In 2025 alone, nearly 4,000 medical doctors left Pakistan to work abroad — the highest number ever recorded in a single year, according to analysis based on Bureau of Emigration data. This alarming exodus comes at a time when the country’s healthcare system is already under severe strain. With a population exceeding 240 million, Pakistan struggles to meet international health standards: the World Health Organization recommends one doctor for every 1,000 people, but in reality, one doctor serves about 3,000 people in urban areas, while in rural areas, a single physician may be responsible for 8,000 to 15,000 people.

These are trained professionals whose education was supported by public resources and the sacrifices of their families. When one doctor leaves, hundreds of patients lose access to care. When thousands leave, the entire healthcare system weakens.

At the same time, government hospitals, especially Basic Health Units (BHUs) and rural health centers, face acute shortages of doctors.

Buildings exist, but doctors are missing. Patients wait for hours or travel long distances just to see a physician. In the presence of this bleak situation, it is hard to understand the government’s priorities — the urgency of the healthcare crisis seems to be overlooked, leaving hospitals understaffed and rural communities neglected. One wonders if government hospitals will one day be treated like PIA and other state-owned enterprises, sold off at throwaway prices, instead of being properly supported to serve the public. Shockingly, while thousands of doctors leave the country and hospitals remain understaffed, one provincial government proudly announced the purchase of a luxury aircraft worth Rs 11 billion — funded by taxpayer money — solely for the chief executive of the province. This glaring display of extravagance highlights the disconnect between government priorities and public needs. Citizens struggle to access basic healthcare and education, yet resources are diverted to satisfy the comfort of a single official. Such decisions not only deepen public frustration but also undermine trust in governance, sending a stark message that the wellbeing of ordinary Pakistanis comes far behind personal luxuries for those in power.

Pakistan already struggles to meet international health standards. Although official figures show a large number of registered doctors, many are not practicing, some are working in administration or private sectors, many female graduates leave practice, and thousands are already abroad. In practical terms, one doctor is serving more than 1,300 to 1,600 people at the national level. In some Basic Health Units, there is no doctor at all. In such a fragile system, losing 4,000 doctors in a single year directly reduces public access to healthcare.

What makes the situation more alarming is that the crisis is not only about numbers — it is about planning, governance, and systemic disrespect toward professionals.

Many people say doctors leave because of higher salaries abroad. Salary is important, but it is not the only reason. Doctors in Pakistan work extremely long hours, face violence from attendants, and have weak security in hospitals. Promotions are slow, and salaries are sometimes delayed. In rural areas, doctors are posted without proper facilities, housing, or support staff. When something goes wrong, the doctor is blamed first. This constant disrespect from administration, patients, and even courts pushes young doctors to seek safer, more respectful environments abroad.

In such conditions, migration becomes not only a financial decision but also one of professional respect and personal safety. In other countries, doctors are provided legal protection, structured training, and clear career paths. They are treated with dignity, and their expertise is valued.

There is also a psychological factor. Years ago, a well-known Pakistani medical specialist returned from the United States to serve his country. He appeared before the Honourable Supreme Court of Pakistan during a case hearing. Instead of encouragement, certain remarks made during the proceedings publicly questioned his integrity and professionalism. The incident became widely discussed among overseas Pakistani doctors. The message many received was simple: returning home may cost you your professional dignity and respect.
Such signals travel fast.

Overseas professionals observe how returning experts are treated. If they feel there is risk to their reputation or respect, they choose not to come back.

As doctors leave, hospitals suffer. BHUs remain without physicians, and tertiary hospitals become overcrowded because patients bypass primary care centers. Doctors who remain face extreme workloads, harassment, and disrespect, which further increases migration intentions.

At the same time, universities face a similar crisis. Pakistan produces roughly 2,500 PhD scholars every year, the highest academic qualification a person can achieve after nearly a decade of higher education and research. However, instead of being absorbed into universities and research institutions, many of these scholars are hired only as visiting faculty. Their payments are irregular and often extremely low — sometimes even less than what a daily wage laborer earns when calculated per working day. Many wait months to receive honorarium. There is no job security, no research funding, and no career structure. This constant undervaluing of expertise discourages talented scholars from continuing to serve the nation. As a result, many qualified scholars either leave the country or leave academia altogether.

Pakistan does not lack talent. It produces tens of thousands of doctors and thousands of PhD scholars every year. What it lacks is a system that protects, respects, and properly values them.

The government must understand that this is no longer a routine administrative issue — it is a national emergency. Producing doctors and PhD scholars annually while simultaneously losing thousands abroad reflects a failure of health and education planning. Building new hospitals without ensuring staffing, posting doctors without facilities, and underpaying scholars while disrespecting their professional contribution will only accelerate the crisis. Immediate reforms are needed: enforce strict protection laws for healthcare workers, provide incentives and secure accommodation for rural service, ensure timely and respectable salaries, create transparent career structures, and regularize qualified PhD faculty. Overseas professionals must be welcomed with respect and institutional support.

If decisive steps are not taken now, Pakistan will continue investing public money in educating doctors and scholars only to export them permanently. A nation that fails to respect its healers and educators risks losing not only its human capital but also its public trust and long-term stability. This is not only about slogans to pay respect to votes, but more importantly, about respecting the professionals and scholars who serve the nation. Politicians and policymakers must realize that without genuine appreciation, protection, and career opportunities, the talent that sustains our healthcare, education, and research systems will continue to leave. It is time to move beyond empty promises and create a system that values expertise, ensures dignity, and rewards commitment — because the future of Pakistan’s health, knowledge, and development depends entirely on those who serve it. Every decision today must safeguard their dignity, protect their rights, and create real opportunities, or the nation will pay a heavy price in human capital, public trust, and sustainable development.

The time for speeches has passed. The time for structural reform and respect is now.

Dr Alamdar Hussain Malik
Advisor Veterinary Sciences
University of Veterinary and Animal Sciences, Swat
Former Financial Adviser, Finance Division,Government of Pakistan