The coronavirus outbreak has forced the Egyptian government to search for urgent solutions to compensate for the acute shortage of medical personnel and to save the medical sector from collapse. But the proposals were not based on scientific studies, which made them strange, controversial, and funny.

Last month, the Ministry of Higher Education and Scientific Research launched the “Stay Ready” initiative, which aims to create a second line of defence using medical and nursing students from Egyptian universities, by intensifying studies for final year students, and focusing on the antivirus field, especially coronavirus.

In the same month, Delta University in Dakahlia Governorate (Nile Delta), launched a second initiative, under the slogan “be a hero,” aimed at training medical school students in the final years about pulmonary and cardiac resuscitation skills, how to use mechanical ventilators, and personal protective equipment. A similar initiative was also adopted at Helwan University, south of Cairo, to train volunteers to work as paramedics in the isolation hospitals.

The Coordination of Parties Youth Leaders and Politicians (an unofficial gathering) launched an initiative called “The White Coat”, as a pre-emptive measure to recruit volunteers from final year students in medical colleges.

Al-Sisi’s proposal

It seems that the success of launching initiatives that aim to compensate for the shortage of Egyptian doctors prompted the Egyptian General Abdel Fattah al-Sisi, to try launching an initiative to gain popularity through solving the crisis of the shortage. Al-Sisi demanded the possibility of converting pharmacists into doctors after obtaining an equivalent certificate be looked into. According to an official letter issued by the Egyptian Army Military Medical Academy, the head of the academy, General Ahmed el-Tawdy, invited the head of the Medical Syndicate Hussein Khairy to a meeting to discuss the proposal.

A member of the Health Committee in the Egyptian Parliament, Magdy Morshed, has called for the use of dentists, pharmacists and people from other disciplines to enhance the number of doctors. The Chairman of the Parliamentary Committee of the Free Egyptians Party and a member of the Health Affairs Committee in Parliament, Ayman Abu el-Ela, also suggested using retired doctors and cadres in other medical professions to bridge the shortage in medical staff.

In addition, the Egyptian government is considering graduating exceptional batches from medical colleges, opening new colleges, and increasing the number of students admitted to medical colleges.

Acute shortage 

Al-Sisi’s controversial proposal is based on the fact that in Egypt there is an abundance of pharmacists, four times the global average, according to a recent study prepared by the Ministry of Health. According to the study, which was released in 2019, there are more than 216,000 Egyptian pharmacists, which provides one pharmacist for every 438 citizens (23 pharmacists for every 10,000 citizens), which exceeds the global average estimated by one pharmacist per 1,000 to 1,600 individuals (6-9 pharmacists per 10,000).

The total number of pharmacy colleges in Egypt is 43; of these, 22 are from governmental colleges and 21 from private colleges. Greater Cairo alone hosts 19 colleges. Egypt ranks second in the world among the countries with the largest share of pharmacy colleges, behind the United States of America, which has 56 colleges. The Egyptian labour market receives more than 14,500 pharmacists annually, and the number is expected to increase after adding the graduates of 14 new colleges.

In contrast to the large number of Egyptian pharmacists, the country suffers from a severe shortage of doctors, with a ratio of 10 doctors per 10,000 citizens, which is less than a third of the global average of 32 doctors per 10,000 citizens, according to the Egyptian Centre for Public Opinion Research. There is a shortage of Egyptian doctors as 62 per cent have emigrated abroad or resigned to work in private hospitals and clinics.

There are currently 82,000 doctors in Egypt out of 213,000 doctors who have a permit to practice the profession, according to a government study. There are only 30 medical colleges in Egypt, of which 27 are government colleges, in addition to three private medical colleges, which is 13 colleges less than the number of pharmacy colleges.

The Egyptian Medical Syndicate refuses

The presidential proposal angered the Egyptian Physicians Syndicate Council, which categorically denied “any precedent for that in the history of the modern medical profession.” The council stressed, in a statement, that it totally rejected the proposal, warning that it would harm the health of Egyptian citizens, as well as harm Egypt’s international medical reputation. The statement added: “Whoever desires to pursue the medical profession and be responsible for the lives of Egyptians, he must join the first year of the College of Human Medicine, and after his graduation and training, he will be granted a licence to practice the medical profession.”

The statement emphasised that “each category of the medical team exercises its role in accordance with scientific and professional principles, and no group can replace the other category, and it is not permissible to say that any complementary study can equate to a different scientific and practical study.” Later, after the uproar that accompanied al-Sisi’s proposal, the head of the Doctors Syndicate, Hussein Khairy, was notified that the meeting scheduled to discuss the proposal to convert pharmacists into human doctors was cancelled, according to Egyptian newspapers.

Observers described al-Sisi’s proposal as funny, stressing that no one can imagine a pharmacist who studied chemistry and how to produce, control and dispose of drugs in the emergency room handling critical cases. They acknowledged the importance of the pharmacist role, which the doctors can’t do, because all medical staff have studied for a specific role.

Criticism

The cancellation of the meeting scheduled to discuss the proposal did not end the tumultuous debate in the Egyptian street, amid accusations by al-Sisi of embarrassing the military establishment and involving the army in a scientific scandal. The proposal to convert pharmacists into doctors is a reminder of the “kofta device” scandal, which the army adopted in 2014, as an alleged treatment for HIV / AIDS, which sparked an international scandal at that time. His proposal also raised questions about the growing influence of the military, and its interference in educational policies, which are mainly within the jurisdiction of the Ministry of Higher Education.

Doctors considered that the proposal jumps over the main problem, which is the fleeing of doctors and their immigration abroad due to the low salaries, compared to judges and officers, in addition to the weak capabilities in government hospitals, and the lack of medical and treatment supplies. Others fear that the presidential proposal will open the door in the future to include graduates of other colleges in disciplines unrelated to them.

Doctors are demanding that the existing imbalance in the number and capacity of pharmacy and medical colleges be tackled by reducing the number of those admitted to pharmacy colleges, and by increasing the number of those admitted to medical schools, while adjusting the structure of wages and salaries to transform the medical sector into an attractive sector which doesn’t push young doctors to flee.