Fading medical dream

The sharp decline in candidates registering for MDCAT, the Medical and Dental College Admission Test, is a warning about the changing aspirations of Pakistan's young people and, perhaps more importantly, their diminishing confidence in the institutions that govern one of the country's most prestigious professions. Official figures show that MDCAT registrations have fallen from 204,253 in 2022 to 138,158 this year. The decline has been gradual but persistent, with numbers falling to 180,534 in 2023 and 140,071 in 2025. Even reopening registration after this year's examination was postponed produced only 2,063 additional candidates.

It would be convenient to conclude that young Pakistanis have simply lost interest in medicine. The MDCAT itself has repeatedly become a source of anxiety. In 2023, the Sindh test was cancelled and ordered to be retaken after allegations of malpractice, leading to legal challenges from candidates. In 2024, the controversy was even more damaging. An FIA forensic investigation found that the paper had been circulated through WhatsApp before the examination, while the Sindh High Court subsequently observed that the leak had compromised the integrity of the process. This distrust is only part of the explanation. Medicine has also become a less attractive economic proposition. Private medical education can cost millions of rupees, while the path from graduation to a stable and rewarding career remains uncertain. PMDC itself acknowledged this year that the country has expanded undergraduate medical education without creating enough funded postgraduate training positions. Meanwhile, students can see alternatives in AI and biotechnology offering potentially faster career progression and greater international mobility.

The falling numbers should prompt an uncomfortable question. Are Pakistan's brightest students abandoning medicine, or are institutions failing to give them sufficient reason to choose it? The answer may be both.