Newly graduated doctors and postgraduate trainee doctors are facing unprecedented exploitation, enduring gruelling working hours and earning salaries that fall far below international standards at most public and private teaching hospitals in Sindh, health and legal experts said at a press conference at the Karachi Press Club on Friday.
They said that at the core of this exploitation was the disparity between the official salary guidelines for house officers (HOs) and postgraduate trainee (PG) doctors, and the actual wages they received.
The press conference was told that as per the government regulations, the HOs were supposed to earn Rs70,000 per month but private hospitals in Sindh often paid them between Rs25,000 and Rs40,000 while expecting them to work in 24-hour shifts.
Highlighting the injustice in the doctors’ compensation, they said an unskilled labourer in Pakistan earned a minimum wage of Rs37,000 for an eight-hour workday. Similarly, they said that as per the recommendations of the College of Physicians and Surgeons Pakistan (CPSP) and Pakistan Medical and Dental Council (PMDC), the PG doctors should earn salaries equivalent to grade 17 officers, which was around Rs104,000, but they had been facing a similar exploitation.
Private hospitals in Sindh paid PG doctors between Rs40,000 and Rs80,000, while burdening them with the responsibilities typically assigned to consultants and medical officers, the press conference was told.
Leaders from the Faran Foundation and Karachi Bar Association spoke at the press conference and highlighted the severe conditions being faced by HOs and PG doctors across the province. “These doctors are the backbone of our healthcare system, yet they are being grossly underpaid and overworked, particularly in Sindh,” said Prof Dr Muhammad Sadiq, chairman of the Faran Foundation. He remarked that while the conditions in Punjab and Khyber Pakhtunkhwa were also far from ideal, they were relatively better than Sindh.
Advocate Hanif Sama, legal adviser for the Faran Foundation, remarked that HOs had been performing duties well beyond their roles, often handling the workload of full-fledged medical officers, but for a fraction of the pay.
Speakers at the press conference also criticised the lack of adequate learning facilities in Sindh’s teaching hospitals. “These doctors are treated not as students but as cheap labour. There is a severe shortage of qualified faculty, and hospitals seem to prioritise profit over education,” remarked Prof Syed Khaliq-ur-Rehman. He said that institutions like the Dow University continued to charge exorbitant tuition fees ranging from Rs200,000 to Rs500,000, despite the CPSP and PMDC not allowing such fees.
It was said that doctors who attempted to raise concerns with regulatory bodies like the CPSP faced swift retribution, including immediate termination without notice. In such cases, their salaries were withheld, and they were also denied a no-objection certificate (NOC), effectively barring them from continuing their training elsewhere, the press conference was told.
The inhumane working conditions were another focal point of the press conference. Many doctors were forced to work shifts lasting between 32 to 48 hours without access to proper rest facilities, clean water and meals, it was said.
In some instances, trainee doctors were coerced by their superiors into referring patients from government hospitals to their own private practices, exacerbating the ethical dilemmas these young doctors faced, the press conference was told.
The speakers urged immediate action from the relevant authorities, including the federal health ministry, Sindh government, Higher Education Commission, PMDC and CPSP. Aamir Nawaz Warraich, president of the Karachi Bar Association, stated that higher courts could be approached if action was not taken to redress the issues of young doctors.
The press conference concluded with an appeal to human rights organisations and medical associations such as the Pakistan Medical Association (PMA) and Young Doctors Association (YDA) to join the cause and advocate for the rights of these doctors. "If the authorities fail to act, we will escalate this matter in the courts. These doctors deserve better, and we are prepared to fight for their rights," asserted Advocate Sama.