Parental Concerns During their Children Aptitude Test and Professional Education in a Medical College of Balochistan: A Qualitative Study

INTRODUCTION 

Though each child possesses unique abilities, temperaments and propensities that play a central role in forming and reforming their behavior, aspirations and achievements.1 However, parents also play a pivotal role in their child's academic and personal development".1

Although several national and international studies have explored the challenges faced by medical students during aptitude tests and professional education, parental perspectives on the challenges their children face during the Aptitude Test and subsequent professional education have not been adequately explored in the existing literature.2,3 Studies focused marital difficulties on their child's professional education, lack of facilities and awareness about education,4,5 limited resources, shortage of colleges and non-availability  of transport problems for providing graduate level education to their children.5,6

In the past challenges during the Aptitude Test and professional education (MBBS and BDS) of students were assessed and discussed.2 However, parental concerns regarding challenges and obstacles faced during the Aptitude Test and professional education of their child were not discussed before. Discussing their views in this research work in return provides an understanding of the challenges and obstacles faced by parents of students during Aptitude Test and in pursuing medical and dental education and will give valuable insights for policymakers and educational institutions in developing targeted interventions and support systems to solve these challenges and obstacles to satisfy parents, ultimately fostering a positive atmosphere with a healthier workforce.

METHODOLOGY

After obtaining ethical approval from the Institutional Review Board of Bolan University of Medical and Health Sciences, Quetta (IRB No. 1061/BUMHS/25, Dated: 26th May 2025) a qualitative phenomenogical approach was used to assess the parents' experiences during their child Aptitude Test and professional education (MBS and BDS).

The interview questions were already applied in a study done in 2024 on female students of the Bolan Medical College, Quetta, due to cultural similarity and the parents belong to the students of this college.2 The validity (face and construct) of this questionnaire was acceptable whereas the reliability index was 0.75. Ten parents of successfully get admission in MBBS and BDS students from Bolan Medical College, Quetta, after clearing Aptitude Test and who consented to participate, were interviewed to explore during the Aptitude Test and professional education. While those who regret to participate or are unable to provide informed consent were excluded. Questions were asked orally and were audio-recorded by the trained staff from the participants.

Data Collection Tool: An interview guide (Annexure I) including Parental Literacy, Financial Constraints, Language Barriers, and issues related to Transport and Accommodation during Aptitude Test and in professional education (MBBS and BDS) was used.

Data Collection Procedure: Data was collected in May 2025. Ten parents were recruited from BMC in the oral pathology department and half an hour was given for each participant to give their concerns about challenges and obstacles as factors during the Aptitude Test and professional education of their children. Before starting interviews participants were sensitized about challenges and obstacles and then their concerns were categorized into themes and subthemes.

The interview questions from Khan NF (2025) study were further refined using expert validation and pilot testing of the content for clarity, relevance, and cultural appropriateness. Further modifications and revisions were done in interview and discussion guides based on expert feedback. The interview was done in the local language (Urdu). To ensure its credibility it is translated by a bilingual Expert and then translated back by another expert. confidentiality was confirmed and informed consent was taken from all recruited participants.

Analysis: Interview responses were carefully heard and transcribed by the researcher, and the transcriptions were randomly checked for correct use of wordings by hearing the interviews again. The transcript was formatted and analyzed using thematic analysis to identify recurring themes related to admission challenges.

Two researchers carefully converted the audio recordings and field notes into written text, which was subsequently reviewed by the principal investigator for quality assurance. The data was manually coded according to thematic areas

Figure 1: Step-by-step guide for Methodology

Designed by Author Nabiha Farasat with SmartArt of Microsoft Word

and descriptions that surfaced during the analysis phase. The analysis primarily utilized an inductive coding approach, allowing themes and patterns to arise directly from the data, with open coding techniques applied to ensure a comprehensive examination of the dataset. Tables were employed to organize the substantial amount of information collected. Related codes were consolidated to create overarching ideas or themes within the database. Figure 1 presented the step-by-step guide for methodology. Thematic analysis was used to examine interview responses, aiming to uncover recurring themes associated with admission

Figure 2: Demonstrates Themes (obstacles and challenges and recommendations) and sub-themes

 challenges, Figure 2 presented themes and subthemes. There were themes including a. Obstacles during Aptitude Test and admission in professional education b. Challenges during primary data collection, c. Recommendation.

