Mapping the landscape: current status, challenges, and perspectives on scholarship of medical educationists in Pakistan

Medical education in Pakistan has undergone a quiet transformation over the past two decades, with regulatory bodies requiring every medical and dental college to establish a Department of Medical Education. Yet while the infrastructure for teaching innovation has expanded, the scholarship that should flow from it has not kept pace. A new study published in BMC Medical Education offers the most detailed picture to date of why medical education research, or MER, remains so thin on the ground in Pakistan, despite a workforce of trained educationists spread across the country’s institutions. The research, led by Saniya R Sabzwari and colleagues at the Department for Educational Development at Aga Khan University in Karachi, maps the barriers that stall careers, silence findings, and keep Pakistani perspectives out of a global literature dominated by wealthy nations.

The methodological design of the study is itself notable for its rigor in a field where such designs are often missing. The researchers used a sequential mixed-methods approach, labeled QUAN-qual, meaning the quantitative phase came first and directly informed the qualitative phase that followed. In the quantitative phase, the team surveyed 71 faculty members who held postgraduate training in medical education, drawn from institutions across Pakistan, and achieved a striking 93.4 percent response rate. Such a high rate matters because it reduces the risk that the survey reflects only the views of the most motivated or most frustrated respondents. The qualitative phase then used two focus group discussions, one with junior faculty and one with senior faculty, to dig beneath the survey numbers and understand the lived experience behind them.

The results reveal a generational split in the obstacles that matter most. Among junior faculty, the primary challenges in conducting medical education research were lack of time, lack of training, and lack of support. These are, in many respects, the classic barriers reported by early-career researchers everywhere, but in Pakistan they take on a particular intensity because medical educationists often carry heavy teaching and administrative loads with no protected time carved out for scholarship. For senior faculty, the picture shifted: their main challenges were lack of funding for publication, the absence of well-reputed local journals devoted to medical education research, and a pervasive culture of mistrust that undermines collaboration. In other words, even those who had survived the early career bottleneck found themselves facing a publishing ecosystem and a professional culture that offered little reward or scaffolding.

The qualitative analysis distilled these findings into overarching themes that applied to both junior and senior faculty. At the systemic level, participants described the absence of protected time and inadequate institutional support as structural features of their working lives, not temporary inconveniences. At the individual level, they acknowledged gaps in their own preparation, including insufficient training in research methods and in the theoretical frameworks that give educational scholarship its analytical backbone. This dual diagnosis is important because it suggests the problem cannot be fixed by training alone or by institutional reform alone; the barriers operate at multiple levels simultaneously and reinforce one another. A well-trained educationist with no protected time produces nothing, while an educationist with generous time but no methodological grounding produces work that journals will not accept.

The context in which these findings sit is a global one. Medical education research is overwhelmingly produced in high-income countries, with limited contribution from low- and middle-income countries such as Pakistan. This asymmetry matters for science as a whole because educational questions in Lahore or Karachi differ in funding realities, class sizes, student demographics, and cultural expectations from those in Boston or London. When the evidence base for how to teach medicine is built almost entirely in resource-rich settings, its findings travel poorly to the places where most of the world’s medical students actually study. Pakistan, as the study’s authors note, has made departments of medical education mandatory in every medical and dental college, creating a large pool of trained professionals whose insights are, in principle, exactly what the global literature lacks.

The study was conducted with formal ethical oversight, receiving approval from the Ethics Review Committee at Aga Khan University Hospital under study ID 2022-7738-23209, with informed consent obtained from all participants and the research conducted in accordance with the ethical principles of the Declaration of Helsinki. The researchers report that the work received no specific grant from any funding agency in the public, commercial, or non-profit sectors, a detail that is perhaps telling in itself: even a study about the lack of research funding had to proceed without it. The authors declare no competing interests, and the article is published open access under a Creative Commons license, making the full findings freely available to the very community of educationists whose circumstances it documents.

