Pakistan Medical and Dental Council: Difference between revisions

Pakistan Medical and Dental Council
پاکستان میڈیکل اینڈ ڈینٹل کمیشن
Abbreviation	PM&DC
Formation	1962; 62 years ago
Headquarters	Mauve Area, Islamabad-44000
Region served	Pakistan
President	Prof. Dr. Rizwan Taj
Parent organization	Ministry of National Health Services, Regulation and Coordination; Higher Education Commission (Pakistan)
Employees	232
Website	pmdc.pk
Formerly called	PMC (Pakistan Medical Commission)

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Pakistan Medical and Dental Council is a statutory regulatory authority that maintains the official register of medical practitioners in Pakistan. Its chief function is to establish uniform minimum standards of basic and higher qualifications in medicine and dentistry throughout Pakistan. It also sets the education standards for medical colleges in Pakistan along with the Higher Education Commission.^[1]^[2]^[3]

History

The Pakistan Medical Council was initially established in 1948 by adopting the British Indian Medical Council Act 1933 on the recommendations of the 1947 Pakistan Health Conference. It was later reorganized under the Pakistan Medical Council Act 1951 whereby each province has its own medical council. In 1957, the West Pakistan Medical Council was formed by merging the Sindh Medical Council and the Punjab Medical Council. The Pakistan Medical Council Ordinance 1962 established the present-day Pakistan Medical and Dental Council as a statutory body in 1962 and all provincial councils were dissolved.^[4] Three amendments were passed thereafter as the Medical and Dental Council (Amendment) Act in 1973, 1999 and 2012.^[5] In 2019, President Arif Alvi passed a Law and dissolved the Pakistan Medical and Dental Council (PM&DC) to create a new council named as Pakistan Medical Council (PMC). However after 3 years in 2022, the Islamabad High Court restored the Pakistan Medical and Dental Council (PM&DC) and declared the formation of Pakistan Medical Commission (PMC) – a body formed through a presidential ordinance in its place – as illegal.^[6]

Registration

All medical and dental practitioners and students are required to register with the commission to legally practice medicine and dentistry in Pakistan. The guidelines for registration are outlined under Chapter IX, Pakistan Registration of Medical and Dental Practitioners Regulations, 2008.^[7]

Criticism

Several corruption allegations and scandals have been associated with the previous council (PMC). In particular, irregularities in the registration of medical and dental colleges and allegations of wrongdoing in the accreditation of doctors have also been leveled in judicial probes of the council's affairs.^[8] A judicial commission was set up under a court order after allegations of embezzlement in the registration of private medical and dental colleges surfaced in 2013. The commission was headed by the former Lahore High Court judge Shabbar Raza Rizvi.^{[citation needed]}

Representatives of various medical organisations have expressed their concerns regarding PMC that it will give autonomy to private medical colleges for fixing their fees, thus increasing the burden on students.^[9]

Dissolution and restoration

In October 2019, the PMDC was dissolved and replaced by the Pakistan Medical Commission (PMC) following President Arif Alvi's signing of the Pakistan Medical Commission Ordinance 2019. The move was done in order to regulate and control the medical profession in Pakistan by establishing uniform minimum standards of medical education, training, and recognition of qualifications in medicine and dentistry. For this to occur, it was argued that PMDC had to be dissolved first in order to properly implement the new ordinance. PMDC offices were temporarily sealed to ensure the protection of essential records and assets. The new PMC would consist of the existing Medical and Dental Council, the National Medical and Dental Academic Board, and the National Medical Authority, which would act as a Secretariat of the Commission.^[10]

On 11 February 2020, the Islamabad High Court nullified the Pakistan Medical Commission Ordinance and restored PMDC.^[11]

On 16 September 2020, PMDC was dissolved again by a joint session of the Senate and Parliament by passing the bill to replace PMDC with PMC to ensure standard medical education in Pakistan.

