Higher education comprises many different areas, one of these is medical education. Some time ago I took an Internationally Certified Training, known as TMET i.e. Training Medical Education Trainers, which is endorsed by the International Federation of Medical Education and is in line with SDG 4 (Quality Education). When I applied for this training course, many people asked me why, as it’s not relevant to my clinical practice. I answered them that we are the force that can bring change in the world by achieving the SDGs, to which I got the usual response; ‘You are wasting your time, why don’t you focus on your internship instead?’
I am sure this has happened to you at some point in your life, too. In trying to understand this mentality towards engaging in informal learning and volunteer activities, I recognized that our education systems, and more specifically medical education, fails to foster the passion and motivation in students to engage in activities outside of their obligatory course work. The education system in Pakistan focuses more on grades and knowledge instead of skills, which is evident by the fact that the usual assessment tools are the MCQ and SEQ based exam papers.1
Medical students are the future healthcare workers and need to be equipped with the right set of skills for communication, leadership and advocacy. It is mandatory that the medical curriculum is made in a way that addresses these needs. However, surprisingly even with the looming deadline of the World Federation of Medical Education, that by 2023 if Pakistan and other countries fail to update their medical curriculum and standardize it, they will not be accredited with Educational Commission for Foreign Medical Graduates, an organization that allows Pakistani medical students to practice in the US and other countries, nothing notable has been done to resolve this crisis situation.2
The concept of Meaningful Student Involvement (MSI) is so new to the relevant stakeholders in the education systems. MSI means that the students and teachers are in a democratic relationship where the students have decision making power and can make their curriculum according to their and the community needs.3 It’s highly irrelevant to study something that is not required by the community that the students have to serve in the future. Therefore, it is the necessity of time to go for student consultation before preparation of curriculum. Similarly, many students are not equipped with the right set of advocacy skills. In Pakistan you either get your needs fulfilled after rounds of protests on the roads or you don’t get them addressed. Why is it like this?
a. The government doesn’t consider us as an important stakeholder.
b. The students do not know how to advocate for their needs.
And whom shall we blame here? Again, this is something that needs to be corrected by the Higher Education Policy Makers. They focus so much on the grading system and the textbooks that the students fail to be an integral part of the community as they are not aware of the community needs, they haven’t done any community-based research and they are not involved in student volunteering. This brings us to the much-heated discussion of lack of community- based research in Pakistan. The typical perception in Pakistan is that students doing community-based research is a waste of time and resources, therefore, there is little funding available for this as well as support from the university administration.
In an era where different nations are working to achieve the SDGs and aligning their Educational strategies to international standards set by various accreditation programs, the Education Policy of Pakistan should also address this area and incorporate SDG4 (Quality Education), at least in its policies. Student led initiatives must be promoted and encouraged by the university administrations and due credit must be given to students who participate in healthy activities that are designed for the implementation of the SDGs.
As the President of the only medical students led organization in Pakistan, i.e. International Federation of Medical Students’ Associations-Pakistan (IFMSAPakistan)4, I have felt the need to empower medical students, to build their capacity and improve their leadership and advocacy skills to allow them to be better health professionals after graduating. All the activities are planned and executed by students, and the activities are based on various IFMSA programs5 related to the different SDGs like Mental Health, Maternal and Child Health, Communicable and Non-Communicable diseases, Human Rights, Refugees Rights, Gender Equity, Climate Action and Sustainable communities.
Students are also given access to various opportunities to meet people from developed countries at the World Health Assembly, AMEE Conference, WMA Conference, World Health Summit and various UN meetings. At these meetings ideas are shared related to sustainable development in areas of Education and Health. Along with this, research is promoted by allowing students to go for research exchanges. This organization is spread over 60 medical institutes out of 100+ medical institutes of the country. The activities done by students are presented at international level in the form of publications and presentations for awards.
As stated above, it is important to realize that change makers don’t necessarily have to be governments, they can be the students like you and me, too. The policy changes that we require in our education setup can be done through the use of advocacy tools and initiating discussions with relevant stakeholders. However, it is important to identify the needs first. I propose:
1) Students consultations as a necessary part of the process of designing curriculums.
2) Students must be allowed to volunteer and must be given credits for it
3) Community-based research projects must be promoted
As students we can move towards sustainability by being a part of student organizations that have an active seat at the governmental meetings as well as WHO and UN and other policymaking bodies. Universities on the other hand need to emphasize the needs of students and promote meaningful student involvement by adopting a curriculum that is based on interactive teaching methodologies, with tools that assess soft skills, too, like communication skills, public speaking skills, and leadership skills. University administration also need to provide a proper platform for students to volunteer for extra-curricular and cocurricular activities.
Similarly, the policymakers in the Higher Education Commission and Education Ministry require to initiate a survey in higher education institutions to identify the needs of students and consult them in designing a curriculum that suits their need. 6 At the same time, external collaborations and partnership with stakeholders in higher education from developed countries can support in designing an education system that is in accordance with the Sustainable Development Goals.
It is necessary that world leaders choose to sit with students on the same table to discuss their education prospects and ensure that the policies made are not just student-informed but student- consulted with students having decisionmaking power. The ARC7 platform is an excellent arena that encourages the students to discuss their education related issues and develop policy recommendations that can be then shared with the Ministers and a relevant action plan can be made and implemented. Similarly, at a national level too, the Ministry for Education must allow students to attend their meetings and give them a say in the policies that are drafted to address the needs of students.
At the same time, the Education Councils at University level must also involve students in decision-making bodies and realize their importance in areas that directly affect the students. In addition to this, student led organizations and other non-governmental organizations must also start a campaign of promoting student led activities, community-based research and meaningful student involvement in the university.
1 MCQ: Multiple choice question, SEQ: Structured Essay Question
2 ECFMG 2023 announcement https://wfme.org/accreditation/ecfmg-2023/
3 Meaningful Student Involvement Guide to Students as Partners in School Change https://www.researchgate.net/publication/274707207_Meaningful_Student_Involvement_Guide_to_Students_as_Partners_in_School_Change
5 IFMSA Programs: https://ifmsa.org/programs/
6 AFFILIATION CRITERIA/GUIDELINES FOR UNIVERSITIES/INSTITUTIONS OF HIGHER EDUCATION IN PUBLIC SECTOR http://www.hec.gov.pk/english/services/universities/Documents/AFFILIATION%20CRITERIA.pdf