Karachi’s young doctors face unequal stipends and limited postgraduate training opportunities. A father’s experience raises uncomfortable questions about the value Pakistan places on medical education.

My daughter is a doctor. She spent years studying medicine, preparing for examinations and working towards a profession that Pakistani parents have long regarded as a secure career.

She is now doing her house job at Abbasi Shaheed Hospital in Karachi.

Her monthly stipend is Rs 45,000.

I am proud of her achievement. I know how much work went into earning that medical degree. But I have begun to wonder what kind of future awaits her when the house job ends.

Recently, I met a doctor who had left medicine and moved into the gaming industry. He told me he was earning three times what doctors currently earn in private hospitals in Karachi.

I kept thinking about that conversation.

He had trained for a profession that involves treating sick people, yet he found better financial prospects elsewhere. I do not know his exact income or the salaries he used for comparison. Still, his decision made me curious about the opportunities available to doctors who want to continue practising medicine.

My daughter’s stipend is temporary. Her career is only beginning.

What concerns me is the path ahead.

Why does my daughter receive Rs 45,000?

A house job is a compulsory period of supervised clinical training after an MBBS degree. It lasts one year and is required for full medical registration.

A house officer is still learning. The stipend should not be confused with the salary of an experienced medical officer or specialist.

I understand that distinction.

But I was surprised when I looked at what other public hospitals in Karachi pay their house officers.

Civil Hospital Karachi’s published house-job application terms specify a monthly stipend of Rs 69,600 for selected paid house officers.

That is Rs 24,600 more than my daughter receives.

Over a year, the difference amounts to Rs 295,200.

Abbasi Shaheed Hospital and Civil Hospital Karachi operate under different administrative arrangements. Their payment rules may not be identical, and the difference alone does not establish a legal violation.

But it deserves an explanation.

Both institutions train medical graduates who have already completed demanding academic programmes. Why should their stipends differ so substantially?

The answer is more complicated than I expected.

The Abbasi Shaheed stipend dispute has reached the courts

Abbasi Shaheed Hospital’s house officers have been raising concerns about stipends for years.

In 2021, the Sindh High Court directed Karachi Metropolitan Corporation and other authorities to clear outstanding payments to house officers. Financial difficulties and delayed releases of funds were among the explanations offered during the proceedings.

The disputes continued.

In a judgment dated August 28, 2025, the Sindh High Court examined a petition brought by former house officers who had worked during 2022 and 2023. Their complaints included unpaid stipends and disputed health-risk allowances.

Another case, reported by The News in November 2025, involved house officers seeking payment under government stipend notifications. The report said the court directed the relevant authorities to pay according to the applicable notification.

In June 2026, the court also heard claims concerning COVID-era allowances for another group of Abbasi Shaheed house officers.

These proceedings involved different groups of doctors and different payment periods. Their findings should not be treated as a single ruling covering every house officer currently employed at the hospital.

Nevertheless, the repeated litigation reveals a persistent administrative problem.

Young doctors have had to approach the courts over payments that should have been governed by clear employment terms and official notifications.

I cannot say whether my daughter’s appointment falls under any of those judgments. That would require examination of her appointment letter and the applicable government orders.

What I can say is that the hospital’s stipend arrangements have been contested for years.

KMC considered an increase. House officers were told to wait

On September 14, 2026, The Express Tribune reported that Karachi Metropolitan Corporation had approved an increase in monthly stipends for postgraduate trainees from Rs 75,000 to Rs 104,390.

The decision concerned doctors undergoing FCPS and MCPS training.

House officers were treated differently.

According to the report, a proposal to raise their monthly stipends from Rs 45,000 to Rs 69,000 was deferred. The mayor had directed officials to review house officers’ services and performance before reconsidering the increase.

I found that distinction interesting.

Postgraduate trainees have different qualifications and responsibilities. Their compensation can reasonably differ from that of house officers.

But house officers also perform clinical duties under supervision. They are an essential part of the training system.

If KMC believes Rs 69,000 is an appropriate proposed stipend, it should explain what conditions must be met before that amount can be approved.

The September report does not establish whether a subsequent decision has been made.

As of this article’s preparation, I could not independently confirm a later KMC order implementing the proposed increase.

My daughter continues to receive Rs 45,000.

What do private hospitals pay doctors in Karachi?

The doctor who moved into gaming made me curious about earnings outside public hospitals.

Private-hospital salaries vary considerably. A newly qualified doctor, a resident medical officer and a specialist cannot be placed in one salary category.

Working hours also matter. A doctor covering emergency night shifts may have a very different employment arrangement from someone working regular daytime hours.

One published example comes from Awadh General Hospital in Landhi, Karachi.

The hospital advertised a resident medical officer position with monthly compensation of Rs 75,000 to Rs 95,000, depending on experience and night-shift allowances.

The position required an MBBS degree and one to two years of clinical experience after the house job.

This is an advertised salary range for one position, not a representative average for Karachi’s private hospitals.

Nevertheless, it offers a useful reference point.

Even the upper end of that range would not automatically represent the earnings of a doctor who has spent additional years pursuing specialist qualifications.

The gaming professional I met claimed to earn three times what doctors currently receive in Karachi’s private hospitals. I cannot independently verify his comparison.

But I understood why he had changed careers.

He believed another industry offered him better financial prospects.

I wonder how many doctors consider a similar move, not because they dislike medicine, but because they see more predictable opportunities elsewhere.

