Mismatch Between Health-Management Training and Public-Sector Employment in Punjab, Pakistan

Abstract

Effective health systems require not only clinical expertise but also competent management. In Pakistan, physicians who complete graduate training in public health, maternal and child health, hospital administration, or related fields often report difficulty finding public-sector roles that match their qualifications. This paper examines that mismatch in Punjab through a descriptive qualitative case study with embedded policy review. The analysis combines official policy and service-rule documents, peer-reviewed literature on health systems and workforce management, and three de-identified physician career narratives from Punjab. The evidence indicates that Pakistan has expanded its health infrastructure, but the organization of management careers remains weak. In Punjab, policy discourse has acknowledged the importance of management posts, yet the publicly visible service architecture still does not function as a clearly institutionalized management stream comparable to the province's clinical tracks. The three narratives show recurring barriers: lack of designated posts, uncertain career progression, frequent transfers, and stronger perceived incentives in clinical specialties.