A young doctor examines a patient, listens to the symptoms, recommends investigations and writes a prescription. For the patient, it is a moment of vulnerability and hope. For the doctor, it is an opportunity to exercise professional knowledge and fulfil a responsibility to humanity. But an uncomfortable question increasingly surrounds Pakistan’s medical profession: has the business of earning money begun to overshadow the business of healing?
The question is not intended to discredit thousands of dedicated doctors who work under difficult circumstances, often sacrificing their comfort and personal lives to save patients. It is about a growing commercial culture surrounding medical education and healthcare, where the enormous cost of obtaining a private medical degree can turn professional aspirations into a financial investment that graduates and their families expect to recover, preferably with substantial returns.
For many Pakistani families, sending a child to a private medical college is no longer simply an educational decision. It is a financial undertaking that can consume years of savings, require the sale of property or force parents into borrowing. Once millions have been spent, the expectation that the child will eventually become a high-earning doctor becomes difficult to separate from the original ambition of serving humanity.
The scale of the financial commitment becomes clear from the fee structure itself. The Pakistan Medical and Dental Council (PMDC), which regulates medical education, initially announced a tuition fee ceiling of Rs1.8 million annually in March 2025. Following scrutiny of audited financial statements and requests from institutions, however, it approved revised, institution-specific fee ceilings in March 2026, with some colleges allowed to charge more than Rs2.1 million annually. At these rates, tuition alone can exceed Rs10 million over five years at the more expensive institutions. Accommodation, books, transport and other expenses add considerably to the final bill.
The controversy is not confined to the official fee structure. In October 2025, the PMDC disclosed that it had issued show-cause notices to 14 medical and dental colleges over excessive fees. Subsequent reports in January 2026 alleged that some institutions were demanding Rs2.5 million to Rs3.5 million upfront despite the notified ceiling. The regulator also warned parents against paying unauthorised charges. These developments raise questions about the effectiveness of regulatory oversight and the ability of ordinary families to challenge powerful educational institutions.
Interestingly, the affordability crisis has begun to affect the colleges themselves. In January 2026, 426 MBBS seats reportedly remained vacant in private medical colleges in Punjab even after several admission rounds. Hundreds of candidates had either declined to join or withdrawn their admissions. In April, the PMDC allowed a one-time reduction in the minimum admission threshold for unfilled seats, lowering the MBBS requirement from 55 to 52 per cent. The development exposed a paradox: institutions had available seats, but many academically eligible candidates could not afford them.
However, the financial sacrifice does not necessarily translate into the promised prosperity. Pakistan’s medical job market has become increasingly competitive, with thousands of graduates entering the profession while opportunities for employment and postgraduate specialisation remain limited.
In a significant admission of the problem, the PMDC acknowledged in March 2026 that Pakistan’s expansion of undergraduate medical education had produced an adequate and, in some disciplines, surplus number of graduates without a corresponding increase in funded postgraduate training positions. Consequently, qualified doctors compete for a limited number of residency placements, particularly in public-sector hospitals. The council urged provincial governments to expand postgraduate training capacity and upgrade district and tehsil headquarters hospitals into accredited training centres.
For a graduate whose family has invested millions, the prospect of spending additional years struggling for specialisation and career advancement can be deeply frustrating. The one-year house job required for a full medical licence is itself only the beginning of professional life, not a guarantee of financial security. Meanwhile, private-sector entry-level positions and house-job stipends often fall far short of family expectations.
This frustration is increasingly visible in online discussions. A public Reddit discussion in August 2026, for instance, featured a user recounting a conversation with a senior doctor who quoted a starting salary of around Rs35,000 for a newly qualified, non-specialist MBBS doctor. Other participants questioned how graduates who had spent more than Rs10 million on their education could survive on such earnings. Although this was an individual account rather than verified salary data, it illustrated the growing public anxiety surrounding the financial returns of medical education.
The consequences extend beyond individual careers. The mismatch between medical graduates and available training opportunities is also contributing to the migration of doctors. A February 2026 report citing a Gallup Pakistan analysis of Bureau of Emigration data estimated that approximately 3,800 to 4,000 doctors left the country in 2025. Better salaries, professional development and working conditions abroad continue to attract young medical professionals. Pakistan is therefore investing heavily in producing doctors, only to risk losing a substantial number of them to foreign healthcare systems.
But the more serious concern is the possible erosion of the humanitarian values that should underpin the profession. When education becomes an expensive investment, the temptation to recover the money through private practice, high consultation charges, unnecessary investigations, expensive prescriptions and commercially motivated referrals can become difficult to resist.
Research published in BMJ Open examining private general medical practices in a rural district of Pakistan has documented concerns about overpricing, unnecessary treatment, irrational drug use and malpractice in the wider private healthcare sector. These problems cannot be attributed exclusively to graduates of private medical colleges, but they demonstrate how commercial pressures can undermine patient welfare.
There is also evidence that professional ethics require greater attention during medical training. A study published in Cureus in July 2026, involving 265 doctors at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, found that 64.5 per cent demonstrated adequate awareness of medical ethics. Awareness was significantly higher among senior doctors and those who had received previous ethics training. The researchers recommended structured, continuous and case-based ethics education, particularly for junior doctors.
The solution, therefore, cannot simply be to criticise young doctors for wanting to earn a decent living. They deserve fair salaries, secure employment, quality training and opportunities for professional advancement. Equally, parents must understand that an MBBS degree is neither a guaranteed passport to wealth nor an investment that entitles a graduate to recover its cost from vulnerable patients.
The government and regulatory authorities must enforce fee regulations, ensure transparency in college finances, scrutinise educational standards and expand affordable public-sector medical education. Private institutions, meanwhile, must be judged not merely by the number of admissions and revenue generated but by the quality of doctors they produce.
Medical colleges must also restore compassion, professional integrity and patient welfare to the centre of their curricula. After all, a doctor is not a trader, and a hospital is not merely a marketplace.
Pakistan needs doctors who can earn respectably without turning human suffering into a business opportunity. A medical degree may cost millions, but the value of a human life cannot be measured in rupees. The real success of medical education should be judged not by how quickly graduates recover their educational expenses, but by how many lives they save, how much suffering they alleviate and how faithfully they uphold the trust placed in them.