igh merit as well the high cost of private education in Pakistan drive many students to seek medical qualifications in foreign lands, especially China and Central Asia. The undertaking comes with its own set of challenges as the foreign medical qualifications often prove substandard so that many of the graduates cannot practice medicine in their own country.

In an interview with The News on Sunday, Prof Dr Ahsan Waheed Rathore, the vice chancellor of the University of Health Sciences, Lahore, expressed concern about Pakistani students pursuing medical degrees in Russia, Central Asian states and China, especially following the recent events in Bishkek, Kyrgyzstan. Many students, who are unable to gain admission to medical colleges in Pakistan due to high merit requirements, turn to Russian, Chinese and Central Asian medical schools, he said. “These institutions often have lower admission standards. Some of them do not require entrance tests or require English proficiency, making them accessible to students who might not qualify for Pakistani medical colleges,” he said.

Approximately 80,000 candidates take the Medical and Dental College Admission Test conducted by the University of Health Sciences every year to compete for 3,047 seats and 5,025 seats in 19 public sector and 49 private sector medical and dental colleges in the Punjab, respectively. There is intense competition for seats in the public sector medical and dental colleges, with latest merit for King Edward Medical University, Lahore, being above 93 percent. The lowest merit, for Dera Ghazi Khan Medical College, Dera Ghazi Khan, was 91 percent. In private sector institutions, the merit is lower compared to public sector institutions. Still, it ranges around 78-80 percent for colleges in Lahore, Multan, Rawalpindi and Faisalabad. The admission criterion gives 10 percent weight to matriculation, 40 percent to FSc pre-medical, and 50 percent to MDCAT score.

Out of the students who miss out on admissions due to high merit, says Dr Rathore, some turn to Chinese medical colleges in smaller towns that have affordable fee structures, often at the cost of quality of education, although the living costs, including accommodation and food, eliminate the difference in cost in studies in Pakistan and abroad. He says that many of these medical schools, particularly in Russia and China, accept candidates who can afford their fees ranging from $20,000 to $30,000 for a five-year degree programme. But he says these schools lack rigorous academic standards and sufficient clinical training facilities. “The students fall in the trap to get a professional qualification. The governments, too, overlook the quality issues in favour of financial gain,” he adds.

Many students miss out on admissions due to high merit, says Dr Rathore. He says that some of them turn to Chinese medical colleges in smaller towns with affordable fee structures, often at the cost of quality of education.

Upon their return, the UHS VC says, these students often lack the essential competencies needed to become proficient and safe doctors.

Many challenges await Pakistani graduates holding foreign degrees on their return. “The examination and certification process in Pakistan is stringent, and many of these graduates struggle to pass the licensing exams, highlighting the deficiencies in their training.”

Every country can set up its own accreditation system. The graduates may possess a medical degree but sometimes their passports carry no evidence of residing in the relevant country. In light of these issues, the UHS has revised the exam structure and migration rules, he says. The migration of foreign students, deficient in any of the subject being taught in Pakistan, is not allowed.

Dr Rathore points out that the influx of inadequately trained doctors can have serious repercussions for the domestic healthcare system. With typically inferior education, some of the foreign medical graduates may lack critical clinical skills and knowledge. This can be detrimental to the well-being of patients and may even endanger their lives. “No one can be allowed to put people’s health at risk out of concern for losing a job or their money invested on their education,” he adds.

He believes that graduates having acquired substandard medical qualifications can undermine the public trust in the medical profession. “There’s also an economic dimension; families spend substantial amounts of money on these foreign degrees, which could be invested in local education if our system were more accommodating,” he says adding that professions such as nursing, pharmacy and allied health sciences have a huge scope.

While proposing the remedies, he says that there needs to be greater regulation and oversight of foreign medical degrees by relevant authorities in Pakistan. Pakistani students, who acquire foreign degrees in medicine or dentistry, must pass the National Registration Examination of the Pakistan Medical and Dental Council with at least 50 percent marks to practice in Pakistan. Furthermore, Pakistani students, who are studying abroad and wish to continue their education in Pakistan, must pass the National Eligibility Board examination.

Dr Rathore emphasises the need to focus on expanding and improving local medical education infrastructure to accommodate more students domestically. He proposes spreading private medical education network to smaller cities, reducing fees and enhancing the quality of high school and college education in Pakistan as ways to mitigate the allure of foreign institutions. Additionally, he says, public awareness campaigns can inform prospective students and their families about the risks of pursuing substandard foreign medical education.

Upon receiving complaints against any foreign medical or dental college, the PMDC investigates and reviews the institution’s status. “The PMDC regularly updates the list of recognised institutions on its website. It is crucial to raise awareness that students should only enroll in reputable foreign educational institutions listed on the PMDC website,” he adds.

The writer is an investigative journalist associated with The News International, Pakistan. An EWC and GIJN fellow, he contributes to various international media outlets. His X handle: @AmerMalik3