Gynaecologists’ promotions: 993 overlooked for 15yrs

Despite dedicated efforts of obstetric and gynaecology specialists to reduce maternal and infant mortality rates, address cancer and infertility, and achieve SDGs, their numbers are disproportionately inadequate to serve half the population of the country.

Furthermore, promotions in the field are also slow, with 993 junior consultants, registrars, medical officers and others serving in various government hospitals awaiting their overdue promotions for the assistant professor position for the last 8 to 15 years.

As a result, young doctors are displeased, which has trickled down to the quality of care provided to a vast number of patients.

According to Directorate General of Health Services (DGHS) data, there are currently only 214 positions available under the Obstetrics and Gynaecology department in 638 government hospitals, despite a total of 1,536 specialists having been serving countrywide.

Out of the 214 available posts, only 19 out of 48 professor positions are currently filled, while the number of serving associate professors (which is supposed to be double that of professors) is only 36 against the 66 positions.

The insufficient recognition and promotion in the workplace often causes significant concerns, hindering our ability to deliver improved services in the management of maternal mortality and maternal health.

— Dr Raunak Jahan Fetomaternal medicine specialist

Meanwhile, there are 220 assistant professors working across the country against 100 available positions, and the rest have been serving as junior consultants, medical officers, registrars and other positions.

The present situation indicates that there is a worrying shortage of doctors. In a country where the annual number of pregnancies is 36 lakh, there is only one doctor available for every 2,374 pregnant mothers.

However, despite this shortage, these doctors have managed to provide over 34 lakh antenatal visits, more than 12 lakh postnatal visits, and performed over 9 lakh deliveries, which include around 5 lakh normal deliveries and more than 4 lakh cesarean section deliveries in 2022 alone.

The majority of the 993 junior consultants and others waiting for promotion to assistant professor positions have completed their FCPS and MS in general gynaecology and obstetrics, high-risk pregnancy, cancer and infertility.

"Currently we are working as junior consultants from the 22nd BCS (Bangladesh Civil Service), while in other departments, doctors from the 27th BCS and some from the 33rd BCS have been promoted to the position of assistant professor," said Dr Raunak Jahan, specialised in fetomaternal medicine.

"The insufficient recognition and promotion in the workplace often cause significant concerns, hindering our ability to deliver improved services in the management of maternal mortality and maternal health," she added.

We are yet to develop proper sub-specialty positions in this field, even though other departments have done it a long time ago. This amounts to nothing but negligence, discrimination, and injustice towards women.

— Prof Ferdousi Begum Flora Obstretrics and Gynecological Society of Bangladesh President

"If the government promotes this highly skilled workforce, it will result in improved services for people in various regions of the country. This would eliminate the need for everyone to travel to Dhaka or seek treatment abroad," she added.

"It is crucial to create an adequate number of new posts in Obs and Gynae and its sub-specialities, considering the needs of the population," said Dr Fowzia Akhter, specialised in general Obs and Gynae.

Obstetrics and Gynaecological Society of Bangladesh (OGSB) sent 232 files for the posts of assistant professor and were able to approve 95 posts only by the Ministry of Public Administration.

OGSB President Prof Ferdousi Begum Flora said, "We are yet to develop proper sub-speciality positions in this field, even though other departments have done it a long time ago. This amounts to nothing but negligence, discrimination, and injustice towards women."

Feto-Maternal Specialists provide complex maternal health services to high-risk pregnancies to prevent maternal deaths, gynaecological oncology specialists offer comprehensive services to the approximately 10-12 thousand women who die of cancer annually in Bangladesh, while reproductive endocrinology and infertility specialists help and treat couples struggling with infertility, she also mentioned.

Contacted, Prof Dr Abul Bashar Md Jamal, additional director general of the Medical Education Directorate, acknowledged the small number of positions available and the slow pace of promotion in the field of general obstetrics and gynaecology.

"The delay in sub-speciality development and the lack of a separate institute for gynaecology patients are contributing factors to this situation," he said.

However, he also noted that the increasing demand for specialists in this field has prompted the directorate to propose the creation of supernumerary posts in gynaecology and obstetrics sub-specialities to the health ministry.

"This proposal is currently awaiting approval from the finance ministry. This process may take some time, but we assure you that we are doing our best to address the issue," he added.