Alarming Decline in MDCAT Participation

The steady decline in the number of candidates over the past four years is deeply troubling

• Downward trend, representing a 31% drop in just three years, raises urgent questions about the future of medical education and healthcare capacity in the country

Prof Dr. Abdullah Arijo

The Medical and Dental College Admission Test (MDCAT) has long served as a gateway for aspiring medical professionals in Pakistan. However, the steady decline in the number of candidates over the past four years is deeply troubling:

• 2022: 204,000 candidates
• 2023: 180,000 candidates
• 2024: 167,000 candidates
• 2025: 140,000 candidates

This downward trend, representing a 31% drop in just three years, raises urgent questions about the future of medical education and healthcare capacity in the country.

Why This Matters

• Shrinking Talent Pipeline: Fewer MDCAT candidates mean fewer future doctors and dentists, exacerbating the already critical shortage of healthcare professionals in Pakistan.
• Educational Disillusionment: The decline may reflect growing disillusionment among students due to rising tuition fees, limited seats, and perceived unfairness in the admission process.
• Economic and Social Barriers: Widening inequality, lack of access to quality pre-medical education, and regional disparities may be discouraging capable students from even attempting the exam.
• Mental Health and Burnout: The intense pressure, coupled with recent controversies surrounding exam conduct and policy changes, may be pushing students away from the medical track altogether.

What Needs to Be Done

• Transparent Reforms: Authorities must ensure fairness, transparency, and consistency in MDCAT policies and administration.
• Supportive Ecosystem: Investment in affordable preparatory resources, mental health support, and regional equity in education is essential.
• Public Dialogue: Stakeholders, including students, educators, policymakers, and healthcare professionals, must engage in open dialogue to restore trust and motivation.
• Here’s the graph showing the decline in MDCAT test takers from 2022 to 2025:
• MDCAT Participation Trend (2022–2025)

The visual clearly illustrates a steady drop from 204,000 in 2022 to just 140,000 in 2025.

There is a serious concern that resonates deeply across many regions, especially in South Asia. The cost-benefit imbalance of pursuing an MBBS degree, where the financial investment is steep but the return in terms of salary or job stability may be modest, is a growing issue. Let’s unpack this a bit:

High Capital Investment

• Tuition Fees: Private medical colleges often charge exorbitant fees, sometimes exceeding PKR 1 crore over five years.
• Living Expenses: Hostel, food, books, and exam fees add significantly to the total cost.
• Opportunity Cost: Students spend 5–6 years in study, followed by a house job and specialization, delaying income generation.

Modest Payback

• House Job Stipends: Often range from PKR 30,000–60,000/month, which is low compared to the investment.
• Postgraduate Training: Requires further years of study with limited income.
• Job Saturation: In urban areas, competition is fierce, and rural postings may lack infrastructure or incentives.
• Migration Barriers: Foreign licensing exams (USMLE, PLAB) are costly and competitive, and not all graduates succeed.

Strategic Alternatives

If the goal is to serve in healthcare or science while balancing cost and impact, here are some paths worth considering:

• BS in Nursing or Allied Health Sciences: Lower cost, quicker entry into the workforce, and rising demand.
• Public Health or Environmental Health: Strong relevance to your climate advocacy work, with policy and community impact.
• Veterinary Sciences or Fisheries: Already aligned with your expertise and often underexplored in terms of career potential.
• Medical Technology or Radiology: High demand in diagnostics, with shorter training periods. Students can opt for these disciplines, and this will pay back their investments.

Read: Attendance Crisis in Pakistani Universities

_____________________

Dr. Abdullah G. Arijo is a retired professor, ex: chairman, Department of Parasitology, Sindh Agriculture University, Tando Jam, ex-advisor Academics & P&D to Vice Chancellor, SAU Tandojam. Email: Email: abdullaharijo@gmail.com