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June 2023, Volume 73, Issue 6


Nursing Internship; a challenge on the door step

Amir Sultan  ( Nursing Scholar in Khyber medical university. )

DOI: 10.47391/JPMA.23-40


Globally, there is a nursing shortage in the health care industry. According to the data of the World Health Organization, an additional 9 million nurses and midwives will be required in 2030 to reach the sustainable development goal 3 on health and wellbeing.1 In America, where there will be a shortage of between 200,000 and 450,000 nurses by 20252 A single medical university in the Khyber Pukhtankhwa province has 92 nursing colleges affiliated to it, the majority of which have been registered in the last five years3. The opening and regularization of these institutes was a revolutionary step by the medical university and regulatory bodies to overcome the shortage. These steps will not only help the health care sector of the province and country but also be a contributor to the national economy if these nurses work in developed and developing countries. These institutes play an important role in the development and promotion of the nursing profession. The major programmes of nursing in colleges are the 4-year Bachelor of Science in nursing degree, which is completed through academic sessions within the institute and clinical skills in the attached hospital. The students of mostly private colleges perform duties mostly in government hospitals as a part of their memorandum of understanding with the hospital. When the programme of 4 years (8 semesters) is completed, the students have to perform one year of clinical training (internship) as a requirement for the degree and licence. Nursing students have the opportunity to bridge the knowledge gap between their theory and practice during the internship.

In Khyber Pukhtankhwa, the nursing colleges of the government are attached to public sector teaching or district head-quarter hospitals, so their students donot face issues in their clinical duties. While only about 10% of private nursing institutes have their own hospitals, the rest send their students to government hospitals. In Swat district, there are currently about 15 registered colleges, and all of their students perform clinical duties in one teaching hospital. The number of institutes is increasing while the availability of hospitals for practice is limited. After a year, when the students of these 15 (approximately) colleges will qualify, then the challenge of internship will be in the spotlight, because it will be difficult for some students to adjust to limited hospitals. Public sector hospitals already have their own government colleges and they will prefer their own students. Who will arrange internships for these students, because without internships, these students cannot receive their degree or their license?

Academic and regulatory bodies should emphasize that this looming challenge should be addressed as soon as possible, and in the future, it should be one of the requirements for affiliation and registration that an institute have their own hospital or have a memorandum of understanding with a hospital for internship and clinical practice.




1.      Nursing and midwifery. World Health Organization. World Health Organization; 2022. Available from: Cited on 12. April 2023

2.      Sultan A, Khan S, Bibi A, Jamal H, Rafeeque S. Attitude of Under-graduate Nursing Students towards Clinical Duties-A cross sectional study. Pak J Med Health Sci. 2022;16:139-.

3.      Bailey Victoria. 200k to 450k nursing shortage expected by 2025 without action [Internet]. New Jersey State Nurses Association. New Jersey State Nurses Association; 2022. Available from: on 12. April, 2023.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: