Quality of post graduate medical training in public and private tertiary care hospitals of Karachi

Objective: To assess the quality of postgraduate fellowship training and to determine the differences in the quality of postgraduate fellowship training in public and private teaching hospitals of Karachi. Methodology: It was a cross sectional survey conducted in four public and private sector hospitals of Karachi from January to March 2012. A total of 246 postgraduate fellowship trainees were interviewed. A standardized questionnaire adopted from CPSP guidelines on postgraduate training standards was developed. Postgraduate fellowship trainees (PG's) were selected on the basis of convenient non-probability sampling technique. Fisher's exact test and chi-square test were used to find differences in quality of postgraduate training. Results: The mean duty hours per week was highest in private sector hospitals i.e., 72.1 as compared to government sector hospital which was 58.3 (P-value <0.01). Of the respondents, 66.0% of PG's in private hospitals agreed that they have a structured study program as compare to 46.5% in public hospitals (P-value <0.001). Only 38.1% of PG's in public hospitals agreed that they spent appropriate amount of time with their family and friends as compare to 1.8% of PG's in private hospitals (P-value <0.001). No significant difference was found in quality of supervision in both public sector and private sector hospitals. Conclusion: The attributes of different aspects of training were different in public and private sector hospitals. So significant room exists for improvement in the quality of postgraduate medical training as indicated by the less than desirable proportion of trainees being satisfied with different aspects of training.