KARACHI - Healthcare is changing in Pakistan as much as anywhere in the world, commented Professor Valerie Wass, Head of the School of Medicine at Keele University in the United Kingdom, while speaking at the concluding session of the Association for Excellence in Medical Education (AEME) and 16th Aga Khan University (AKU) symposium titled ‘education for service and patient safety in health professions’ on Sunday. It is vital that the change Professor Wass is referring to be made taking into account the needs of the particular community and not just by lifting broader principles used globally. She also suggests that Pakistan focus on improving healthcare with special focus on family medicine. “There is a great deal of evidence suggesting that family medicine doctors can help save a great deal of money especially in areas of preventative healthcare and non-communicable diseases such as diabetes.” By focusing on family medicine Pakistanis can allocate resources to other important areas such as research and development which remain largely ignored. In a country with limited resources the need to use resources present more efficiently becomes even more crucial as the chief guest for the conference, Deputy Chairman of the Planning Commission, Dr Nadeemul Haque pointed out in his address. “Change is long overdue, not just in healthcare but across the board,” he said adding, “We have limited resources and we can’t afford to give more money [to healthcare] because people just don’t pay taxes.” Roughly 0.5 per cent of the GDP is allocated to healthcare whereas over two per cent of the GDP is lost in dealing with the energy crisis. “We can’t just change in microcosm but we need to change everywhere.”Moderating the concluding session of the conference Prof Ara Tekian Associate Dean for University of Illinois at Chicago said,” Between understanding, elaboration and implementation [of change] comes another stage which is adapting [the change] to local circumstances in context.”Ripples of change are already being felt among medical students who are using technology to their advantage. “Students are moving at a fast, if not at an almost exponential pace, in using technology which is a great equaliser for them to compete locally as well as globally,” said Prof Zulfiqar Bhutta Chair for Women and Child Health at AKU.“Students equipped with iPads and other devices in classrooms now have instantaneous access to information during lectures helping to increase their learning curve,” he added. Prof. Bhutta also stressed the need for the technological change to be in context. “India, for example, is completing reforming their health and education systems to meet their nation’s needs. Also in Thailand the process has already begun. We need to do the same.”Professor Rukhsana W Zuberi, Associate Dean for Education, FHS, Chair of the Department for Educational Development at AKU took the springing of medical colleges as a prime example to highlight the importance of contextual change. “In a conversation between two people commenting on the number of medical colleges in the country one person said ‘well there are 114 medical colleges’, and the other replied ‘that was last night!’”. The comment points to a deep-rooted problem of a lack of recognising the needs of the community and offering solution that may that may be inappropriate.Professor Stephen Lindgren, President of the World Federation for Medical Education (WFME) said, “In the revised standards for basic medical education, WFME has paid special attention to aspects on the social accountability of medical education. The standards reflect whether the educational institution addresses the need for health promotion in the society they serve and globally. This includes the needs in society for knowledge development and research.”Other speakers include Professor Umar Ali Khan, Pro Vice Chancellor at Isra University, Islamabad who spoke on patient safety. “We need to educate health professionals to do service before self. Patient safety is such a vital concern that it must become part of our undergraduate and postgraduate curriculums. If we are able to keep patient safety in our cognizance in all clinical workings, only then health care provision is made safe. Patient Safety should be the agenda item number 1 for all hospital activities,” he said.