Only three Pathologists in country impact diagnosis

1 from military, 1 expatriate pathologist and 1 civilian pathologist

The shortage of specialists in a few departments in Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) is still a concern. Especially in the departments of Pathology, Anesthesiology, Ophthalmology and Dermatology.

The medical superintendent of the hospital, Dr. Gosar Pemba said currently JDWNRH has 3 pathologists, 1 from Royal Bhutan Army (RBA), another is expatriate pathologist until January from Nepal and other is the only civilian pathologist.

The anesthesiology department has only 4 specialists. It would have been much better if they have additional 2 more specialists, Dr. Gosar said.

In ophthalmology they have 4 specialists, where 2 specialists are in EOL and 1 resigned, so there is also a need of eye specialists. There is a shortage of dermatologists too with only 2 specialists. The hospital need at least 3 specialists in dermatology department, said Dr. Gosar.

Dr. Gosar said when the hospital has less specialists, the workload will be more and also there will be backlog. And also due to shortage of pathologists test result takes more than three weeks depending on the type of test.

HOD of Pathology, Dr. Krishna said pathologists have a very responsible and complicated job because the diagnosis depends on them.

Dr. said the ultimate diagnosis has to come from pathologists even it is a cancer or non-cancer or any diseases and surgeons or the medical people, they all depends on the pathologists for the better diagnosis. That is why sometimes there is lot of pressure, Dr. added.

Having only three pathologists makes it difficult to manage and sometimes the workload is too much. Dr. Krishna said if the technician suspect that the pap smear done in regional hospital has something wrong than that slide has to travel all the way from regional hospital to Thimphu hospital and similarly all the biopsy travel from other dzongkhags hospital to Thimphu hospital, these adds to the workload in Thimphu hospital. Regional hospital even do not have one. Dr.Krishna also shared that one of the expatriate pathologist is reluctant to continue the contract because too much of workload.

“So until 2021, it will be a difficult time for us,” said Dr. Krishna.

However Dr. Krishna also shared some good news that by 2022, regional hospitals will have adequate pathologists. The country will have 9 Bhutanese pathologists which is enough for Bhutan. In the 12th plan RCSC has budgeted for Super Specialization of Pathologist. So by 2025 Bhutan will be very comfortable with the good number of specialized pathologists in country.

Currently 6 Bhutanese doctors are undergoing specialized training outside country. 2 are in Bangladesh and 4 are in Thailand.  Dr. Krishna said 1 specialist will be joining end of this year and other 5 will be joining by end of 2021. They will be joining regional hospitals because it is very important for the people in district to also get the services. The priority should be given to the regional hospitals, Dr. added.

JDWNRH has 4 radiologists, 10 specialists in medical department, 6 specialists in surgery department, 5 specialists in orthopedic, in pediatric they have 5 specialists, 6 specialists in gyaenacology, in emergency department they have 4 specialists.

7 specialists hired or in contract basis paying USD 2500 to 3500 in a month.

Health minister Dechen Wangmo said the ministry is trying to train more of our doctors to get specialization. She said specialists cannot be trained overnight, they take four or five years. So the temporary measure is to recruit specialists from outside.

Earlier this year, Prime Minister (Dr) Lotay Tshering said the government will seek specialists from Bangladesh, given the shortage of medical specialists in the country.

Earlier Foreign Minister Tandi Dorji said the request and exchanges has already been taken place between two countries. The government of Bangladesh is also trying to find doctors to send here but what the government has learnt is that the financial packages offered for the Bangladeshi specialists were not attractive. It was learnt that the government offered USD 3500 in a month.

On April this year, when the Prime Minister made his first visit to Dhaka, health ministry and the Bangladeshi Health and Family Welfare signed a Memorandum of Understanding (MoU). The Bangladeshi government was to send in 20 specialists and four sub-specialists to Bhutan if the Cabinet approves the team’s pay package which is about Nu 345,000 and about Nu 311,000 for the sub-specialists. They will work in Bhutan on a contract basis.