Why 80% of Pakistani Doctors Leave Within Five Years of Graduation

The healthcare catastrophe behind the remittance number

Pakistan loses approximately 80 percent of its trained medical doctors within five years of graduation. One in three Pakistani medical students reports an intention to migrate after graduation. The healthcare system that the state has subsidised for decades is being drained almost as fast as it can be replenished.

This piece sits inside the Human Cost of Pakistan's Brain Drain cluster, under the broader Pakistan Brain Drain: The Graveyard of Remittancers pillar.

The headline numbers

Pakistan's medical brain drain is one of the most acute manifestations of the wider crisis.

• ~80 percent of trained doctors leave within five years of graduation (Brain Drain Statistics Report 2025; Pakistan Medical Commission registration data)
• 1 in 3 Pakistani medical students intends to migrate after graduation (Nadir et al., 2023)
• ~5,000 doctors emigrated from Pakistan between 2024 and 2025
• ~1,640 nurses migrated through BEOE in 2025 alone
• Nurse emigration rose 2,144 percent between 2011 and 2024
• 31,418 doctors migrated cumulatively from 1971 to 2022 (PMC, 2023)
• 12,853 nurses migrated 1971 to 2022
• 5,839 pharmacists migrated 1971 to 2022

What it costs the Pakistani state per doctor

The state pays for almost the entire pipeline. Public medical college tuition runs about PKR 38,055 to PKR 100,000 per year (~$135 to $360). Add 7 to 10 years of subsidised training, public hospitals for clinical experience, and the broader public-school baseline, and the estimated state subsidy per doctor reaches roughly $25,000.

With approximately 10,000 doctors emigrating annually, Pakistan loses around $250 million per year in pure training investment alone. That is before the opportunity cost of the doctors not being there to treat patients.

The mortality cost the state does not count

A peer-reviewed study by Saluja et al. (2020) estimated the global mortality cost of physician migration from low- and middle-income countries at approximately $15.86 billion annually. The greatest costs are incurred by India, Nigeria, Pakistan, and South Africa.

Mortality cost means deaths that occur because the doctors who could have treated those patients are working elsewhere. The patient in Multan who could not get a cardiologist appointment. The woman in Quetta who died in childbirth because the obstetrician took the Saudi job. The rural clinic with one doctor for 50,000 people.

The bodies that come back are not the only body count. There is a less-counted body count: the patients at home who never got the doctor.

Where Pakistani doctors go

Estimated Pakistani-origin doctor populations abroad:

Region	Estimated Pakistani-origin doctors
United States (APPNA members)	15,000 to 20,000
United Kingdom (NHS)	8,000 to 10,000+
Saudi Arabia and Gulf	10,000+
Canada, Australia, Europe	5,000 to 8,000
TOTAL ESTIMATED	40,000 to 50,000+

For context, Pakistan has ~250,000 registered doctors total. The diaspora doctor population represents 15 to 20 percent of the size of Pakistan's domestic medical workforce. I have written the longer breakdown at How Many Pakistani Doctors and Engineers Live Abroad.

Why they leave: the documented driver list

A peer-reviewed PMC study (2023) directly identified the causes:

"The unsustainable political environment, lack of advanced technology-based institutes, poor healthcare infrastructure, low job opportunities and salary benefits in Pakistan caused the brain drain of highly qualified people including healthcare professionals."

Mid-career Pakistani doctor salary: PKR 200,000 to 300,000 per month (~$720 to $1,080). Same role abroad: $5,000 to $10,000+ per month. Underfunded labs. No specialty training pathways for many subfields. Multiple political crises since 2018. Public hospitals understaffed and under-equipped.

What the foreign system gets

A 28-year-old Pakistani doctor arriving in Canada, the UK, or Australia has had ~$25,000 spent on training by Pakistan, plus ~22 years of subsidised schooling, healthcare, and infrastructure. Canada, the UK, and Australia get them right when they begin producing taxes, treating patients, and contributing to GDP.

The OECD estimates the cost of "raising and educating a citizen" at $200,000 to $500,000 per person. Foreign healthcare systems skip that entire cost when they admit a Pakistani doctor through Skilled Worker visas, points-based PR pathways, or NHS recruitment.

A 2019 IMF working paper estimated that skilled migration from developing to developed countries transfers approximately $400 to $500 billion annually in human capital value , more than double all global foreign aid combined.

In closing

The state subsidises the training. Foreign systems collect the doctor. The Pakistani patient pays the bill. This is not the textbook definition of a development strategy.

If Pakistan wanted to retain its doctors, it knows how. Israel offers 10-year tax exemptions to returning scientists. Ireland, Taiwan, and South Korea built diaspora-return programs that worked. Pakistan has the diaspora, the precedent, and the capability. What it lacks is the political decision to build a healthcare system worth staying in.

Until that decision is made, the line of departing doctors at the airport will remain longer than the line of patients waiting for them at the hospital.

, Asad Baig

Frequently asked questions

What percentage of Pakistani doctors emigrate? Pakistan loses approximately 80 percent of its trained doctors within five years of graduation. One in three Pakistani medical students reports an intention to migrate after graduation.

How many Pakistani doctors are abroad? Estimates suggest 40,000 to 50,000+ Pakistani-origin doctors live abroad , 15,000-20,000 in the US (via APPNA), 8,000-10,000+ in the UK NHS, 10,000+ in Saudi Arabia and the Gulf, 5,000-8,000 in Canada, Australia, and Europe.

How much does Pakistan lose per emigrating doctor? The estimated state subsidy per Pakistani doctor is approximately $25,000 over 7-10 years of training. With around 10,000 doctors emigrating annually, Pakistan loses around $250 million per year in pure training investment alone.

Why do Pakistani doctors leave? Documented reasons (PMC, 2023): unsustainable political environment, lack of advanced technology-based institutes, poor healthcare infrastructure, low job opportunities and salary benefits. A mid-career Pakistani doctor earns ~$720-1,080/month at home vs $5,000-10,000+ abroad.

What is the mortality cost of doctor emigration? Saluja et al. (2020) estimated the global mortality cost of physician migration from low- and middle-income countries at ~$15.86 billion annually, with Pakistan among the most affected countries. These are deaths that occur because doctors who could have served their home populations are working elsewhere.

Sources and notes

• "Brain drain of healthcare professionals from Pakistan from 1971 to 2022," PMC (PubMed Central), 2023
• Nadir et al. (2023) , Pakistani medical student migration intentions
• Saluja et al. (2020) , "Mortality cost of physician migration from low/middle-income countries"
• Brain Drain Statistics Report 2025 (gitnux.org)
• Pakistan Medical Commission registration data
• Lecturio "Top 10 Medical Universities in Pakistan: 2025 Rankings & Fees"
• IMF Working Paper on skilled migration economic transfers, 2019
• OECD migration studies

Related reading

Pillar: Pakistan Brain Drain: The Graveyard of Remittancers Parent cluster: The Human Cost of Pakistan's Brain Drain

Sibling spokes:

• How Many Pakistani Bodies Are Repatriated From Saudi Arabia Each Year
• What Is the Kafala System and Why Pakistanis Suffer Under It
• How Many Pakistani Doctors and Engineers Live Abroad

Other pillars:

• Why Pakistan's Remittance Economy Is a Development Trap
• Why Pakistani Workers Earn Less Than Indians in the Gulf
• The Real Brain Gain Plan

Thank you for reading.

, Asad Baig