On 23 August 2022, The Senate Standing Committee on Health on Tuesday approved the Pakistan Medical and Dental Council Amendment Bill, 2022, with a majority vote, after which the legal status of the PMC has ceased to exist.^[12]

On 12 January 2023, The President of Pakistan gave final approval to the PMDC Bill 2022 after which the Pakistan Medical and Dental Council have been established.^[13]

References

^ "Code of medical ethics being revised (by PMDC)". Dawn newspaper. Archived from the original on 18 December 2002. Retrieved 25 December 2023.
^ "Dissolution of PMDC through ordinance challenged in IHC". Dawn newspaper. Pakistan. 31 October 2019. Retrieved 22 August 2020.
^ Ikram Junaidi, Malik Asad (2 November 2015). "PMDC scandal: Disillusioned with the Hippocratic Oath?". Dawn newspaper. Retrieved 22 August 2020.
^ "The Medical and Dental Council Ordinance - 1962" (PDF). punjab.gov.pk.
^ The Medical and Dental Council (Amendment) Act, 2012
^ "IHC restores PMDC, declares PMC dissolved". The Express Tribune newspaper. 11 February 2020. Retrieved 17 January 2023.
^ Council, Pakistan Medical and Dental. "Pakistan Medical and Dental Council > Admission rules > PG". pmdc.org.pk website.
^ Junaidi, Ikram (29 September 2021). "NAB seeks details of MDCAT contract". Dawn newspaper. Retrieved 17 January 2023.
^ Junaidi, Ikram (21 September 2020). "Medical bodies assail PMC bill". Dawn newspaper. Retrieved 12 August 2021.
^ Ikram Junaidi (24 September 2020). "Building sealed, PMDC employees stopped from working". Dawn newspaper. Retrieved 12 August 2021.
^ Tahir Naseer (11 February 2020). "IHC restores PMDC, dissolves new medical council formed through presidential ordinance". Dawn newspaper. Retrieved 12 August 2021.
^ "PMC virtually ceases to exist". The Express Tribune newspaper. 23 August 2022. Retrieved 25 August 2022.
^ "Change is in the air at restored PMDC". The Express Tribune newspaper. 16 January 2023. Retrieved 17 January 2023.

External links

Official website
"Pakistan Medical & Dental Council official website". 13 November 2001. Archived from the original on 11 February 2016.
PMDC license registration and renewal

[Dawn6-1] "Code of medical ethics being revised (by PMDC)". Dawn newspaper. Archived from the original on 18 December 2002. Retrieved 25 December 2023.

[Dawn-2] "Dissolution of PMDC through ordinance challenged in IHC". Dawn newspaper. Pakistan. 31 October 2019. Retrieved 22 August 2020.

[Dawn1-3] Ikram Junaidi, Malik Asad (2 November 2015). "PMDC scandal: Disillusioned with the Hippocratic Oath?". Dawn newspaper. Retrieved 22 August 2020.

[4] "The Medical and Dental Council Ordinance - 1962" (PDF). punjab.gov.pk.

[5] The Medical and Dental Council (Amendment) Act, 2012

[6] "IHC restores PMDC, declares PMC dissolved". The Express Tribune newspaper. 11 February 2020. Retrieved 17 January 2023.

[7] Council, Pakistan Medical and Dental. "Pakistan Medical and Dental Council > Admission rules > PG". pmdc.org.pk website.

[8] Junaidi, Ikram (29 September 2021). "NAB seeks details of MDCAT contract". Dawn newspaper. Retrieved 17 January 2023.

[9] Junaidi, Ikram (21 September 2020). "Medical bodies assail PMC bill". Dawn newspaper. Retrieved 12 August 2021.

[10] Ikram Junaidi (24 September 2020). "Building sealed, PMDC employees stopped from working". Dawn newspaper. Retrieved 12 August 2021.

[11] Tahir Naseer (11 February 2020). "IHC restores PMDC, dissolves new medical council formed through presidential ordinance". Dawn newspaper. Retrieved 12 August 2021.

[12] "PMC virtually ceases to exist". The Express Tribune newspaper. 23 August 2022. Retrieved 25 August 2022.

[13] "Change is in the air at restored PMDC". The Express Tribune newspaper. 16 January 2023. Retrieved 17 January 2023.

