The Pakistan Medical and Dental Council’s decision regarding Afghan nationals enrolled in Pakistani medical and dental institutions has been presented by some political groups primarily as a humanitarian issue. But the decision raises a broader question that cannot be separated from the principles of sovereignty, national security and the management of limited public resources: does access to a country’s publicly regulated institutions constitute an unconditional right for foreign nationals, or does the state retain the authority to determine who may access those institutions and under what conditions?
On September 1, 2026, the Pakistan Medical and Dental Council issued directives to medical and dental institutions concerning Afghan nationals. The directive barred new admissions, placement, transfers and migration of Afghan nationals during the current academic session and instructed institutions to complete the necessary administrative formalities for previously enrolled Afghan students to return to Afghanistan. It also directed institutions to facilitate their departure, including through the issuance of requisite documentation.
Sovereignty Means the State Retains Regulatory Authority
Pakistan’s Foreigners Act, 1946 expressly provides the federal government with powers concerning the entry, presence and departure of foreigners. Section 3 empowers the government to make orders regulating or restricting the entry, departure or continued presence of foreigners in Pakistan.
This establishes an important legal principle. Foreign nationals studying in Pakistan remain subject to the laws and policies governing their presence in the country. Their educational status does not place them outside the state’s immigration or security jurisdiction.
The PMDC also operates within a statutory regulatory framework. Its admissions regulations recognize foreign-student categories and provide for designated foreign seats, demonstrating that the state already distinguishes between domestic and foreign admission arrangements.
In other words, foreign admission itself is not an absolute entitlement. It exists within a regulatory framework established by Pakistan.
National Security Cannot Be Separated From Immigration Policy
The second consideration is security.
Pakistan’s relationship with Afghanistan has undergone significant deterioration amid continuing cross-border security concerns. In such an environment, the state has legitimate grounds to reassess policies governing the presence of foreign nationals in sensitive sectors.
That does not mean that every Afghan student should be treated as a security threat. Nor does the policy itself establish criminality on the part of the students affected. The distinction is important.
A sovereign security policy can seek to reduce institutional vulnerabilities without collectively criminalising a particular nationality.
Medical education involves access to universities, teaching hospitals, clinical facilities and other regulated institutions. The state is entitled to determine whether existing arrangements remain appropriate in a changed security environment.
The September directive should therefore be understood primarily as a regulatory and security decision, rather than as a declaration against Afghan students as individuals.
Who Should Receive Priority in Limited Public Capacity?
There is also a legitimate policy question concerning resource allocation.
Medical education is not simply a classroom-based academic programme. It requires teaching hospitals, clinical rotations, laboratories, faculty, specialist infrastructure and regulated training capacity. These resources are finite.
Pakistan itself faces a substantial demand for medical education from its own population. Consequently, the allocation of seats in publicly regulated institutions is ultimately a question of national policy.
It would be inaccurate to suggest that every Afghan student occupies a seat directly financed by Pakistani taxpayers, because Pakistan’s system includes private institutions and designated foreign-seat categories.
But that distinction does not remove the state’s authority to decide whether foreign-national enrolment should continue under prevailing conditions.
The relevant principle is not that foreigners have no legitimate access to Pakistani education. They can and have accessed it through established regulatory channels. The principle is that such access is conditional upon the policies of the host state.
Pakistan’s Decades of Afghan Assistance Do Not Create Permanent Entitlement
Pakistan’s long record of hosting Afghan nationals remains an important part of the country’s humanitarian history. Millions of Afghans have lived, studied and worked in Pakistan over several decades.
That history demonstrates considerable accommodation by Pakistan. But humanitarian accommodation cannot logically become a permanent obligation to provide access to every category of national resource regardless of changing circumstances.
States routinely reassess immigration, education and residency policies according to national requirements.
Previous assistance therefore cannot be interpreted as surrendering Pakistan’s sovereign authority to determine its future policies.
The same principle applies to education.
Afghanistan’s Own Education Policies Add Another Dimension
The issue also acquires a wider regional context because Afghanistan’s current authorities have imposed severe restrictions on women’s education.
Afghan women and girls have been excluded from universities and higher education, while restrictions on female education and professional participation have severely narrowed educational opportunities inside Afghanistan.
Pakistan’s previous willingness to educate Afghan students therefore had an important humanitarian dimension.
But humanitarian responsibility cannot be understood as an indefinite one-way obligation.
Administrative Fairness Still Matters
There is, however, an important distinction between sovereign authority and arbitrary implementation.
A state can exercise its regulatory powers while ensuring that affected individuals are treated through clear and orderly procedures.
The PMDC directive itself reportedly requires institutions to complete necessary administrative formalities, including issuing requisite NOCs and facilitating students’ departure.
This is significant. The policy does not require institutions simply to abandon students without documentation. An orderly process protects academic records and allows affected students to establish their educational status.
That approach is consistent with the broader principle that immigration and security policies should be implemented through established administrative procedures rather than through uncertainty or arbitrary treatment.
Sovereignty and Humanitarianism Are Not Opposites
The debate ultimately should not be reduced to a choice between being humanitarian and being sovereign.
Pakistan can acknowledge the individual circumstances of Afghan students while simultaneously asserting its authority to regulate foreign-national access to domestic institutions.
The September 1 PMDC directive demonstrates precisely this tension. The state has chosen to alter its policy regarding Afghan medical and dental students while directing institutions to manage the administrative process surrounding their departure.
The broader principle is clear: humanitarian considerations can influence state policy, but they do not eliminate the state’s sovereign authority to determine who may enter, remain and study within its institutions.
After decades of hosting Afghan nationals, Pakistan’s decision to reassess aspects of that accommodation should therefore be viewed within the framework of national security, regulatory authority and institutional capacity.
The question is not whether Afghan students deserve dignity or due process. They do.
The question is whether Pakistan is entitled to determine its own educational and immigration policies according to its national interests.
Under a sovereign state’s legal and regulatory framework, the answer is yes.
