Improve pay-scales to control brain drain–Dr Yasser Dr. Yasser Riaz Malik is a promising foreign qualified dental surgeon who did his BDS from Baqai Dental College in 2006 and then proceeded to do his master’s in public health from Sydney University. He is presently associated with Sir Syed College of Medical Sciences (Dental Section) as Assistant Professor & Head of Department (HOD as well as Secretary to Principal for dental affairs in the Community/ Preventive Dentistry Department After completing his masters from Australia he joined Ministry of Health, Saudi Arabia as Dental Specialist in 2011 and remained there till May 2014. A humble person with a friendly personality, Dr Yasser was recently interviewed by Dental News to have more insight about his experience of studying in Australia and what value addition it made to his overall skillset. The excerpts of his exclusive interview with Dental News are as follows:- 1- Being a graduate from overseas, how do you see the difference between the teaching methodologies and facilities in Australia and Pakistan? Well, before getting into comparison regarding teaching aids available I must mention that we have some of the best Professors available in our medical and dental schools, throughout Pakistan and their contribution in modernizing this profession and bringing it on par with international standards cannot be denied. On the contrary, regardless of their personal efforts, we are facing some serious deficiencies in terms of teaching facilities available. The most worrisome fact here is that, as time passed, the overall quality of medical and dental teaching methodologies and facilities available actually declined. Opening of new dental colleges is a good thing, as it provides job opportunities, but unfortunately it is the other way around here, as new dental colleges in every nook and corner with faculty shortages show that it’s all about business and making money, rather than imparting quality education. Compare the fee structure with facilities actually given to students. See the pay scales of house officers and fresh graduates. These days a driver of lecturer teaching in a college is getting more salary, than the lecturer him/herself from college. So, if this how you treat your teachers, what kind of knowledge they would be able to impart and under what motivation? Coming to differences between Australia and Pakistan, they have purpose built institutions and their teaching methodologies are well structured. They have this approach of CLEAR COMMUNICATIONS WITH STUDENTS, IN-DEPTH KNOWLEDGE OF SUBJECT AREA, STIMULATING LEARNING ENVIRONMENT, PROVISION OF EFFECTIVE ASSESSMENT AND FEEDBACK, WHILE THEY EVALUATE, MONITOR AND IMPROVE THEIR TEACHING PRACTICES. Unfortunately we don’t have such an approach here in Pakistan. You can’t develop methodologies unless you have proper facilities available. 2- What prompted you to go for your postgraduate studies overseas and how you managed the whole process? I was just another fresh graduate, confused and discouraged by locally qualified seniors in seeking education overseas and that biggest debate of our times you must have heard of “FCPS wala zyada pay laita hai and MSc walay se behtar hota hai”. You see we don’t have this basic concept even that who should academically teach and who should clinically train you. Late Dr Zohair Siddique cleared my confusion. My mentor and my dear friend Dr. Najib Sidki actually pushed me to seek education in Australia. But above all my father and mother strongly supported the idea of going abroad for education. While looking for assistance in getting admission I got lucky and came across Auspak International. Mr Hashim Hassan, to whom I was just a stranger, cleared all my apprehensions and from admission in university to visa process. Mr Hashim made the process so easy and transparent especially when I compared that to my other colleagues who were travelling to other countries and those day to day hardships in admission process they were facing. I must say that his role was appreciable. Those dental graduates, who are seeking admission in Australian universities, should visit him at least once. 3- How was the experience? It was a wonderful as it both shaped me as a professional but also groomed me as human being. It provided me a chance to interact with students from all over the world. I come from a family background where, I never had to do anything by myself but in Australia, had no such privileges hence I got exposed to the real world on my own. This is when I realised the day to day chores which my parents had to deal while taking care of things for me. This experience brings you closer to your religion as there is no one you can look upon when you get in trouble. You learn tolerance when sharing things, time management, domestic chores while studying and preparing for exams actually makes you tough and humble at the same time. It’s not about just getting a degree; it’s about learning a way of life. It changed my perspective towards profession and taught me how I may contribute in the best way possible. It gave me bigger horizon to look at with self-assurance that I am ready to take on challenges as a trained professional. 4- Tell us something about your university and the course content? The University of Sydney is an Australian Public sector University founded in 1850 regarded as one of its most prestigious and world's 27th most reputable university. The course is very unique and it is not a regular master of Public health degree. It is called Masters in International Public Health (M.Int.PH) where dental public health has been incorporated and it has been designed with international approach in it. With core units of public health such as epidemiology and biostatistics you also have to study foundations of international health, project management preventive dentistry, population oral health, dental health services, oral health promotion, and oral health policy with research methods in dentistry. 5- Would you like to talk about the dental curriculum in Pakistan based on the international standards? Would 5 years BDS be a logical solution or is it better to keep it 4 years by incorporating subjects and revising the curriculum? The existing dental curriculum needs to be revised. More emphasis on clinical and theoretical knowledge should be inculcated in the dental schools. I do support this idea as Internationally 5 year dental programs are accepted nowadays. Even India has adopted the 5 year BDS program. 6- What are the prospects after doing M.Int.PH from Australia, locally as well as internationally? Prospects are great. Locally students would be able to start their career as an academician in community dentistry. They can be in teaching faculty not for undergrads but also in those universities here where postgrad dental public health programs have been started. They can also enroll in PhD programs here as this would be the next step after masters. Apart from this they can work for National governments and locally-funded agencies. I would like to specially thank Mr. Danish Sheikh from administration of Sir Syed Dental College who always showed faith in me and provided me with open platform twice to perform my skills without any hindrance and provided full support whenever I needed. I am lucky that I am working under Professor Dr H.R. Sukhia who helped me more like a brother than a principal of college. Internationally the prospects are even greater as they will have the opportunity to undertake a placement in Vietnam, Philippines, Malaysia or China where you’ll work on practical projects with organizations in-country. These placements will reinforce what you have learned in the classroom and allow you to apply your knowledge and skills in a practical situation. They can also work with Ministry of Education and Ministry of Health in Saudi Arabia. Also they can be in teaching faculties of Australian and Malaysian dental colleges. 