PDA could not leave a mark, new council will not start from January 1st; Dr Mahmood Shah

by Dr Hira M. Khan

Dr Syed Mahmood Shah became president of the Pakistan Dental
Association in 2017 but has been working with the association for over a
decade. Dental News spoke to him about his contribution to the dental
profession and community, in Pakistan, from his position of power.

Dr Mahmood Shah was also
elected as Chairman of Oral Diseases Commission, Asia Pacific Dental Federation
(APDF) at APDF Elections held during 40th APDC. He told Dental
News about his efforts toward positive representation of Pakistan on global
dental platforms.

After completing BDS and
residency at Liaquat National Hospital, President Pakistan Dental Association
Dr Syed Mahmood Shah moved to Ireland for his Diploma in Dental Health from
Trinity College, University of Dublin. On returning, he joined Sindh Government
Service. Later, he got admission in University of California, Los Angeles, in
an Orthodontics program. On completion of his foreign degree, he resigned from
government service and devoted himself to fulltime practice. For over 20 years,
Dr Shah practiced at private dental hospitals before he finally established his
own dental clinic.

The excerpts of the
interview are as under:-

Dental News: Please tell us about yourself, why you chose to
become a dentist and an orthodontist?

Dr Syed Mahmood Shah: Dentistry was not my first choice. After I did
my intermediate in pre-medical from St. Patrick’s College, I went on to pursue
admission in MBBS program at Dow Medical College. I could not get in at that
time and decided to opt for dentistry. Back in the days, Liaquat Medical
College was the only institute offering dental program in Karachi. To date, I
am unable to fully express enough gratitude for this turn of event. Dentistry
has given me the status and prominence that could not have been possible in the
medical field.

how I stepped into the Orthondontic specialty: I spent many years in government
service after graduation; during that time the practice was mainly about minor
oral surgery. Most of the cases were of RTA or extractions, which led to the
exhaustion of my interest in oral surgery. I applied for admission in
endodontics and orthodontics programs in a foreign university and got accepted
for both. However, I had begun finding Orthodontics as a very exciting field,
and I still think it is an extremely interesting specialty. I feel that
maxillofacial surgery and orthodontics are the only two main specialties in
dentistry, because other procedures, including RCT, restorations etc., are very
commonly performed by general dentists as well. But orthodontics is a
specialist’s field and, therefore, I chose it.

DN: Introduce PDA, its vision, its objectives, and the role played
by its office bearers.

MS: Pakistan Dental Association (PDA) was formed in 1960 and has been
representing the entire Pakistani dental community ever since. We have a
Central Office, which represents the entire country; I am currently the
President of that. Then we have 5 further divisions, each for the 4 provinces
and the federal capital. These are called zones. These zones are further
subdivided into branches established in all major cities.

PDA network functions to safeguard the interest of the dentist, to promote oral
and dental health, and to advise the relevant bodies on what should be the
policy institutions and policy matter as PDA sees it. PDA’s major role is also
to represent Pakistan in the global dental community. I am proud to state that
Pakistan is a very active member of the World Dental Federation (FDI), which
has representation from around 200 countries worldwide. The FDI President on a
couple of occasions has asked for an invitation to Pakistan. They want to visit
our country. Similarly, we have represented Pakistan well at the Asia Pacific
Dental Federation. I am currently the Chairman Oral Disease Commission of APDF.

DN: What achievements do you count as PDA’s greatest? Please
specify the achievements under your specific tenures.

MS: Unfortunately, I cannot name an achievement of PDA that brought a
significant paradigm shift in dentistry in Pakistan, and there are reasons for
that. But to highlight a few achievements let’s start with the Asia Pacific
Dental Conference, which was held in Karachi in 2006. 28 countries took part in
the conference, for which I was the patron. In 2012 and 2015, again,
international conferences were organized in Pakistan. I was the patron of these
as well.

my current tenure as the President PDA (Center), my most notable achievement is
the revival of the branches. Despite challenges, I managed this uphill task, by
conducting elections in 19 cities of the country where PDA branches were either
inactive or absent. I am of the viewpoint, the task of organizing conferences
and symposiums should now be handled by these branches, now that we have
activated them. The Central Council of PDA mainly participates in presenting
policy matters.

DN: In your view, what are the main problems that agitate the
dental profession?

MS: The problems are varied because the field of dentistry itself is.
We have academicians, private practitioners, and young dentists. Then there is
another category of postgraduate students and another of undergraduate
students. All these groups are facing different problems. What I see as the
leading problem in dental field is the overproduction of dentists in Pakistan,
especially in the urban areas, which is giving rise to unemployment; whereas,
the rural areas are not producing enough dentists. This mismatch will amount to
a significantly problematic situation if government does not intervene with
effective policies. 

DN: Your contribution to dentistry in Pakistan as chairman of oral
disease commission APDF and other similar positions held in the past?

MS: Yes, I have held a similar position in the past as well; I was the
Vice-President of APDF. The protocols and responsibilities change with ranks.
As APDF officers, we have to carry out tasks aligned with the targets assigned
to us by APDF. For example, we are currently working on a report on the
prevalence of dental caries in the Asia Pacific region, which will also include
data from Pakistan. The report will have recommendations on how to fight and
limit the prevalence and incidence of dental caries in this region.

is not like FDI where you are given grants, but you might be allotted
conferences via which revenue is generated, especially by the hosting country.
Pakistan last hosted APDC in 2006. We have made all possible efforts to bring
the Conference back, but remain unable due to the order situation in the

now, APDF has tentatively allotted Pakistan the APDC in 2022, which will be an
immense achievement if we can execute it. 

