The National Medical Authority of Pakistan Medical Commission (PMC) on Monday announced the results of the National Licensing Exam (NLE) Step 2 (Medical) examination held from October 29 to October 31. According to PMC, as many as 1,012 students sat for the NLE Step 2 (Medical) examination with results of 149 students who appeared at the Multan Center withheld. The pass percentage for the NLE Step 2 (Medical) was 6.95%. The 2021 NLE Step 2 (Medical) is applicable for foreign graduates only to assess their clinical skills to function as a safe and independent practitioner. A Full License to practice in Pakistan is to be issued only after passing the NLE Step 2 examination. A foreign graduate who is unable to qualify the NLE Step 2 is also allowed to attempt the NLE Step 2 (Medical) three times within a maximum five year period. The low pass percentage of the current result unfortunately represents the lack of clinical skills training in some foreign colleges. PMC has consistently shared its concern in the past over the lack of clinical training of foreign graduates from certain countries. This concern has now been confirmed by the outcome of the NLE Step 2 (Medical) result. Two of the key issues highlighted during assessments carried out by the authority is the non-availability of sufficient hospitals and patient flow necessary for clinical training of foreign students in these countries and the language barrier which exists at local hospitals and amongst health care professionals who are expected to impart clinical education. This ultimately results in foreign students not undertaking proper and mandatory clinical training at these colleges and hospitals. Many of these foreign colleges have been offering and marketing MBBS programs as foreign programs rather than offering the locally recognized medical program in that country. Effectively these colleges cater primarily to students from countries like Pakistan to provide them with a medical degree which they can take back to their home country for seeking a medical license. It is also for this reason that majority of the graduates from these colleges never obtain practice license in those countries or practice there as they would not fulfill the educational and training required for such licensing, it added. The PMC said that the clinical training is an integral part of a medical training program and is mandatory for patient diagnosis, treatment, and care. It must be noted that hospitals are the key to a medical training program and without clinical training, a student cannot progress to becoming a licensed doctor and would certainly not represent a safe doctor. The NLE Step 2 (Medical) examination assess the competence and skill of a student to be a safe doctor and only upon passing the exam is allowed to practice in Pakistan. On the pass percentage of the NLE Step 2 (Medical) Dr. Arshad Taqi, President, Medical and Dental Council said, “It is PMC’s fundamental responsibility to induct only safe doctors in the healthcare delivery system of Pakistan. It is expected that every doctor issued a license to practice should have the basic skills to practice independently.” He said that the NLE Step 2 (Medical) is a standard test assessing the level of clinical training of a student. “The result highlights our reservations about the quality of medical and dental education in certain foreign countries and the lack of clinical training.” He said, “A doctor cannot practice without clinical training and a license can’t be issued if they do not pass the exam. We have a responsibility towards the citizens of our country and only safe doctors can become part of Pakistan’s healthcare system.” The PMC has repeatedly warned aspiring medical and dental students who don’t get admission in Pakistan due to lack of merit or failure to obtain admission in the public sector college to not apply to such foreign colleges where there is a lack of clinical training. Furthermore, it has been reiterated on numerous occasions to avoid admissions in offshore colleges that offer a qualification not locally recognized in that country and hence do not result in a license to a graduate locally in the country where these institutions are located. The commission cannot issue a license to practice without ensuring a student meets a set standard of competence and skill. As a healthcare regulator, PMC has a duty to safeguard patient health and allow for safe doctors to enter the healthcare delivery system of Pakistan. There can be no exception to this as this is a responsibility the PMC owes singularly to every citizen of Pakistan when licensing a person to practice medicine or dentistry, it added.