Point of View

Medical Universities’ Entrance System: A Barrier to Merit and Accessibility

February 2, 2025

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The proliferation of private academies and coaching centers has further exacerbated the divide between rich and poor students

These institutions charge exorbitant fees for test preparation, offering to confirm passing the MDCAT entrance exams

Zaheer Udin Babar Junejo

In recent years, particularly in the context of public universities, the commercialization of higher education in Pakistan has become a growing concern. Once regarded as bastions of knowledge and equal opportunity, public universities are increasingly criticized for prioritizing profit over merit and accessibility. This shift has created significant challenges for students from low-income backgrounds, who find it increasingly difficult to compete in an education system that seems to favor wealth over talent. Nowhere is this more evident than in the admissions process for medical universities, where the dream of becoming a doctor has become a “hard apple to eat” for poor students.

Public Medical and engineering universities in Pakistan were traditionally seen as affordable institutions that provided education to students from all socioeconomic backgrounds. However, over the past decade, the cost of education in these institutions has risen dramatically. For instance, the admission process itself often requires substantial financial investment, these investments are made to get desired marks from board exams, fees for entrance tests, and huge amounts for admission application forms.

The increasing commercialization of public universities in Pakistan is a pressing concern that requires immediate action

Medical universities, in particular, have become a symbol of this growing inequality. The competition for seats in medical colleges is fierce, with thousands of students vying for a limited number of spots. While the merit-based system is theoretically designed to ensure fairness, the reality is that students from affluent families often have access to expensive preparatory academies, private tutors, and high-quality study resources. This gives them a significant advantage over their less privileged peers, who may struggle to afford basic textbooks.

The proliferation of private academies and coaching centers has further exacerbated the divide between rich and poor students. These institutions charge exorbitant fees for test preparation, offering to confirm passing the MDCAT entrance exams. While these academies claim to level the playing field by providing students with the tools they need to succeed, they effectively create a two-tiered system where only those who can afford their services stand a realistic chance of securing admission.

For poor students, the cost of attending these academies is often prohibitive. Many are forced to rely on self-study or low-quality resources, putting them at a distinct disadvantage. This disparity is particularly pronounced in rural areas, where access to quality education and preparatory resources is already limited. As a result, students from urban centers and wealthy families dominate the admissions process, leaving little room for talented but underprivileged candidates.

The commercialization of public universities undermines the principle of meritocracy, which is supposed to be the cornerstone of higher education in Pakistan. When wealth becomes a determining factor in admissions, the system fails to recognize and reward true talent. This not only deprives deserving students of opportunities but also perpetuates cycles of poverty and inequality.

My daughter, a bright and determined student with a Badin domicile, appeared for the MDCAT in 2024 not once, but twice. Her journey through this highly competitive and often controversial process has been nothing short of a rollercoaster, exposing the deep flaws in Pakistan’s medical education system. The first attempt was marred by the infamous paper leak scandal, which shattered the dreams of countless students, including my daughter. The second attempt, conducted by the Institute of Business Administration (IBA), was a marked improvement in terms of fairness and transparency. However, even this success was short-lived, as new challenges emerged, leaving deserving students like my daughter in the lurch.

The higher education landscape is riddled with contradictions

The second MDCAT exam, conducted by IBA, restored some faith in the system. The test was well-organized, and the results reflected a more accurate assessment of students’ abilities. Interestingly, many of the students who had secured top positions in the first attempt were unable to replicate their success. This time, like the last one my daughter performed well, scoring above 88% a result that filled us with hope and pride.

However, our optimism was short-lived. As the admission process unfolded, a new issue emerged: the role of “improvers” in the intermediate board exams. Suddenly, students who had reappeared to improve their grades began dominating the merit lists. While there is nothing inherently wrong with striving for better results, the system’s failure to balance the opportunities for both freshers and improvers created an unfair advantage. Freshers like my daughter, who had scored above 88% in the MDCAT and had strong academic records of 88% in Intermediate, and 87% in matriculation, found themselves pushed to the bottom of the waiting list. This sudden shift left us questioning the fairness of a system that seemed to prioritize improvers over first-time candidates.

In the case of medical universities, the consequences of this trend are particularly alarming. The medical profession is one of the most respected and sought-after careers in Pakistan, offering the promise of social mobility and financial stability. However, when access to medical education is restricted to the wealthy, it reinforces existing class divisions and limits the diversity of the healthcare workforce. This, in turn, has broader implications for the quality of healthcare services in the country, as a homogenous group of medical professionals may struggle to address the needs of a diverse population. My daughter is a differently abled child securing her seat even being on the merit list seems impossible for me.

Addressing the commercialization of public universities requires a multi-faceted approach. First and foremost, the government must increase funding for higher education to ensure that public universities can operate without relying on excessive fees. Scholarships and financial aid programs should be expanded to support students from low-income backgrounds, particularly in high-demand fields like medicine.

If entrance tests hold no real value, why waste resources and energy conducting them?

Additionally, there is a need to regulate the private education sector to prevent it from exacerbating inequalities. This could include capping the fees charged by coaching centers and ensuring that all students have access to affordable, high-quality preparatory resources. Public universities should also consider implementing affirmative action policies to level the playing field for students from disadvantaged backgrounds.

Finally, there must be a broader cultural shift in how education is perceived in Pakistan. The value of a degree should not be measured by the wealth of the institution or the student but by the knowledge and skills it imparts. By prioritizing merit and accessibility, Pakistan can ensure that its public universities remain true to their mission of serving the public good.

The increasing commercialization of public universities in Pakistan is a pressing concern that requires immediate action. The higher education landscape is riddled with contradictions. If entrance tests hold no real value, why waste resources and energy conducting them? If board exams are considered the definitive criteria for securing one’s academic future, why aren’t stricter measures in place to curb corruption within that system? Moreover, the availability of special and self-financing seats raises another question: why are exorbitant fees imposed on students? This situation disproportionately affects students from low-income backgrounds, making their dreams of higher education, particularly in prestigious fields such as medicine, increasingly unattainable. To address these challenges, Pakistan must tackle the root causes of the problem by reinforcing the principles of meritocracy and equal opportunity. By doing so, the country can pave the way for a fair and inclusive education system, enabling its youth to contribute meaningfully to a brighter and more prosperous future.