGE:

The Council was informed that Rawal Medical College and Dental College
was recognized for 100 MBBS students vide Notification dated 30-12-2011.The
1h
institution was inspected through a surprise inspection on 09 March, 2016, wherein the
college secure 501.4/1000 and was placed in category "z" and subsequently in
compliance of 143rd Council decision, admissions of college were suspended vide this
office letter No. PF.12-F-2016(RIHS Isb)/ 290425, dated 261h May, 2016. The college
filed WP No 1817/16, challenging the inspection of the PM&DC on the basis that it was
biased and the court has ordered a fresh inspection. Meantime, the then council was
dissolved and Ad hoc Council was constituted and ordered its inspection. According to
this inspection the college was not qualified and reparation for 100% tuition fee was
imposed for the sessions 2016-17, 2017-18. The court through its various orders had
permitted the students to appear in exams however, no order has been passed with

Minutes of the 194tl1 Session of the Council held on 20-04-2019 at Islamabad.

Page 29/32
regards to student registration by PM&DC. High Court vide its order dated 18-2-2019 has
•
suspended the reparation imposed by the council and directed the college to inform
Council once it is ready for inspection under section 13 & 15 of Regulations 2012 and
dismissed the petition with the observations that in case college does not fulfill PM&DC
Criteria its students shall be adjusted in other recognized colleges (VVP No. 3953/18).
With regards to reparation an ICA by PM&DC has been filed which is pending. The
Council after taking into consideration the inspection report, legal position and court
orders decided to continue with its appeal on the decision of reparation and had referred
the matter to the Evaluation Committee for inspection post adoption of new criteria by the
Council.
In compliance of the order of Islamabad High Court dated 09th April, 2019
whereby the court had directed for inspection the college was inspected on 15th April,
2019 after consulting the Evaluation Committee and Law, Regulatory and Compliance
Committee.
The sealed inspection report as received from inspector was opened by
the President PM&DC and was placed before the Council during the session for
deliberation. The Council perused the recommendations made by the inspector wherein
it was reported that the college does not comply with Section 13 of the PM&DC criteria.
Considering that after the enforcement of 2012 institutions recognition criteria, the
college was given three years' time to conform with the same and in 2015 the institution
was yet again provided with the opportunity of compliance within six months, the college
till to date is persistently non-compliant with the aforementioned regulations hence
violating the provisions of law the Council unanimously decided to de recognize the
college in view of its failure to fulfill the evaluation criteria for a private medical college.
However, as the matter is pending before the Honorable High Court, the Council directed
for the decision to be placed before the Honorable Court for further proceedings. The
students of the college would be adjusted in other recognized colleges in the area as per
Section 23 of the Ordinance on an immediate basis.

MINUTES OF NEB COMMITTEE HELD ON 20th APRIL, 2019 at 9:00

AM AT PM&DC SECRETARIAT:
The Council approved the minutes of NEB Committee of its meeting held
2019 at CPSP Karachi and directed NEB section to dispose of matters
accordingly

Minutes of the 194tl1 Session of the Council held on 20-04-2019 at Islamabad.

Page 30/32
• 3. IMPORTANT DECISIONS OF CLOSED SESSION:

A. The PM&DC Council, pursuant to consideration of an Inquiry held in the

matter of theft of an original file of additional qualification involving a fake
FCPS letter of Dr. Aatif Jahangir Lashari PM&DC Registration No.14162-
N, has directed the following persons to be suspended on account of
prima facie misconduct and gross negligence with immediate effect.
Show Cause Notices setting out the statement of allegations shall be
communicated to the persons with an opportunity to explain their conduct
and hearing before the President PM&DC or a committee to formally
charge sheets them and proceed accordingly or otherwise in due course
of time.

S.No. Name of Employee Designation

1. Dr. Sarah Ali Assistant Registrar
2. Mr. Arshad Wazir Director Administration
3. Mr. Shahabuddin Assistant
4. Mr. Rahat Shah Assistant
5. Mr. Adnan L.D.C
6. Mr. Mudassar Jan Gardner (Presently working as
Naib Qasid)

B. The PM&DC Council, pursuant to consideration of the matter pertaining to

concealment and misrepresentation of facts in Writ Petition No.2031 of
2010 titled Muhammad Ismail Fazal vs FOP etc. and misrepresentation of
facts in internal record resulting in obtaining of directions without lawful
and factual basis, has directed the following persons to be suspended on
account of prima facie gross misconduct and misrepresentation with
immediate effect.
S.No. Name of Em 10 ee
1. Dr. Shaista Faisal
2. Mr. Muhammad Ismail Fazal

Show Cause Notices setting out the statement of allegations shall be

communicated to the persons with an opportunity to explain their conduct
: ~ ~ and hearing before the President PM&DC or a committee formed by him
Q \ \' In due course.
In reference to permission granted in lieu of two drop out students granted
to Hamdard College of Medicine, Karachi show cause will be issued to Dr.
Shaista Faisal, Deputy Registrar to explain her position with regards to

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 31/32
 r

Letter No. PF. 65-F-2019 (Student Registration)/ 315895 dated 11 th

•
March,2019.

4. MS/MD DEGREES:

With regards to MS/MD programs offered by various universities it was

discussed and agreed that there is no uniformity in their entry criteria and syllabus. It was
also concerned that there is lack of monitoring over the standards of these
programs/degrees.
It was proposed that MS/MD be divided into two distinct programs, one
being a research degree and the other a training program. The clinical programs be
designed to provide a specialist training at par with the CPSP programs. It was
considered that an option would be to design the program and ask a national level entity
like the HEC to manage and operate the same. In addition, it was discussed that a
grandfather clause can be considered for those who have already acquired MS/MD
degrees to enable them to become trainees.
It was unanimously agreed that steps are required to be taken to
standardize these programs with defined minimum standards of a structured training. A
consultative seminar will be held with all stake holders including universities offering
these courses for a way forward at the earliest.

d1'~
Dr. Sit ra Hassan
Acting Registrar

Minutes of the 194th Session of the Council held on 20-04-2019 at Islamabad.

Page 32/32