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@@ Line 1: / Line 1: @@
+{{Short description|Government regulatory agency}}
-{{Infobox government agency
+{{Use Pakistani English|date=February 2020}}
-|agency_name     =Pakistan Medical and Dental Council
+{{Use dmy dates|date=February 2020}}
-|type            =
+{{Infobox organization
-|nativename      =
+| name = Pakistan Medical and Dental Council
-|nativename_a    =
-|nativename_r    =
+| image =
+| size = 150px
-|logo            =
+| alt = <!-- alt text; see [[WP:ALT]] -->
-|logo_width      =
+| map = <!-- optional -->
-|logo_caption    =
+| mcaption = <!-- optional -->
-|seal            =
+| native_name = پاکستان میڈیکل اینڈ ڈینٹل کمیشن
-|seal_width      =
-|seal_caption    =
+| type =
+| nativename =
-|picture         =File:Pakistan-Medical-Dental-Council.jpg
+| nativename_a =
-|picture_width   =250px
-|picture_caption =
+| nativename_r =
+| logo =
-|formed          =Established in 1947
+| logo_width =
-|preceding1      =
+| logo_caption = Logo as of 2023
-|preceding2      =
+| seal =
-<!-- (etc.) -->
+| seal_width =
-|dissolved       =
+| seal_caption =
-|superseding     =
+| picture =
-|jurisdiction    =
+| picture_width =
-|headquarters    =[[Islamabad]], Pakistan
+| picture_caption =
-|latd=  |latm=  |lats=  |latNS=
+| formation = {{start date and age|1962}}
-|longd=  |longm=  |longs=  |longEW=
+| preceding1 =
-|region_code     =
+| preceding2 = <!-- (PMC) -->
-|coordinates     = <!--{{coord|LATITUDE|LONGITUDE|type:landmark_region:US|display=inline,title}}-->
+| dissolved =
-|motto           =
+| abbreviation = '''PM&DC'''
-|employees       =
+| formerly = PMC (Pakistan Medical Commission)
-|budget          =
+| superseding =
-|minister1_name  =
+| region_served = Pakistan
-|minister1_pfo   =
+| headquarters = Mauve Area, [[Islamabad]]-44000
-|minister2_name  =
+| coordinates =
-|minister2_pfo   =
+| employees = 232
-<!-- (etc.) -->
+| leader_name = Prof. Dr. Rizwan Taj
-|deputyminister1_name  =
+| leader_title = President
-|deputyminister1_pfo   =
+| agency_type =
-|deputyminister2_name  =
+| parent_organization = [[Ministry of National Health Services, Regulation and Coordination]]<br/>
-|deputyminister2_pfo   =
+[[Higher Education Commission (Pakistan)]]
-<!-- (etc.) -->
+| parent_agency =
-|chief1_name     =
-|chief1_position =
+| child1_agency =
+| child2_agency =
-|chief2_name     =
+| website = {{URL|pmdc.pk}}
-|chief2_position =
-<!-- (etc.) -->
-|agency_type     =
-|parent_department =
-|parent_agency   =
-|child1_agency   =
-|child2_agency   =
-|website         ={{URL|http://www.pmdc.org.pk/}}
-|footnotes       =
-|map             =
-|map_width       =
-|map_caption     =
 }}
+'''Pakistan Medical and Dental Council'''  is a statutory regulatory authority that maintains the official register of [[Physician|medical practitioners]] in Pakistan. Its chief function is to establish uniform minimum standards of basic and higher qualifications in medicine and dentistry throughout Pakistan. It also sets the education standards for [[List of medical schools in Pakistan|medical colleges in Pakistan]] along with the [[Higher Education Commission (Pakistan)|Higher Education Commission]].<ref name=Dawn6>{{cite news|url=http://www.dawn.com/2002/02/19/nat19.htm|url-status=dead|archive-date=18 December 2002|access-date=25 December 2023|newspaper=Dawn newspaper|title=Code of medical ethics being revised (by PMDC)|archive-url=https://web.archive.org/web/20021218150131/http://www.dawn.com/2002/02/19/nat19.htm}}</ref><ref name="Dawn">{{cite news | url=https://www.dawn.com/news/1513964 | title=Dissolution of PMDC through ordinance challenged in IHC |newspaper=Dawn newspaper| date=31 October 2019 | location=Pakistan | access-date=22 August 2020}}</ref><ref name=Dawn1>{{cite news|url= https://www.dawn.com/news/1216936 |title= PMDC scandal: Disillusioned with the Hippocratic Oath? |author= Ikram Junaidi, Malik Asad |date= 2 November 2015 |newspaper=Dawn newspaper|access-date=22 August 2020}}</ref>
+==History==
