SPECIALIST TRAINING IN PAKISTAN: TIME TO STOP DEFENDING THE SYSTEM AND START FIXING IT
Abstract
Postgraduate medical education in Pakistan is not working as it should, and the evidence for that judgment comes from those inside it. Residents report programs that go unreviewed, research they cannot conduct, and hours for which they are not paid. A province and the national college are now openly at odds over who controls specialist training, months before an induction cycle. Abroad, our own fellows were placed in arrangements that paid them less than the doctors working beside them. None of this is rumor. All of it is documented in peer-reviewed studies, official notifications, and independent reporting, and every claim below is cited so it can be checked.
The College of Physicians and Surgeons of Pakistan built this system. Founded in 1962, it made the FCPS the qualification most Pakistani specialists hold, and it did so for decades with limited support and less money. ¹ That history earns the College a serious hearing. It does not earn it an exemption from the evidence. The College describes itself as entering a phase of transformation, citing simulation-based assessment, artificial intelligence in evaluation, restructured workshops and research capacity-building. Each of these is worth having. None of them addresses what the trainees are actually reporting.
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Copyright (c) 2026 Shiraz Jamal Khan
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