APPNA MERIT – Ten-Year Journey

In 2006 an ad-hoc education initiative was undertaken to complement and enhance Health care in Pakistan. The Medical Education and Research Investment Task force (MERIT) came into being. Dr. Naheed Usmani and Dr. Shahid Rafiq are the founding Chair and founding member respectively with support from Dr. Nadeem Kazi. Dr. Shahid Rafiq (MERIT chair 2017) is the first chair of Neurology Net.  This task force became a full standing committee of APPNA as MERIT (Medical Education and Research, International Training and Transfer of Technology) in 2007. Following are the highlights of its success story.

  • December 2006 APPNA winter meeting in Pakistan. The members of MERIT task force met with medical education Leadership in Pakistan for a Diagnostic Phase.
  • January to June 2007: A series of meeting continued in early part of 2007 with VC of medical universities, Principal of Medical colleges and Post graduate institutes as well as leaders of HEC, CPSP, PMDC, and Federal Ministry of Labor’s National Talent Pool VEPCON program.
  • July to December 2007: In light of the feedback obtained from various needs from Pakistan, main programs were structured and organized.
  • APPNA visiting faculty program was the initial pinnacle program to boost the center of excellence in Pakistan and CME Webinar live lecture program. Dozens of US faculty visited Pakistan in 2008 to teach at DHUS and other universities. However due to laborious red tape process of VEPCON many who applied had difficulty setting up their visits to Pakistan.
  • In Fall of 2007 APPNA Sukoon (APPNA Palliative and Hospice Care Educational Program) was established. In December 2007 Palliative care conference was held in Karachi. In 2008 APPNA MERIT endorsed the INCTR clinical guidelines for Palliative care in low resource countries. Following years many of the leadership in SKMCH, INMOL and Children Hospital Lahore collaborated with MERIT.
  • Specialty- Specific MERITNETs. In 2008 specialty based focus effort was launched. Initial MERITNETs were Neurology, Dermatology, Anesthesia and Critical care.
  • Medical Curriculum Reforms: In 2008 KEMKANA President invited MERIT to KEMU to start dialogue in this important initiative. December 2008 a day long curriculum reform Colloquium was arranged. KEMU VC Dr. Zafar Ullah Khan and the local and US faculty brainstormed on various aspects of the curriculum reforms. The establishment of medical education department in KEMU and other medical colleges followed this.
  • New Fellowships in ER, Critical care and Pediatrics Hematology Oncology: Dow University VC Dr. Masood Hameed Khan was instrumental in these APPNA MERIT initiatives at Dow U. MERIT members worked with CPSP and finally got all three fellowships approved in summer of 2009.
  • APPNA MERIT E- Teaching Initiative: Spring meeting 2009 in Dallas saw this project started with IT company of APPNA member Jamal Mubarak and pilot program was presented at Summer meeting in San Francisco 2009 by Neurology MERITNET E Conference organized by Dr. Shahid Rafiq.  This was followed by a vast IT infrastructure, which supported twice weakly live lectures from US faculty to Pakistan medical institutions in various medical disciplines. This continued till 2011 when the annual budget of APPNA MERIT for this endeavor ballooned and became unsustainable.  At that point Drs. Baber Rao took over as Chair and Shahid Rafiq as Co chair APPNA MERIT and restructured the once weakly live lectures, which are going on since then successfully.
  • APPNA MERIT Telemedicine Initiative: Some of earlier efforts were taken in 2007 to train Lady health visitors using ICT based Tele health care in rural Mardan. This was followed by Dermatology tele medicine initiative by Dr. Khaleel Kahtri. In 2015 under APPNA President Dr. Mubashir Rana, Dr. Naheed Usmani started a task force and developed a network of over 200 US consultants to provide consultation for Pakistani physicians through a secure Web based network. In 2017 Telemedicine has taken a full circle and has re joined APPNA MERIT.
  • Child Psychiatry initiatives: In the year 2015, College of Physicians and Surgeons Pakistan (CPSP) has approved the Child Psychiatry Fellowship (FCPS) in Pakistan recently. Waqar Azeem Yale faculty at the time and APPNA MERIT team members along with their colleagues in Pakistan, USA and UK have played a key role in developing this fellowship. Pakistan is one of the first countries in Asia, which has a child psychiatry fellowship at National level based on US model of 2 year training in child psychiatry after finishing training in general psychiatry for 4 years. This of course cannot cater to enormous need of children with psychological disorders in Pakistan. Thus Dr. Azeem has collaborated with Dow University and has developed a one-year certification program for adult psychiatrist delivered through MERIT webinars starting summer of 2017.
  • APPNA MERIT is collaborating with Pakistan Psychiatric Society (PPS) on various educational and training issues and many of the speakers have collaborated with physicians in Pakistan and published articles
  • APPNA MERIT organized a career-planning program for female medical students in Pakistan. This program was developed in collaboration with the US-Pakistan Women’s Council.