Are Pakistans female medical students to be

doctors or wives?
In Pakistan's prestigious medical schools, female students outshine and outnumber their
male counterparts. However, many do not end up as practising doctors - and now there are
calls to limit their numbers, the BBC's Amber Shamsi in Islamabad reports.

Twenty fourth-year medical students are learning how to examine a patient with a throat
infection. Today's lesson is as much about patient care as it is the anatomy of the throat.

The patient is real, a woman, and the instructor invites several of the female students to examine
her, since cultural sensitivities dictate that she does not want to be inspected by a man. The
instructor has his pick, since there are 17 women and three men in this group of students.

It is almost as if men are an endangered species in Pakistan's medical colleges.

'Catching a husband'
The government body that regulates the medical profession, the Pakistan Medical and Dental
Council (PMDC), says more than 70% of medical students are women. Competition to get into
these medical colleges is tough - at one college I was told that they receive 10,000 applications
for a 100 places. In the more prestigious colleges, students must get 90% grades or more in order
to be considered.

I ask one male student why the women were outshining the men. He is in his fifth year,
specialising in ear, nose and throat. "Boys go out, hang out with their friends," he says. "Girls
can't go out as much, so they stay at home and rote-learn." In other words, perhaps the success of
women students is not so much their own hard work, it is embedded in the culture of keeping
girls at home. And government figures suggest most of these bright female undergraduate
doctors do not actually go on to practise. Only 23% of registered doctors are female.

Hot ticket
The vice-chancellor of the prestigious Shaheed Zulfiqar Ali Bhutto medical university in
Islamabad, Dr Javed Akram, says that girls are more focused on excelling academically than
boys. At the same time, he accepts that some female students are more keen on catching a
husband than on pursuing a career.

"It's much easier for girls to get married once they are doctors and many girls don't really intend
to work as professional doctors," he says. "I know of hundreds of hundreds of female students
who have qualified as a doctor or a dentist but they have never touched a patient."

Privately, many doctors - both male and female - tell me that a medical degree is an extremely
hot ticket in the marriage market.

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To confirm this claim, I visit the Aisha Marriage Bureau run by Kamran Ahmed and his wife.
Business is so good they are opening their second branch in Islamabad. Mr Ahmed says his best
clients are mothers seeking doctor wives for their sons. "In social gatherings, it's very prestigious
to introduce your daughter-in-law or wife as a doctor." And he says if a young female doctor is
even a little good-looking, then finding a match for her is a breeze. "By the way, if you know of
any single doctor girls, please let me know. I have boys who are looking," he adds in a cheeky
aside. But the "doctor wife" is more than a trophy: her absence from hospitals has serious
implications on the healthcare system of a poor country like Pakistan. The government spends
millions of rupees on subsidies per student - yet there is a serious shortage of doctors, especially
in rural areas where women prefer to be examined by female doctors.

'More women-friendly'
Dr Shaista Faisal is an official with the PMDC whose research into the subject led the council to
try and introduce a limit on the number of women being admitted to medical colleges. When
news of the "quota" on male-female admissions broke in the local media it quickly drew flak and
controversy. But the PMDC insists it is the only solution. "It's not a quota. We want 50% of
admissions to be for males and 50% for females," Dr Faisal says, a little defensively. "It's not
discrimination. I don't think we're allowing boys who don't study to get into medical schools.
This shortage of doctors is the biggest challenge to Pakistan's health system."

Human rights lawyer Shahzad Akbar strongly disagrees. "The wrong here is that women are
being discriminated against here for being too smart." Mr Akbar has filed a petition in court
challenging the decision to introduce the "quota". He calls it unconstitutional and says the
government should encourage women to stay in the profession instead. "The answer is that they
have to make the working environment more women-friendly rather than saying, no, you can't be
a doctor because you end up leaving the profession." Columnist Fasi Zaka also believes that the
government has the wrong end of the stick. "Yes, doctors are leaving, but the restrictions should
be at the point of exit rather than entry." He suggests asking those who fail to practise to
reimburse the government the large sums it costs to train them.

Back at the medical school, two starry-eyed female students tell me they are determined to
become doctors. But if they were asked to choose between their careers or their families, which
would it be? "I'd try to convince them," says 20-year-old Eliya Khawar. "But if they aren't, I'd
choose family." Her classmate Manza Maqsood concurs. "Family. In our culture, family always
comes first." Everyone seems to agree on the diagnosis of the problem, but not on the cure.
Maybe, it's time to introduce a quota for women with pushy families.

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