DN: Why is it that female dentists are hardly represented in PDA,
while they outnumber male dentists?

MS: About females in Dentistry, I am of the opinion that the reason
that dentistry is still thriving in Pakistan is because of the female dentists.
It is kind of a paradox. Let me explain: 80% of the admitted candidates in
dental colleges are females, out of which 80% of the graduating females never
practice, or leave practice after spending a year or two in it. (This is a
guesstimate.) The practicing dentists left behind are few and mainly male.
Despite that the unemployment rate for dentists is high. Imagine if 100% of the
graduating lot was to enter the workforce, we would have a crisis.

to lesser working women in the field we see lesser female representation in
associations like ours.

DN: What are your comments on PMDC, its role, and the
new ongoing changes?

MS: Aha! PMDC is my favourite subject to speak on. Over the years,
PMDC has derailed from its regulatory responsibilities and has turned into
“Private Medical and Dental Colleges Recognition Council”. And so instead of
promoting general and oral health, PMDC has become more interested in raiding
colleges. PMDC used to be an effective body when its roles were well-defined.
It would take notice of significant matters like quackery and different
epidemics. Due to the underperformance of PMDC, Pakistan has become one of the
unfortunate countries where we do not have proper data on disease prevalence;
we are clueless in terms of numbers about our dental caries prevalence,
periodontal index, and oral cancer spread. We do not even have a plan to limit
these conditions. When you do not have the diagnosis, how will you draft a
treatment plan? This is one of my main questions for PMDC.

PMDC is running on Ad hoc- and individual-based policies. A new candidate would
come into power and, instead of working on inherent issues, would start doing
things their way. There are no concrete, long-term policies, which leads to the
Council’s faltering time and again, whereas the real healthcare issues remain
unresolved and are left to multiply. Despite having around 50 dental colleges
in the country, the trend of oral diseases in still on the rise, which does not
make sense. Something somewhere is very wrong.

discussion with my council I drafted a letter and shared it with President Dr
Arif Alvi. In the letter I pointed out the flaws in PMDC; the Council runs on
revenue collected from doctors and dentists, yet the new ordinance promoted a
selected council instead of one produced after fair elections between
representatives of the same field.

solution is simple; there is no need to reinvent the wheel. The PDA has
suggested it and would consider it their most impactful delivery to the dental
field if a separate Pakistan dental council was made. There are separate
councils for Nurses, Homeopaths as well as Tib, then the forced
unification of medical and dental council makes no sense. There are over 30,000
dentists and around 50 dental colleges in the country, yet the dental council
is attached to the PMDC like an appendix. The need for separation is based on
the fact that the woes and challenges, and, therefore, the solutions, of
dentistry in Pakistan, are different.

I want to request the President of Pakistan to form a steering committee with
MNAs from PTI, PML-N, PPPP, and representation from PMA, PDA, and PAMI. These
are the 6 major stakeholders of the future of medicine and dentistry in
Pakistan. A PMDC draft that is unanimously agreed upon by this committee should
be passed in the National Assembly. This should be a smooth process considering
all parties were involved in the decision-making. If need be an expert health
planner should be involved since PMDC should be a healthcare-specific council.
I believe that the subsequent bill will win without opposition. Short-cut
ordinances that are reinvented and introduced after every few months carry no
promise but the promise to relapse.

there also needs to be a Dental Act, which will specify standards for dental
practice. Mandatory specifications of dental units, radiology units, etc.;
creating a system for an organized dental structure and addressing tier-based
problems, all come under Dental Act.

has been striving for the introduction of, both, Dental Council and Dental Act
and will continue to do so.

DN: According to the updated PDA constitution, the new president
will assume office on January 1st, 2020. Is that right? What are your comments?

MS: When constitutions are formed, tentative dates are added. January
1st is mentioned as the first calendar year, but the current
PDA office did not assume charge on that date. Our elections were held in
August, so you can well imagine that if the tenure did not start on January
1st, it will not end on it. There are other dates mentioned for important
events as well, but they are tentative and are not always met. PDA is at
liberty to make alterations in dates if the need arises and the change is not
in violation of the constitution.

said that let me assure you that the next elections for PDA center will be held
in 2020. And it will be a year of change in PDA.

DN: What are your comments on Dental News’s contribution to the
dental profession?

MS: I have had a longstanding and close-knit relation with Dental News
ever since it came into being in 1995. I believe that I was one of the first
dentists to be interviewed by the magazine, and here we are again! It is a
matter of pride to consider how Dental News has flourished over the years; the
publication is now among the most prestigious and reliable, and is the leading
dental periodical in Pakistan. Their journalism is objective and unbiased, and
aligned with their editorial policies.

News in its impactful ways has contributed lots to the evolution of the dental
profession and professionals in the country. It has remained at the forefront
of the movement to develop organized dentistry and continuing dental education.
PDA has many times collaborated with Dental News for such conferences and
wishes to do so in the future as well.

The post PDA could not leave a mark, new council will not start from January 1st; Dr Mahmood Shah appeared first on Dental News Pakistan.

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