The MBBS Abroad Frenzy

The white coat – beckons countless Pakistani students towards a career in medicine. However, the path to acquiring a coveted MBBS degree within the country itself is a narrow and treacherous one. Here, ferocious competition for a limited number of seats collides with the exorbitant cost of private medical education, reaching a staggering $35,000-$50,000 USD (approximately 9.8 – 14 million PKR). This harsh reality has fueled a significant exodus of Pakistani students seeking MBBS education abroad, particularly in countries like Kyrgyzstan, Ukraine, Russia, and China. But is this exodus truly the “Great Escape” it appears to be, or is it a gamble fraught with unforeseen risks?

This surge in studying MBBS abroad is a confluence of factors. The social dimension of this trend is undeniable. In Pakistan, the medical profession sits atop the academic hierarchy, signifying social mobility and societal respect. Parents, fueled by a desire to see their children succeed and often burdened by societal expectations, exert immense pressure on their offspring to pursue MBBS. This pressure intensifies the competition for a limited number of seats in Pakistani medical colleges, pushing many students to explore alternatives abroad.

Capitalizing on this intense desire, educational consultancies in Pakistan have mushroomed into a lucrative industry. Operating with minimal oversight in some cases, these consultancies act as intermediaries, placing students in universities abroad in exchange for hefty fees. Herein lies a critical issue: the potential for profit to overshadow student well-being. Consultancies may prioritize their bottom line over student success, placing students in universities of questionable quality or neglecting to fully inform them about the challenges of studying and practicing medicine abroad.

Further complicating the issue is the economic factor for universities in Central Asian states. The influx of Pakistani students presents a significant financial opportunity. According to a 2023 report by the Pakistan Medical Commission (PMC), over 12,000 Pakistani students were enrolled in MBBS programs in Kyrgyzstan alone. The huge majority of the international students — some 24,000 — are from India and Pakistan and they mainly study medicine, paying about $3,000 in tuition per year. They collectively spend millions more dollars in Kyrgyzstan for room and board and living expenses. They bring between $136 million and $181.4 million to our country every year, contributing to our economy. The universities tailor their programs to cater specifically to this demographic, potentially compromising the quality and rigor of the education offered in the pursuit of higher student enrollment.

The pass rate of these students on the National Licensing Examination (NLE), mandatory for practicing medicine in Pakistan, remains dismally low. The Pakistan Medical Commission (PMC) issued a warning in previous years to aspiring medical students, urging them to be wary of informal agents when seeking admission to foreign medical and dental institutions. This warning comes in light of the dismal performance of foreign graduates on the National Licensing Examination (NLE). Over 80% of these graduates failed the exam, highlighting a significant gap in their preparation. The PMC clarified that foreign graduates who have completed their degrees with house jobs or practical clinical experience have a much higher success rate on the NLE. According to the PMC, around 30,000 students annually pursue medical and dental education abroad. The Commission advised these students to ensure their chosen institutions are verified by the PMC and to avoid being misled by informal agents. The PMC investigation revealed that many foreign medical and dental colleges offer programs with inadequate resources, limited hospital exposure, language barriers, and a lack of practical clinical experience. These factors, combined with the influence of profit-driven agents and the allure of cheaper education, are blamed for the low NLE pass rates among foreign graduates. The consequences of failing the NLE are devastating. Years of investment, both financial and emotional, are rendered null and void. The student’s dream of becoming a doctor crumbles, often leaving them with a mountain of debt and a sense of disillusionment.

The recent incident of violence against Pakistani students in Kyrgyzstan serves as a stark reminder of the potential security risks associated with studying abroad. This incident underscores the need for robust support systems and improved communication between educational consultancies, the Pakistani government, and universities in these countries.

So, how can we navigate this complex situation?

Firstly, a multi-pronged approach to address the issues within Pakistan’s medical education system is crucial. Increasing the number of public medical colleges, offering scholarships for underprivileged students, and implementing stricter quality control measures for private institutions are essential steps.

Secondly, empowering students to make informed decisions is paramount. The role of educational consultancies needs to be reevaluated, with a focus on transparency and prioritizing student well-being. In a study conducted in 2010, about 85pc were unregistered consultants of whom a majority were found engaging in ethically dubious practices. Collaboration between consultancies, the PMC, and Pakistani embassies abroad can establish strong support networks that address student concerns regarding security, curriculum equivalence, and NLE procedures.

Thirdly, students must be encouraged to conduct thorough research. This includes investigating the university’s reputation and accreditation, the language of instruction, the curriculum offered, the track record of Pakistani students at that particular institution, and the living conditions in the host country.

Fourthly, exploring alternative career paths within the healthcare sector should be encouraged. Professions like nursing, pharmacy, and allied health fields offer promising career opportunities without the same financial burden and fierce competition.

Lastly, there is a need to address the societal pressures that glorify the medical profession above all others. Promoting a culture that values diverse career paths and celebrates academic success in various fields can help alleviate the pressure on students to pursue MBBS solely due to societal expectations.

The pursuit of an MBBS abroad for Pakistani students is a gamble shrouded in the allure of escaping a fiercely competitive system. The path forward requires a collective effort. A diversified healthcare landscape offering fulfilling career paths is crucial. Only then can Pakistan truly unleash the potential of its aspiring medical professionals, ensuring a healthier future for all.

The opinions shared in this article reflect the author’s personal views and do not necessarily align with the institution’s official stance.