7- Do you suggest that students should go overseas after doing their BDS, what value does it add, if any? ‘Either you go for best and become somebody or you settle for less and remain nobody’. I would sincerely advise new dental graduates that if they can afford to go abroad for education then do not hesitate, as you are exposed to the world and the latest techniques in all spheres of dentistry. The standard of dental education in countries such as UK, USA, Australia, Canada and even Malaysia and Turkey are beyond excellence. 8- Can you tell us about the common dental diseases and disease patterns in Pakistan with causes and preventive measures needed? Despite the tremendous achievements in oral health conditions globally, if we look at the figures provided by WHO Worldwide, 60–90% of school children and nearly 100% of adults have dental cavities which are quite alarming. Along with this severe periodontal (gum) disease is found in 15–20% of middle-aged (35-44 years) adults. Globally, about 30% of people aged 65–74 have no natural teeth. Oral disease in children and adults is higher among poor and disadvantaged population groups. In Africa and Asia 90% children who have NOMA which is gangrenous lesion die if untreated. The incidence of oral cancer ranges from one to 10 cases per 100 000 people in most countries. In South Central Asia, cancer of the oral cavity ranks amongst the three most common types of cancer. sharp increases in incidence rates of oral/pharyngeal cancers have been reported for several countries such as Germany, Denmark, Scotland, Central and Eastern Europe and, to a lesser extent, Japan, Australia, New Zealand and USA. In Pakistan dental plaque, cavities and periodontal diseases are on the rise. Most people ignore dental caries till it reaches the inner pulp tissue of the tooth, infecting the tooth and the underlying bone. Oral cancer in Pakistan is the second most common cancer after lung cancer in males and breast cancer in females in the country. Lack of knowledge about oral health care, improper tooth brushing techniques, ignoring dental plaque and routine checkups by dentists, unhealthy diet habits and use of tobacco in all its forms are main contributing factors to above mentioned oral conditions in Pakistan. 9- Tell us about the dental care available in Australia and KSA vis a vis Pakistan? In Australia they have state/ territory wise dental health services program for low income adults on treating more public dental patients and it is funded through National Partnership Agreement where they are spending 1.3 billion dollars on dental health services. The Commonwealth provides assistance for 2-17 year olds through the Child Dental Benefit Schedule. The dental care is regularized and you cannot overcharge dental patients. They have National Oral health plan for 2014-2023. In KSA they have government run dental centers under Ministry of health where all the latest equipment and material have been provided by Govt. Dental care in Saudi Arabia for their citizens is totally free of cost. Unfortunately I haven’t heard of any such programs by government in Pakistan. You can get best dental care mostly from private clinics but they are usually overpriced and it’s really expensive here. A few dental colleges are providing quality dental care in their OPDs to general public on nominal rates and one such great example of this is Sir Syed College of Medical Sciences for Girls. 10- What are the main problems that agitate dental profession? Lack of jobs and postgraduate opportunities are the main agitating factors facing the dental profession. The new dental graduate having spent time, effort and money, due to non-availability of jobs, feels that LACS of rupees have been wasted after graduating. Compare the fee structure with facilities actually given to students. See the pay scales of house officers and fresh graduates. These days a driver of lecturer teaching in a college is getting more salary from their parents than the lecturer him/herself from college. So this is how when you treat your teachers what kind of knowledge they would be able to impart and under what motivation? It is good that some universities have commenced postgrad qualifications like MPhil, MSc and MDS programs. This is a great development from the MCPS and FCPS dominated scenario, which are considered as consultant qualifications. 11- Is there any similarity between new generation dental surgeons and the old ones? I believe the old generation of dental surgeons enjoyed quality education. They practiced all fields of dentistry in their private practice with confidence and ease. However, times have changed and in this era of specialty based practices today, it is important for new dental graduates to choose and concentrate on one specialty of their choice. However, the new dental surgeons are over-burdened with new textbooks and clinical techniques and need to know more to survive as compared to 20 years ago. 12- Do you think that a school-based oral health program is beneficial? Yes, School based programs are always beneficial. The young growing mind learns oral hygiene better when taught at that level. More emphasis should be spent on community dental visits to create oral health awareness. Proper tooth brushing techniques and flossing should be demonstrated, and proper education and awareness should be created regarding pan, beetle nut and gutka. 13- Should there still be more emphasis on preventive dentistry? I think preventive dentistry is the cornerstone of dentistry itself. Preventive dentistry teaches the general population to maintain healthy teeth and gums, leading to less dental related issues. Proper emphasis should be created at the under-graduate dental level to create awareness in the young dental minds regarding ways to teach oral health among their friends and families. Beyond the scope of this questionnaire please feel free to comment on any other aspect which we may not have touched upon. I feel that lately lots of fresh graduates are leaving after graduation, in search of jobs overseas or they are looking for jobs in pharmaceuticals/ Dental equipment supplying companies and labs. The damage is twofold as by doing this they are wasting their seat of BDS and also taking jobs from relevant graduates of those respective fields. This brain drain is directly caused by improper pay scales of fresh graduates in dental colleges. Opening a private clinic is out of question as that also requires a lot of money. It is my request to concerned authorities to look in to this matter and consider revising descent pay scales for fresh graduates so that after all those years of hard work they can earn respectable living.
