More foreign med students could shrink space for aspiring lower income doctors
Rasul Bakhsh Rais
The Pakistan Medical Commission (PMC), a new regulatory authority that determines standards of admissions in medical colleges and universities, attests credentials of doctors and registers them, has kicked up several controversies since its creation a few months ago.
Established under federal law, the PMC replaced decades’ old Pakistan Medical and Dental Council (PMDC) that performed the same functions. The reason it was dissolved was alleged corruption in its rank and file and equally controversial decisions regarding the opening of too many private medical colleges without meeting standard requirements.
Since there is ever rising demand for medical professionals worldwide, prominent business houses and political families linked to powerful political dynasties in the country have been investing in launching medical colleges.
The result is, we have seen a big surge in the opening of new medical institutions during the last ten years. At present, there are 114 medical colleges and universities in Pakistan that have the capacity to enrol 15,000 students each year. Private owners run and manage 70 medical institutions-- an overwhelming number compared to 40 institutions in the public sector.
But not all medical graduates prefer to work in Pakistan-- a significant number leave to work in the East, or in the US and Europe.
Apparently, there is a big business stake in the decisions that the PMC has recently taken regarding the Medical Admission Test (MDCAT) and the abolition of quota or reserved seats for foreign students in private and public medical colleges.
Previously, public medical institutions earmarked 15 percent of admissions for foreign students, including children of overseas parents, while private sector colleges were allowed 10 percent of reserved seats. The foreign students have been a big source of earnings both for public and private medical colleges for the reason that there is a different fee structure for different categories of students.
There are three categories. The Pakistan students getting admission on open seats in public medical colleges, which is highly competitive and requires very level academic scores pay only Rs.1,800 per annum, which is roughly $110. Pakistan students entering the same college on a self-finance basis pay close to a million rupees in annual fees.
Private medical colleges have different fee structures which are very high.
How much fee to charge students has been a controversial matter, which finally landed on the doorstep of the Supreme Court of Pakistan. The Court fixed a range of fee for foreign students between $10,000 to $12,000 for public colleges and $15,000 to $18,000 annually for private medical institutions. This very high fee level may explain the reason behind the decision to abolish any quota for foreign students.
Some medical professionals and political parties in the opposition fear that foreign students may flood the medical institutions of Pakistan, crowding out Pakistani students. Seat allocations at 10 to 15 percent for foreign students had earlier capped their entry-- removing it may increase their flow into Pakistani colleges.
Finding it financially lucrative, private and public colleges may further shrink space for students entering college on an open merit system that pays very little fee. While private medical colleges may see roaring business in opening the floodgates to foreign students, and public colleges improve working conditions via an inflow of higher fees, medical education for poor and lower-middle-class students could remain just a dream.
I believe there are several anomalies in the decision of the PMC in devising three different admission tests. While it has required MDCAT for ‘uniformity of standards’ and to determine merit across the provinces, which is considered quite tough, it has allowed the Agha University in the private sector and the National University of Medical Sciences run by the military to design their own admission tests. Other private medical institutions may also seek exemptions using their growing financial and political clout.
The MDCAT may also favor foreign students and those coming out of the expensive private schools in Pakistan, as English language is one of the components of the test besides the disciplines of biology, chemistry and physics.
It seems neo-liberal economic ideas have started taking root in every sector of Pakistan.
The present government facing an economic crunch wants to shift the budgetary burden on to public educational institutions, particularly professional colleges and universities.
It wants to tap into the huge numbers of overseas Pakistanis who are keen to place their children in medical colleges and the global demand for medical education that appears to be on the rise. Meanwhile, medical education may become out of reach for bright students from poor and lower-middle-class families.