February 2013, Volume 63, Issue 2

Letter to the Editor

Post-graduation plans of medical students — Perspective from Islamabad and Rawalpindi, Pakistan

Anila Kamal  ( National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan. )
Masood Ali Shaikh  ( Group No. 71, Al Rehab, Cairo, Egypt. )

Madam, medical students and newly minted physicians from several developing countries including Pakistan, plan post-graduation studies in America and England.1-5 A study in Lahore of 275 final year medical students and recent medical graduates reported 60.4% planned to seek post-graduation, with America or England as the most favoured countries.4 While another study in Karachi from two private medical colleges reported 65% to 95% of final year medical students had post-graduate study plans abroad.5 There are no such studies from Islamabad/Rawalpindi, or any studies on year 3 or 4 medical students in Pakistan.
A cross-sectional survey with convenience sampling was conducted among male and female, year 3-5 medical students in Islamabad and Rawalpindi at various medical colleges; to study their post-graduation plans, and satisfaction with their decision to go to medical college, from January-June 2011. An interviewer-administered, pre-tested, structured questionnaire with close-ended questions was used by two female and two male trained graduate students, after obtaining verbal consent and ensuring confidentiality. Results were analyzed using STATA-12, by applying chi-square and Fisher Exact tests to assess the independent relationships between categorical variables studied and gender. Statistical significance was defined by two-sided P-values of <0.05.
Cumulatively, 378 students were interviewed; 168 (44.4%) male and 210 (55.6%) female respondents.

Table, provides the frequency of plans for post-graduation, and answers to other questions asked, disaggregated by sex, and statistically significant associations. Cumulatively, 341 (90.2%) students were satisfied by their decision to join medical college; and 323 (85.4%) reported post-graduation plans. The only statistically significant associations were between males who were more likely to plan for going to America or England compared to females. While, 216 (57.1%) of all respondents reported plans to do FCPS in Pakistan. There was some overlap between these post-graduation plans; there were 31 females and 30 males who reported plans for doing both i.e. FCPS as well as going to America, while 35 females and 40 males reported plans for FCPS and going to England for post-graduation.
Post-graduation plans were common in both sexes, with males more likely to be opting for going abroad; the fact that some respondents were reporting such plans in multiple countries perhaps reflects the fact that they are still in college and crystallizing plans. High internet use for studying and seeking educational opportunities abroad augurs the need for early mentoring so as to better guide and prepare students to excel as future physicians.


1. Akl EA, Maroun N, Major S, Afif C, Abdo A, Choucair J, et al. Post-graduation migration intentions of students of Lebanese medical schools: a survey study. BMC Public Health 2008; 8: 191.
2. Chen LC, Bouffard JI. Fatal flows-doctors on the move. N Engl J Med 2005; 353: 1850-2.
3. Talati JJ, Pappas G. Migration, medical education, and health care: a view from Pakistan. Acad Med 2006; 81(12 Suppl): S55-62.
4. Imran N, Azeem Z, Haider II, Amjad N, Bhatti MR. Brain Drain: Post Graduation Migration Intentions and the influencing factors among Medical Graduates from Lahore, Pakistan. BMC Res Notes 2011; 4: 417.
5. Syed NA, Khimani F, Andrades M, Ali SK, Paul R. Reasons for migration among medical students from Karachi. Med Educ 2008; 42: 61-8.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: