Dilemma and Delusion: The Exodus of Pakistan’s Doctors

 Dilemma and Delusion: The Exodus of Pakistan’s Doctors

                                                                                                                                                                                                                

                                                      

*By Prof. Waqar Hussain*

(Ex.Head of Chemistry Department; Freelancer; M.Sc. Chem, M.A. History,
M.A. Pol. Sc., M.A. Isl. St.; CSS, PCS Qualified; Correspondent Course
in Journalism NIJ;national Institute Of Journalism)

A general discussion in the media currently revolves around three
pressing issues: doctors leaving the country, a supposed scarcity of
medical professionals coupled with alleged negligence, and horrors
such as the PIMS tragedy in which fourteen newborn babies died in a
fire. Before the probe goes deeper, a statistical sketch of the
profession makes the argument easier to follow.

There are about 319,000 registered doctors in Pakistan.

The official doctor-population ratio is 1:751. The WHO’s benchmark is
1:1,000. On paper, Pakistan looks better than the WHO floor. On the
ground, the picture changes entirely due to unemployment, emigration,
and doctors who simply do not practise.

Medical colleges produce 16,000 to 22,000 new MBBS graduates every year.

Public MBBS seats number about 9,200, while private seats are about 9,300.

The government cost of producing one doctor is reported at Rs 10–15
million. A government MBBS student pays less than Rs 1 million over
five years. In a private college, the bill is around Rs 15 million.
While there is no single official audited figure for the full public
subsidy—Rs 4 million has also been cited in print—the gap between what
the student pays and what the state spends remains massive.

The gender split is striking. Female MBBS students make up 65–70% of
the cohort in recent claims, with older claims putting them above 80%.
Among registered doctors, women account for about 47–50% and men
50–53%. Broadly, the student ratio is about two women to one man; the
registered-doctor ratio is about one to one.

Government jobs: the last bulk regular recruitment was 900 Medical
Officer (BPS-17) posts in July 2024 (Advertisement No. 13/2024). Since
then, no large permanent MO batch has been announced. Instead, the
state has been hiring doctors more like daily labour—by the shift,
often six hours at a time. The more hours one serves, the more one is
paid, akin to overtime. My son is a doctor; I mention this so the
reader knows I have a direct stake in both the plight and the
performance of the profession.

Emigration is rising. 2025 was the worst year on record: 3,800–4,000
doctors left the maternal nest for better grain.

These eight points sketch the dilemma. The ultimate question is why they leave.

Pay is remarkably low. Some of my son’s friends have been offered as
little as Rs 18,000. Private clinics and hospitals commonly offer Rs
40,000–60,000. Whenever this scribe visits a hospital or clinic and
asks about pay, the answer falls within that range. Those institutions
prefer the discussion to stay general, so names stay out of this
piece.

Furthermore, career growth is slow, and working conditions are poor.
Doctors often complain in anonymity: A BPS-17 doctor is often
humiliated by a BPS-17 Assistant Commissioner. Public representatives,
especially in rural areas, can make a doctor’s life hell. Some demand
that the doctor leave a rush of patients at a rural center to visit
their families at home. Others pressurize the doctor to forge injury
reports to suit their legal cases. Patients, too, sometimes turn
furious and treat healthcare workers aggressively.

The crushing patient load is yet another issue. In a busy government
hospital, one Medical Officer on a morning OPD often sees 80 to
150-plus patients, and in crowded districts the number can climb even
higher. There is no official national “patients-per-doctor” rule; this
is the staggering load commonly reported from DHQ and THQ OPDs. Time
per patient is often reduced to a mere two to five minutes. The queue
is long, the staff is thin, and the clock does not wait.

Compare this to the United Kingdom, where a hospital clinic doctor
typically sees about 10 to 20 patients in a full-day clinic.
Appointments are substantially longer than a Pakistani OPD slot, and
the British Medical Association officially designates “25 contacts” as
a safe daily limit, with a standard GP slot lasting about 10 minutes.
Similarly, in the United States, a primary-care doctor in a normal
clinic sees about 20 to 25 patients a day, spending a comfortable 15
to 20 minutes with each.

The contrast, therefore, is not a rumour. A Pakistani government MO on
a packed morning OPD may see three to six times as many patients as a
UK or US clinic doctor—and with only a fraction of the time to
diagnose and prescribe. That is the very ground on which “negligence”
is so often shouted, and the very ground on which many young doctors
decide to leave.

When young doctors compare this reality with the standing of doctors
in Western countries, and convert those foreign salaries into
Pakistani rupees, the figures run into millions—with far less outside
pressure and humiliation. So, they leave for a better future.

Those who stay often specialise and eventually open their own
hospitals and laboratories. Unfortunately, some treat patients in a
way that recovery is not swift, ensuring the patient returns again and
again, paying Rs 3,000–4,000 a visit plus expensive tests. Others
drift into illegal organ transplants, corruption, or prescribing one
specific company’s medicine in exchange for the company paying their
electricity bills and providing other perks.

Meanwhile, those who work honestly in public hospitals complain of
meagre resources, missing medicines and equipment, and severe staff
shortages.

Health is simply not a priority when the government spends less than 1
percent of GDP on it—about 0.8 percent in FY 2025–26. Politics
captures more attention than the health of the populace. That exact
milieu is what is forcing our doctors to fly!