Dr. Mushtaq Ahmed: Professor of Surgery Dr. Mushtaq Ahmed joined AKU in 1984 as Associate Professor of Surgery, becoming a Professor in 1989. Since 1995, he has been appointed the Hassanali Sajan Professor and Chairman of the Department of Surgery. A renowned surgeon, teacher, academic administrator and clinical scientist, he is one of those gifted individuals who are able to excel in all areas of modern academic medicine. Dr. Mushtaq obtained his MBBS from Karachi's Dow Medical College with academic honours in 1966. He then proceeded for postgraduate surgical training to the UK, obtaining his FRCS in 1971. From 1971 through 1984, he served on the surgical faculty at Dow Medical College, rising to the rank of Associate Professor. At the affiliated Civil Hospital, he was part of the famous Surgical Unit One that became known as a surgical centre of excellence throughout Pakistan. At AKU, legions of medical students and house officers speak of his brilliance as a clinical teacher. His surgical ward rounds are considered by many a rite of passage. In 1996, he received the University's coveted award for 'Excellence in Teaching'. A highly astute clinician, Dr. Mushtaq continues to devote himself to patient care at the bedside and in the operating room, despite his many administrative obligations. Dr. Mushtaq is the author of many national and international research papers in the areas of surgical care delivery, hepatobiliary function and invasive amebiasis. He has also been involved in international consultancies with WHO on providing rural surgical services. What is it about academic surgery that stimulates you? Academic surgery is about seeking and disseminating knowledge. In Pakistan, very few receive higher education of a quality that prepares them for this role. If one is fortunate enough to be among the select few, there is a moral obligation to pay back to society. Stimulation comes from being effective, and is very dependent on institutional support. It is hard to imagine another institution in the region that is as supportive as AKU. What makes you an effective clinical teacher? I have a keen interest in education. Teaching clinical reasoning, for example, is quite interesting. It is fun to enable medical students to develop testable hypothesis from the patient's clinical presentation and engage in the process of seeking further evidence to confirm or refute the hypothesis. One has to be patient and persevering. I do strive to build an overall learning environment, an essential component of which is teamwork. People learn during the course of their daily work in the context of the problems they face, especially when they are encouraged to take decisions within the limits of their competence. They are keen to know about the effectiveness of their work and their strengths and weaknesses. They do not mind having others, including team members, evaluate them, provided it  is  for  their improvement and fair opportunities are offered for improvement. Although there has been a measure of success in encouraging teamwork within the speciality, much remains to be done to achieve  multi-speciality and interdisciplinary teamwork involving  nurses and other health care personnel. What are the achievements of the Department of Surgery and of AKU? This question can be framed another way: have we responded to society's needs? One of the main reasons for my joining AKU was the potential of the University to meet the needs of society in Pakistan and other developing countries. AKU has met that challenge partially by producing well-educated and well-trained individuals. The consistently high calibre of our graduates from the MBBS and postgraduate programmes bears testimony to this. However, our inability to retain the majority of our graduates in Pakistan is a challenge. In this respect AKU has not quite met society's needs, yet. What is the solution for the brain drain? Preparation of students for higher education is important. There are many areas of preparation including critical thinking, communication skills and social and environmental awareness. The last is most important for creating a desire to serve in the community, even though it may be under privileged. Social awareness can be developed through courses in the humanities including Islam, but more importantly, by actual experience of working in society. In this respect, I look forward to AKU's proposed contributions from the College of Arts and Sciences and the Institute for the Study of Muslim Civilisations. It is also important to provide career opportunities. Our  graduates are seeking opportunities for personal and professional development  and social and economic security. To some extent, AKU responds  to these wants.  Consequently,  a  third   of  our  Medical College faculty is comprised of our graduates. We should  however, be looking more and more for opportunities outside AKU to attract our graduates. The University should seek out institutions for collaboration on a sustainable basis, where the advantage to AKU is in academic terms and employment of its graduates, and to the collaborating institutions in terms of improvement of service quality and efficiency. We have had success in this area with the Aga Khan Health Service, Pakistan. I believe it is important to earmark resources for developing collaborative ventures of this kind. It is important also to develop leadership qualities in our graduates. Exceptional individuals should be selected for leadership development to enable them to succeed in improving conditions in our public and private sectors in Pakistan. No doubt, success will motivate them to stay on. How does one develop leadership traits? Good role models play a crucial role. That is one reason why faculty development for leadership roles is necessary. We are currently working on making the faculty development process much more systematic. How else can AKU influence society constructively? By setting an example. Unethical medical practice is so common in Pakistan. Aga Khan University Hospital (AKUH) is not perfect, but it has  resolved to put in  place self-regulation, and to meet internationally accepted quality of care standards. It is not easy to achieve these objectives. Many things may have to change: organisational values as reflected in personnel policies, extent of faculty involvement and sense of ownership as reflected in the governance structure of the hospital, approach to work as reflected in the formation of interdisciplinary teams. When we finally get there, AKUH is likely to have a positive impact on other providers. However, we must take care that the standards we set can be replicated. To be effective, we must also establish an effective dialogue with the Government, professional organisations, and the public. Headway with the Government has been made in some areas, e.g. the Task Force for Improvement of Higher Education in Pakistan, in which the AKU President and the Rector are playing vital roles. Certainly, AKU Institute for Educational Development and the School of Nursing have had significant impact on teacher and nursing education  respectively. The acceptance of Family Medicine by the College of Physicians and Surgeons, Pakistan, is a significant achievement. We may also have influenced Pakistan Medical and Dental Council in some ways. We could almost certainly play a role  in guiding the development of the country's health services. We must work harder at influencing our physician colleagues by more active participation in professional organisations. Likewise, public education should receive more attention. The proper use of modern media of instruction is a huge challenge and should be explored. What does the future hold? The object is to evolve a culture that supports higher education. Fortunately, humans have the ability to control their evolution, not in the biological sense, but in the sense of consciously evolving their culture. According to the Stanford biologist, Paul Ehrlich, we are biologically equipped for 'quick reflexes' and can respond well to hunger, sexual desire and imminent danger; we ought to equip ourselves through our culture with 'slow reflexes' to deal with the challenges of society and environment. As the University moves relentlessly from one programme to another, in response to society's multiple needs, it must pause to see how effective it is in meeting those needs: are its graduates doing what they are meant to? Are its standards replicable? Is the dialogue with policy-makers, colleagues and the public sufficiently intense and persuasive?