The bigger problem begins after the house job

When parents encourage their children to enter medical college, they often imagine a fairly straightforward professional journey.

Complete the MBBS degree. Finish the house job. Enter postgraduate training or obtain employment.

The reality can be much less predictable.

On March 19, 2026, the Pakistan Medical and Dental Council issued a statement about postgraduate medical training capacity.

Its findings deserve attention.

The regulator acknowledged that Pakistan had expanded undergraduate medical education without creating a corresponding number of structured, funded postgraduate training positions.

It described a growing gap between the number of medical graduates and the residency opportunities available to them.

The PM&DC also identified inadequate employment pathways as a serious concern.

This is an important institutional admission.

Medical colleges can produce graduates. But those graduates cannot all become specialists unless recognised hospitals have the funded positions and supervisory capacity to train them.

The PM&DC recommended substantially increasing postgraduate training positions and, where feasible, doubling capacity in phases.

The council also explained that much of the responsibility for establishing and funding public-sector training posts rests with provincial health departments.

The regulator can recommend reform. Provincial governments must decide how many positions to finance.

That division of responsibility matters.

A young doctor may complete the MBBS degree and house job, only to discover that the next stage depends on competition for a limited number of training positions.

For families, the uncertainty begins long before a doctor earns a specialist qualification.

Pakistan needs doctors, but where can they work?

There is an apparent contradiction in Pakistan’s healthcare system.

Many communities struggle to obtain reliable medical care. Yet some qualified graduates face difficulty finding suitable training opportunities.

The contradiction becomes easier to understand when we examine how hospitals function.

A medical graduate cannot simply be sent to a district hospital and expected to provide every specialist service.

The hospital needs equipment and suitable facilities. Junior doctors require experienced supervisors. Government departments must approve and fund positions.

Producing more graduates without expanding these services may increase competition for training rather than improve healthcare access.

The PM&DC’s March statement recognised the imbalance.

It recommended upgrading suitable district and tehsil hospitals so they could become accredited postgraduate training institutions.

That approach could widen training opportunities beyond major teaching hospitals, provided the facilities meet the required standards.

I have previously examined hospital funding and accountability in my article KP’s Rs80 Billion Hospital Question: What Did Nausherwan Burki’s Reforms Deliver?

The institutional problem is related. Allocating money to hospitals is only one part of the task. Governments must show how that spending improves staffing and patient care.

When doctors look beyond medicine

Some doctors pursue careers abroad. Others move into pharmaceutical companies or healthcare administration. A few leave the medical profession entirely.

Their decisions cannot all be explained by low salaries.

Some seek different working hours. Others discover interests that are better suited to another occupation.

The doctor I met had chosen gaming.

I do not regard that as a failure. A medical degree does not oblige someone to practise medicine for life.

But Pakistan should examine why doctors who want to remain in clinical practice sometimes find their professional prospects uncertain.

The PM&DC has itself linked limited postgraduate training opportunities with the migration of skilled graduates.

That is a more substantial concern than one doctor’s decision to enter gaming.

When qualified doctors leave because suitable training is unavailable, hospitals may lose people who could otherwise have developed into experienced clinicians.

The effects can extend to patients.

In an earlier article, Pakistan Seals Thousands of Quack Clinics. Who Holds Hospitals Accountable?, I examined the difficulties patients face in finding safe and accountable medical care.

Pakistan needs qualified doctors in functioning healthcare institutions. It also needs a system that gives those doctors reasons to build their careers here.

What KMC and provincial governments should explain

I would begin with the house-job stipend.

KMC should publish the current approved rate for Abbasi Shaheed Hospital and identify the notification governing it.

It should also clarify the status of the proposal to raise the amount to Rs 69,000.

The earlier court proceedings make transparency particularly important.

If different groups of house officers are covered by different rules, the hospital should explain those distinctions before graduates accept appointments.

Provincial health departments face a larger responsibility.

They should publish the number of funded postgraduate training positions, along with the selection criteria and available specialties.

Applicants need to know how many positions exist and how they are allocated.

The PM&DC’s proposal to expand residency capacity should be accompanied by a timetable and a realistic funding plan.

Training positions cannot simply be announced. Hospitals must have the staff and facilities to support them.

Doctors also need credible ways to challenge administrative decisions without putting their careers at risk.

None of these measures requires treating young doctors as a privileged group.

They require treating medical training as a serious public responsibility.

What I want for my daughter

My daughter will not remain a house officer forever.

Her stipend is temporary, and I know that her medical career is still at an early stage.

I do not expect her to earn a consultant’s salary while she is learning. But I want her to have a fair opportunity to continue that learning after her house job ends.

I want her qualifications to matter when she applies for postgraduate training.

I would also like to see clear rules about compensation. A young doctor should not have to discover the applicable stipend policy through a court case.

Recently, I read a LinkedIn post written by a father whose three children had become doctors. He was deeply disappointed by the professional difficulties they faced.

His words stayed with me.

I understand his feelings because I am beginning to ask similar questions.

When my daughter entered medical college, I was thinking about the profession she would eventually join. I did not give much thought to the administrative decisions that might shape her early career.

Now I do.

Her Rs 45,000 stipend matters. So does the difference between what Abbasi Shaheed Hospital pays and what another Karachi hospital offers.

But the question that worries me most is not about this month’s payment.

It is what happens when her house job ends.

She has done the work required to reach this stage. The next opportunity will depend partly on her effort and partly on the institutions responsible for training Pakistan’s doctors.

I hope those institutions give her a fair chance.