Official publication of Rawalpindi Medical University
Challenges Faced by International Undergraduate Medical Students in Pakistan: A Qualitative Phenomenological Study

How to Cite

1.
Janjua JR, Janjua RS, Omer W. Challenges Faced by International Undergraduate Medical Students in Pakistan: A Qualitative Phenomenological Study. JRMC [Internet]. 2026 Sep. 30 [cited 2026 Sep. 30];30(3). Available from: https://journalrmc.com/index.php/JRMC/article/view/3118

Abstract

Objective: This study explored the difficulties faced by international undergraduate medical students in Pakistan and portrayed their lived experiences.

Methods: This was a qualitative study using a descriptive phenomenological approach. We used semi-structured interviews with students from five different colleges in Pakistan. The participants had completed their schooling overseas and had families living overseas. The interviews were conducted face-to-face or through video calls.

Results: The main difficulties faced by international medical students in Pakistan were seen to be related to culture shock, loneliness, and an inability to cope. Most students experienced loneliness and culture shock, yet their implications were not always disturbing. Yet, coping difficulties were experienced by a smaller number of students, and it affected them to the extent that they needed to get psychiatric support and were even on the verge of dropping out of college and returning home. Conclusion: Unless the challenges faced by international students who come to Pakistan for their studies are addressed, they will definitely be a deterrent for future generations of students who would consider coming to the country for studies from overseas.

Keywords: Acculturation, Challenges, Culture Shock, International Cultural Competency (ICC), International Medical Students, Stress.

https://doi.org/10.37939/jrmc.3118

References

Cole, N. L. Global Capitalism organizing knowledge of race, gender and class: The case of socially responsible coffee. Race, Gender & Class 2008;15:170–187.

Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005;39(6):594-604. https://doi.org/10.1111/j.1365-2929.2005.02176.x.

Gertsen MC, Soderberg AM. Expatriate stories about cultural encounters - A narrative approach to cultural learning processes in multinational companies. Scandinavian Journal of Management 2010;26:248-257. https://doi.org/10.1016/j.scaman.2010.06.003

Bennett RJ, Volet SE, Fozdar FE. “I’d Say it’s Kind of Unique in a Way”: The development of an intercultural student relationship. Journal of Studies in International Education. 2013;17(5):533-553. https://doi.org/10.1177/1028315312474937

Lindsey Parsons R. The effects of an Internationalized University experience on domestic students in the United States and Australia. Journal of Studies in International Education. 2010;14(4):313-334. https://doi.org/10.1177/1028315309331390

Bevis TB, Lucas CJ. International students in American colleges and universities: A history. New York, NY: Palgrave Macmillan. 2007. https://doi.org/10.1057/9780230609754

Harrison N, Peacock N. Cultural distance, mindfulness and passive xenophobia: Using integrated threat theory to explore home higher education students’perspectives on ‘internationalisation at home’. British Educational Research Journal. 2010;36(6):877–902. https://doi.org/10.1080/01411920903191047

Kim YY. Cross-Cultural Adaptation. Encyclopedia of Human Behavior (Second Edition), Academic Press, 2012, pp. 623-630, Https://doi.org/10.1016/B978-0-12-375000-6.00115-4

Zhao CM, Kuh GD, Carini RM. A comparison of International student and American student engagement in effective educational practices. The Journal of Higher Education. 2016;76(2):209-231. https://doi.org/10.1080/00221546.2005.11778911

Akanwa Emmanuel E. International Students in Western Developed Countries: History, Challenges, and Prospects. Journal of International Students 2015;5:271-284. https://doi.org/10.32674/jis.v5i3.421

Rienties B, Nanclares NH, Jindal-Snape D, Alcott P. The role of cultural background and team divisions in developing social learning relations in the classroom. Journal of Studies in International Education. 2013;17(4):332-353. https://doi.org/10.1177/1028315312463826

Malau-Aduli BS. Exploring the experiences and coping strategies of international medical students. BMC Med Educ. 2011;11:40. https://doi.org/10.1186/1472-6920-11-40.

Kuo YH. Language challenges faced by International graduate students in the United States. Journal of International Students 2011;1(2):38-42. https://doi.org/10.32674/jis.v1i2.551

Robertson M, Line M, Jones S, Thomas S. International students, learning environments and perceptions: A case study using the Delphi technique. Higher Education Research and Development. 2000;19(1):89-102. tttps://doi.org/10.1080/07294360050020499

Andrade, M. International students in English-speaking universities: Adjustment factors. Journal of Research in International Education 2006;5(2):131-154. tttps://doi.org/10.1177/1475240906065589

Duff A, Moore J, Morgan A. Speak up: Preparing for international clinical placements. Med Teach. 2018;40(12):1311-1312. https://doi.org/10.1080/0142159X.2018.1471454

Hawthorne L, Minas IH, Singh B. A case study in the globalization of medical education: assisting overseas-born students at the University of Melbourne. Med Teach. 2004;26(2):150-9. https://doi.org/10.1080/0142159032000150539

Cemalcilar Z, Falbo T. A Longitudinal Study of the Adaptation of International Students in the United States. Journal of Cross-Cultural Psychology 2008;39(6):799–804. https://doi.org/10.1177/0022022108323787

Chou PC, Chao YM, Yang HJ, Yeh GL, Lee TS. Relationships between stress, coping and depressive symptoms among overseas university preparatory Chinese students: a cross-sectional study. BMC Public Health. 2011;11:352. https://doi.org/10.1186/1471-2458-11-352.

Khawaja NG, Stallman HM. Understanding the coping strategies of international students: A qualitative approach. Australian Journal of Guidance and Counselling, 2011;21(2):203–224. https://doi.org/ 10.1375/ajgc.21.2.203

Sawir E, Marginson S, Deumert A, Nyland C, Ramia G. Loneliness and International students: An Australian study. Journal of Studies in International Education 20108;12(2):148–180.https://doi.org/10.1177/1028315307299699

McMahon P. ‘Making the grade’: a grounded theory explaining the student experience of Asian and Middle-Eastern postgraduates in a British university, Journal of Higher Education Policy and Management 2018;40(1):34-47. https://doi.org/10.1080/1360080X.2017.1411061.

Stewin E. An exploration of food security and identity among International students studying in Guelph and Windsor, Ontario, Canada. 2013.

Chetanath G, Lowery CL, Mays C, Dayan Durant. Challenges for global learners: a qualitative study of the concerns and difficulties of International students. Journal of International Students 2016;6(2):501-526. https://doi.org/10.32674/jis.v6i2.368

Ward C, Masgoret A, Ho E, Holmes P, Cooper J, Newton J, Crabbe D. The experiences of International students in New Zealand. 2004.

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2026 Wafa Omer