Pakistan's Non-training Junior Doctor Crisis: A Ticking Time Bomb for Healthcare

Introduction
Junior doctors are the backbone of Pakistan's healthcare system and play a vital role in patient care along with senior physicians. However, the system faces a critical challenge owing to the junior doctor crisis. This crisis is characterized by low job availability, severe underpayment, and exploitation of non-training junior doctors, particularly in the private sector. In addition, the absence of a regulatory body exacerbates this situation. Without proper intervention, this crisis will continue to worsen and potentially have detrimental effects on the healthcare system.

The Bleak Reality of Young Doctors
Many young doctors, especially those holding medical officers (MO) and demonstrator positions, are significantly underpaid in the private sector. For instance, the stark disparity in earnings, with many young doctors earning just above the minimum wage for unskilled labor (around PKR 35,000–50,000), highlights the financial challenges they face. This situation is exacerbated by the scarcity of training positions in the public sector, pushing some doctors towards private practice despite its drawbacks. The absence of a regulatory body to set guidelines and prevent exploitation by private institutions further worsens this situation.

Consequences of a Disgruntled Workforce
The underpaid and overworked junior doctors are at risk of burnout and dissatisfaction, leading to a loss of faith in the healthcare system. This can ultimately trigger a system collapse. Tertiary care hospitals, heavily reliant on young doctors, face staffing shortages while these same doctors are burdened with senior-level responsibilities. The constant search for better opportunities abroad creates a revolving door of talent, further straining
the system.

A Path Forward: Protecting Young Doctors
The establishment of a regulatory body specifically for young doctors is crucial. This body should set a minimum wage close to public sector salaries to safeguard young doctors from exploitation. Currently, house officers are regulated by the Pakistan Medical and Dental Council, and postgraduate trainees by the College of Physicians & Surgeons Pakistan. However, there is no such oversight for young, non-trained doctors.

Key Stakeholders: Working Together
The onus for resolving this crisis involves several key stakeholders. The government must play a proactive role in establishing a regulatory body and ensuring its proper functioning. The PMDC and CPSP (College of Physicians and Surgeons Pakistan) can offer valuable insights into the regulatory process. Private healthcare institutions must embrace ethical practices and provide fair compensation for young doctors. Finally, a broader coalition, including existing young doctors' associations and the formation of a new association specifically focused on the needs of non-training young doctors in the private sector, is crucial. This new association can effectively advocate for their rights, working alongside existing organizations to find solutions that benefit all young doctors.

In conclusion, establishing a regulatory body involving key stakeholders and advocating for fair compensation are crucial steps in addressing the junior doctor crisis in Pakistan