Objective: There are growing concerns towards the quality of medical education in Pakistan. To help strengthen accreditation processes, this study identifies the challenges towards quality assurance of Basic Medical Education in Pakistan. Methods: A qualitative case study was carried out from March to August 2018. Participants included inspectors from various disciplines in both public and private medical colleges, and medical educationists from Pakistan. Semi-structured interviews were conducted with 12 inspectors, while focus group discussion included 10 medical educationists. All the interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted to capture the intricacies of meaning within the data. Results: Data identified 14 sub-themes grouped under three major themes. Challenges towards quality assurance included mounting political influence, commercialism in medical education, weak regulatory capacity of accrediting body, violation of rules, lack of valid accreditation standards and skilled inspectors. Conclusion: Quality assurance of Basic Medical Education in Pakistan involves various systemic, resource and personnel related challenges. The accrediting body needs to bring major reforms in its accreditation system and strengthen its regulatory and technical educational capacity to ensure the quality of medical education in nearly 168 medical and dental colleges of the country. doi: https://doi.org/10.12669/pjms.36.2.1319 How to cite this:Khan AW, Sethi A, Wajid G, Yasmeen R . Challenges towards quality assurance of Basic Medical Education in Pakistan. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1319 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Objective: To identify the learning strategies used by the medical students with high Grit for design and implementation of a three months course, to assist the medical students having low Grit. Methods: A mixed-method study with explanatory sequential design was followed by an intervention to improve Grit amongst first year students at Foundation University Medical College from March to August 2019. Non-probability convenience sampling was used in the Phase-I. In Phase-II, through purposive sampling, students with high score on GRIT were interviewed. The interview questions were validated and piloted for clarity. All interviews were recorded, transcribed verbatim, and thematic analysis was done. The themes generated were used to design an intervention, which was implemented as a part of the curriculum for less Gritty students to see whether it can enhance Grit in them. Results: A total of 133 students participated out of which, 23(17%) had a high, whereas 10(7.5%) had a low level of Grit. Five themes generated from the transcripts, namely Planning, Metacognitive skills, Mastery learning, Cognitive strategies, and Self-regulation, that led the development of an intervention abbreviated as “RESET-P-GOALS”. A Wilcoxon signed-rank test showed that the intervention did elicit a statistically significant change in the Grit score in students having low Grit (Z = -2.8, p= 0.005). Conclusion: Good planning, Mastery learning and self-regulation are the reasons for success of Gritty students. The learning strategies with the name “RESET-P- GOALS” are effective in enhancing Grit in students with less score on Grit. doi: https://doi.org/10.12669/pjms.37.2.2999 How to cite this:Mirza TI, Yasmeen R, Mahboob U. Nurturing Grit among Medical Students. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.2999 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Objective:To explore use of metacognitive skills by medical teachers in relation to Zimmerman’s model of self-regulation.Methods:A qualitative phenomenological study was conducted at Riphah International University from February 2017 to August 2017. A semi structured interview of ten medical teachers was planned to uncover the lived experiences of selected teachers to demonstrate how these teachers use metacognitive strategies in different phases of learning. Data was collected by asking five open ended questions after expert validation. Data was analyzed by using N-Vivo software.Results:Total eight themes were extracted. For prediction and planning three themes, brainstorming, making concept map and sufficient time required were isolated while teachers selected learning objectives and level of students for resource selection while for motivation theme selected was previous experience. Two themes, self- questioning to improve the learning and extra effort required to meet the timeline were isolated for monitoring and reflection during and after learning for evaluation of learning process.Conclusion:During forethought phase, medical teachers predict their learning process through learning objectives and plan after brainstorming to make a concept map and use suitable learning resources. During learning, they monitor learning process through self-questioning and put extra-effort to meet the deadlines. During and after learning, teachers reflect on their performance.