-'''Pakistan Medical and Dental Council''' (abbreviated as '''PMDC'''), established in 1962, is a regulatory authority for practitioners and students of medicine and dentistry in [[Pakistan]]. It was established under Pakistan Medical & Dental Council Ordinance 1962 as a body corporate. It is known and respected worldwide and is part of international community of medical regulatory authorities (IAMRA). Pakistani doctors are considered one of the best and are doing meritorious service in all parts of the world and that is a testimony to the effective regulation of medical education being done by the PM&DC. No Pakistani Doctor can practice in Pakistan or abroad without being registered with PM&DC or without being in good standing with it.
+The ''Pakistan Medical Council'' was initially established in 1948 by adopting the ''British Indian Medical Council Act 1933'' on the recommendations of the 1947 Pakistan Health Conference. It was later reorganized under the ''Pakistan Medical Council Act 1951'' whereby each province has its own medical council. In 1957, the West Pakistan Medical Council was formed by merging the Sindh Medical Council and the Punjab Medical Council. The ''Pakistan Medical Council Ordinance 1962'' established the present-day Pakistan Medical and Dental Council as a statutory body in 1962 and all provincial councils were dissolved.<ref>{{cite web|url=http://www.punjablaws.punjab.gov.pk/public/dr/THE%20MEDICAL%20AND%20DENTAL%20COUNCIL%20ORDINANCE,%201962.doc.pdf|title=The Medical and Dental Council Ordinance - 1962|website=punjab.gov.pk}}</ref> Three amendments were passed thereafter as the ''Medical and Dental Council (Amendment) Act'' in 1973, 1999 and 2012.<ref>[http://www.na.gov.pk/uploads/documents/1346053132_545.pdf The Medical and Dental Council (Amendment) Act, 2012]</ref> In 2019, President Arif Alvi passed a Law and dissolved the Pakistan Medical and Dental Council (PM&DC) to create a new council named as Pakistan Medical Council (PMC). However after 3 years in 2022, the Islamabad High Court restored the Pakistan Medical and Dental Council (PM&DC) and declared the formation of Pakistan Medical Commission (PMC) – a body formed through a presidential ordinance in its place – as illegal.<ref>{{Cite web |date=2020-02-11 |title=IHC restores PMDC, declares PMC dissolved |url=https://tribune.com.pk/story/2154448/ihc-declares-pmdc-dissolution-null-void |access-date=2023-01-17 |website=The Express Tribune newspaper|language=en}}</ref>
+==Registration==
+All medical and dental practitioners and students are required to register with the commission to legally practice medicine and dentistry in Pakistan. The guidelines for registration are outlined under ''Chapter IX, Pakistan Registration of Medical and Dental Practitioners Regulations, 2008''.<ref>{{cite web|url=http://www.pvmc.org.pk/|title=Pakistan Medical and Dental Council > Admission rules > PG|first=Pakistan Medical and Dental|last=Council|website=pmdc.org.pk website}}</ref>
-Its current president is [[Sibtul Hasnain]]. PMDC has its headquarters located in [[Islamabad]] and regional offices in [[Lahore]], [[Karachi]]. [[Peshawar]] and [[Quetta]].
-==Mission==
+==Criticism==
+Several corruption allegations and scandals have been associated with the previous council (PMC). In particular, irregularities in the registration of medical and dental colleges and allegations of wrongdoing in the accreditation of doctors have also been leveled in judicial probes of the council's affairs.<ref>{{Cite news |last=Junaidi |first=Ikram |date=2021-09-29 |title=NAB seeks details of MDCAT contract |url=https://www.dawn.com/news/1648996 |access-date=2023-01-17 |newspaper=Dawn newspaper |language=en}}</ref> A judicial commission was set up under a court order after allegations of embezzlement in the registration of private medical and dental colleges surfaced in 2013. The commission was headed by the former [[Lahore High Court]] judge Shabbar Raza Rizvi.{{Citation needed|date=September 2022}}
+Representatives of various medical organisations have expressed their concerns regarding PMC that it will give autonomy to private medical colleges for fixing their fees, thus increasing the burden on students.<ref>{{Cite news|last=Junaidi|first=Ikram|date=21 September 2020|title=Medical bodies assail PMC bill|url=https://www.dawn.com/news/1580794|access-date=12 August 2021|newspaper=Dawn newspaper|language=en}}</ref>
-To safeguard public interest, PM&DC has been given a mission to establish uniform minimum standard of basic & higher qualifications in Medicine & Dentistry throughout Pakistan.
+==Dissolution and restoration==
-==Brief History==
+In October 2019, the PMDC was dissolved and replaced by the Pakistan Medical Commission (PMC) following [[President of Pakistan|President]] [[Arif Alvi]]'s signing of the ''Pakistan Medical Commission Ordinance 2019''. The move was done in order to regulate and control the medical profession in Pakistan by establishing uniform minimum standards of medical education, training, and recognition of qualifications in medicine and dentistry. For this to occur, it was argued that PMDC had to be dissolved first in order to properly implement the new ordinance. PMDC offices were temporarily sealed to ensure the protection of essential records and assets. The new PMC would consist of the existing Medical and Dental Council, the National Medical and Dental Academic Board, and the National Medical Authority, which would act as a Secretariat of the Commission.<ref>{{Cite news|title=Building sealed, PMDC employees stopped from working|url=https://www.dawn.com/news/1581355/building-sealed-pmdc-employees-stopped-from-working|language=en|newspaper=Dawn newspaper|author=Ikram Junaidi|date=24 September 2020|access-date=12 August 2021}}</ref>
+On 11 February 2020, the [[Islamabad High Court]] nullified the Pakistan Medical Commission Ordinance and restored PMDC.<ref>{{Cite news|title=IHC restores PMDC, dissolves new medical council formed through presidential ordinance|url=https://www.dawn.com/news/1533799|language=en|author=Tahir Naseer|newspaper=Dawn newspaper|date=11 February 2020|access-date=12 August 2021}}</ref>
-* Established by adopting Indian Medical Council Act 1933 on the recommendation of Health Conference in 1947.(1948)
-* Re-organized under P.M.C. Act of 1951. (1951)
-* West Pakistan Medical Council was created on the formation of West Pakistan by merging Sindh & Punjab Medical Councils. (1957)
-* The Council was re-constituted under Medical & Dental Council Ordinance 1962, and Provincial Medical Councils were dissolved. (1962)
-* The Medical & Dental Council (Amendment) Act. (1973)
-* (The Lapsed)The Medical & Dental Council (Amendment) Ordinance(lapsed on September 24,1999). (25th May 1999)
+On 16 September 2020, PMDC was dissolved again by a joint session of the Senate and Parliament by passing the bill to replace PMDC with PMC to ensure standard medical education in Pakistan.
-==International Accreditation Of PM&DC Standards==
+On 23 August 2022, The Senate Standing Committee on Health on Tuesday approved the Pakistan Medical and Dental Council Amendment Bill, 2022, with a majority vote, after which the legal status of the PMC has ceased to exist.<ref>{{Cite web |date=2022-08-23 |title=PMC virtually ceases to exist |url=http://tribune.com.pk/story/2372793/pmc-virtually-ceases-to-exist?amp=1 |access-date=2022-08-25 |website=The Express Tribune newspaper}}</ref>
-===United States Education Department (NCFMEA)===
+On 12 January 2023, The President of Pakistan gave final approval to the PMDC Bill 2022 after which the Pakistan Medical and Dental Council have been established.<ref>{{Cite web |date=2023-01-16 |title=Change is in the air at restored PMDC |url=https://tribune.com.pk/story/2396239/change-is-in-the-air-at-restored-pmdc |access-date=2023-01-17 |website=The Express Tribune newspaper |language=en}}</ref>
-The system of recognition/accreditation through inspection by PM&DC had also been reviewed by the National Committee on Foreign Medical Education & Accreditation (NCFMEA) of U.S. department of education.The standards used by PM&DC for accreditation and inspection of medical and dental colleges in Pakistan have been declared comparable to U.S standards
+==See also==
-===Recognition by General Medical Council U.K. IMED  & FAIMER===
+* [[List of medical colleges in Pakistan]]
+* [[College of Physicians and Surgeons Pakistan]]
-The system of accreditation had also been approved by the General Medical Council U.K. and all the colleges recognised under the PM&DC ordinance 1962 are also automatically recognised by the General Medical Council and the graduates of these colleges are eligible to sit in PLAB examination for the purpose of higher education in United Kingdom. Previously the General Medical Council used to conduct inspection of medical colleges in Pakistan through their own inspection team for the purpose of recognition of medical college. All the colleges recognised under the PM&DC ordinance 1962 are also automatically recognised by FAIMER and IMEd in the world directory.