What makes the study’s conclusions actionable is the specificity of its recommendations. The authors argue that scholarship in medical education in Pakistan is hindered by individual, institutional, and systemic factors, and they direct their prescriptions accordingly. Institutions, they conclude, need to focus on providing protected research time, bolstering training in medical education research, and establishing robust mentorship and collaborative networks to strengthen the research culture. Protected time, in particular, is a recurring theme in faculty development research worldwide, but the Pakistani data give it local weight: when 93 percent of trained educationists in a national survey point to time as a barrier, the case for institutional scheduling reforms becomes difficult to ignore.

The mistrust that senior faculty identified as a barrier to collaboration deserves particular attention, because it points to a problem that no amount of funding can solve on its own. Collaborative research depends on norms of credit-sharing, transparent authorship, and confidence that intellectual contributions will be respected. Where those norms are weak, researchers retreat into silos, small studies go unpublished, and the cumulative building of knowledge stalls. Similarly, the absence of well-reputed local journals means Pakistani educationists face a choice between competing in high-income-country journals with rejection rates shaped by different priorities, or publishing in venues with limited visibility. A credible regional publication infrastructure, the findings imply, is not a vanity project but a structural prerequisite for a self-sustaining research community.

The implications extend well beyond Pakistan’s borders. The World Health Organization and international medical education bodies have repeatedly emphasized that health workforce education in low- and middle-income countries must be evidence-driven rather than imported wholesale from contexts that differ fundamentally. Studies like this one provide the diagnostic foundation for that ambition, identifying exactly where the pipeline from trained educationist to published researcher breaks down. The senior authors, including Naveed Yousuf, and co-author Syed Moin Ali of Aga Khan University’s Department for Educational Development, along with Rafay Iqbal of the university’s Department of Family Medicine, frame their work as a mapping exercise, and the map they produce is one that institutional leaders, policymakers, and international funders can all read. For junior faculty wondering whether their struggles are personal failings, and for deans wondering why their education departments generate so little publishable output, the answer documented here is neither indolence nor incapacity, but the accumulated weight of missing time, missing training, missing money, missing journals, and missing trust.

Beyond its specific findings, the study offers a useful illustration of how research capacity itself can be built in resource-constrained settings. The near-complete survey response suggests that Pakistani medical educationists were eager to have their professional difficulties documented, an appetite for engagement that institutions could harness. The sequential design also demonstrates a pragmatic model for LMIC researchers: a modest survey followed by focused group discussions can generate publishable, policy-relevant evidence without the large budgets that often deter early-career scholars in such settings.

The timing of the work is also worth noting. The article was released as an accepted manuscript ahead of its final version of record, a publishing route that shortens the lag between peer review and public availability. For a field whose participants explicitly identified slow, difficult publication as a barrier, faster dissemination models have practical relevance. The open access license further means the findings can circulate freely among the very institutions expected to act on them, including smaller colleges that may lack journal subscriptions.

There is also a measurement lesson embedded in the study. By separating junior and senior faculty experiences, the researchers avoided treating the workforce as a monolith, revealing that career stage changes which barriers dominate. That distinction has direct implications for intervention design: mentorship schemes and protected time may matter most early on, while funding access, journal infrastructure, and trust-building become decisive later. Capacity-building programs imported from high-income countries frequently assume a uniform faculty trajectory, and this evidence argues for tailoring support to career stage. The study thus functions both as a diagnosis of Pakistan’s medical education scholarship landscape and as a template for how other low- and middle-income countries might map their own.

Subject of Research: Mapping the landscape: current status, challenges, and perspectives on scholarship of medical educationists in Pakistan

Article Title: Mapping the landscape: current status, challenges, and perspectives on scholarship of medical educationists in Pakistan

Article References: Sabzwari, S. R., Ali, S. M., Iqbal, R., & Yousuf, N. (2026). Mapping the landscape: current status, challenges, and perspectives on scholarship of medical educationists in Pakistan. BMC Medical Education. https://doi.org/10.1186/s12909-026-10078-0

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10078-0

Keywords: Mapping, landscape, current, status, challenges, perspectives, scholarship, medical, educationists, Pakistan, scientific research