-==Others==
-Quest International University Perak (QIUP) paid a courtesy visit to the Pakistan Medical & Dental Council (PMDC) recently <ref>[http://qiup.edu.my/index.php/news/item/qiup-delegates-meet-with-pakistan-medical-dental-council QIUP delegates meet with Pakistan Medical & Dental Council]</ref>. This visit was in conjunction with QIUP’s participation in the Malaysia Education Fair 2014 in Pakistan.
-Representing QIUP during the visit was  Mr Nicholas Goh, Chief Operating Officer, Professor Dr Alam Sher Malik, Dean of the Faculty of Medicine and Mr Ananth Lachumanan, Deputy Director of Student Recruitment Department.
-The QIUP delegation had a fruitful discussion with the PMDC President and council members.
-==Functions & Duties Of PM&DC==
-* For uniform application across Pakistan. PM&DC has been given a mandate to:
-**prescribe a uniform minimum standard of courses of training for obtaining graduate and post graduate medical **and dental qualifications.
-**prescribe minimum requirements for the content and duration of graduate and post graduate medical and dental courses of study.
-**prescribe the conditions for admission of courses of training as aforesaid.
-**prescribe minimum qualification and experience required of teachers for appointment in medical and dental institutions.
-**prescribe the standards of examinations, methods of conducting the examinations.
-**prescribe the qualifications, and experience required of examiners for professional examinations.
-* Register Faculty and Students of Medical & Dental Institutions
-* Maintains the Register of Medical & Dental Practitioners.
-* Inspect and formulate recommendations regarding recognition of Medical & Dental Institutions for training of undergraduate & postgraduate qualification <ref>[http://www.thenews.com.pk/Todays-News-6-266935-PMDC-plans-action-against-substandard-medical-colleges PMDC plans action against substandard medical colleges]</ref><ref>[http://www.dawn.com/news/1136524 PMDC to de-notify seven universities]</ref>.
-* Inspect undergraduate & postgraduate examination for standardization.
-* Decide cases against registered  practitioners for infamous conduct and professional negligence.
-* Inspect and approve of Hospitals for House Job.
-* Prescribe guidelines for Medical & Dental Journals.
-* Issue experience certificates to faculty
-* Set up of schemes of reciprocity with other countries and medical regulatory authorities
 ==References==
@@ Line 115: / Line 76: @@
 ==External links==
-*{{official|http://www.pmdc.org.pk}}
+*{{Official website|http://pmdc.pk}}
+*{{cite web|url=http://www.pmdc.pk/ |date=13 November 2001|archive-date=11 February 2016|title=Pakistan Medical & Dental Council official website           |archive-url=https://web.archive.org/web/20160211001836/http://www.pmdc.pk/ }}
-*[http://www.pfmsg.com PFMSG]
+*[https://www.dranas.pk/2023/01/how-to-get-pmdc-online-medical-license.html PMDC license registration and renewal]
+{{Ministry of National Health Services Regulation and Coordination (Pakistan)}}
+{{Health care in Pakistan}}
 {{Education in Pakistan}}
-{{Health care in Pakistan}}
 {{Medical schools in Pakistan}}
+{{Authority control}}
-[[Category:Pakistani dental organisations]]
-[[Category:Pakistan federal departments and agencies]]
 [[Category:Professional associations based in Pakistan]]
 [[Category:Medical and health organisations based in Pakistan]]
 [[Category:1962 establishments in Pakistan]]
-[[Category:Medical regulation]]
+[[Category:Medical regulation in Pakistan]]
+[[Category:Government agencies established in 1962]]
+[[Category:Medical and health regulators]]
+[[Category:Organizations established in 1962]]
+[[Category:Regulatory authorities of Pakistan]]

v t e Ministry of National Health Services Regulation & Coordination
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Departments	College of Physicians and Surgeons Pakistan Drug Regulatory Authority of Pakistan National Institute of Health, Islamabad National Institute of Population Studies Pakistan Medical and Dental Council Pakistan Health Research Council Pakistan Nursing Council Pharmacy Council of Pakistan Human Organ Transplant Authority Pakistan Institute of Medical Sciences Border Health Services (BHS)
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