RESULTS

 Ten parents were recruited to assess their concerns regarding the challenges and obstacles they faced during the Aptitude Test and the professional education (MBBS and BDS) of their children. Eight parents (80%, 8/10) children were MBBS students and were from rural areas and they visited Quetta for their child's Aptitude Test. The majority (70%, 7/10) of parents (both mother and father) come with their child to heighten their motivation, stamina and courage, father of only 2 (20%, 2/10) students come with their child and only 1 (10%, 1/10) of the female students was brought

Table 2: Presents Obstacles and Challenges faced by Parents during Aptitude Test and Professional Education of their children.

 to the center by her brother for this test. Table 1 demonstrates demographic details of participants whereas Table 2 present themes, subthemes and views of participants.

DISCUSSION

The study was among the first to explore the parental concerns on challenges encountered during the Aptitude Test for medicine and dentistry and professional education in Balochistan. The analysis of the study revealed main challenges faced by the parents were cultural norms, residential issues, unavailability of educational resources, financial constraints and safety measures whereas lack of waiting areas with proper management of daily requirements of the washroom, water and snacks shop, illiteracy and language barriers were most prevalent obstacles during Aptitude Test.

BUITMS is an engineering university situated 9 kilometers away from Quetta city (Figure 3).7,8 Administration of Bolan University of Medical and Health Sciences (BUMHS) and Bolan Medical College Quetta (BMC), combined select BUITMS for Aptitude Test due to its huge intra-structure and availability of multiple halls that merge a big crowd of students appear in Aptitude Test every year.8 In previous years it was conducted at University of Balochistan

Figure 3: presents the distance of Takatu Campus BUITEMS from Quetta city i.e. 25 min (13.2 km) via Baleli Road.7

but it caused a rush and roadblock as UoB is located within the city and student's late arrival at the test center makes it difficult to start and conduct the test on time. Therefore, in the last few years, the Aptitude Test has been conducted in BUITMS, situated at Baleli Road. Due to its feasibility, it's preferred by the administration of BUMHS and BMC The parents sat the whole day in sunlight without any basic facilities (waiting rooms with separate male and female washrooms, water and snacks shop). Taking some essential steps in favor of stake holders including providing waiting area along with seperate male and female wash rooms and snacks shop make it easy to the parents to pass the time during their children test. Another obstacle faced by the parents was the language barrier which enabled parents to express their issues/requirements and/or concerns to others. Providing assistance and or a translator at the test center can resolve this obstacle.

Parental education,9,10 financial constraints11 and cultural norms12 are the factors that often hinder student's higher education supported by Khan NF in 2018 and 2022.13,14 Geographically, Balochistan has a vast and resourceful landmass. The population is small, scattered, and poorest as compared to other provinces of Pakistan due to a lack of employment opportunities.14 Rural accommodated areas are seventy-three percent,16 with a large number of poor14 and unemployed population without formal education, training or skills.13 A illiterate father and/or mother, lack of financial resources and lack of awareness are the factors that hinder parent's positive attitude and unavailability to participate actively in their child's education.3 For illiterate parent's government started a program Taleem-e-Balighan in the past which should be restarted. For employment private and government sectors (central and/or provincial level) should generate productive employment opportunities.13

In the province of Balochistan, a big gap existed between the urban and rural areas. In rural areas a large number of the population (73%)14 has no basic opportunities for obtaining education consequently rural areas development is progressively slow.11,17,18 Ishfaq (2018),5 Habeeb R (2022)11 and Chachar ZA (2023)16 recognized the lack of facilities in rural areas including resources of schools/colleges, incompetent/low qualified teachers,19 socio-cultural influences and lack of coaching center deficient graduate level education. Parents of students residing in rural areas are not satisfied with these limited facilities. There is a need for quality education with qualified and skilled faculty, and technical facilities (multimedia and projector) to enhance quality education. Skilled and competent teachers produce and heighten cognition and change agents that's why a trained skilled and competent teacher is a pre-requisite to student's development and best learning.11 Along with allocation of a good amount of budget to run the educational process smoothly. Teacher training programs should be initiated to polish the skills of teachers according to the latest trends in education. Parents should be taken as stakeholders in forming educational policies to compensate for the requirements of student's education.18

Regarding the availability of educational resources, the findings demonstrated a lack of educational resources19 and limited access to coaching facilities in rural areas highlighting a geographical disparity that may hinder Aptitude Test aspirants from these regions, exacerbating the educational resources in rural gap.2 This gap can be filled by providing coaching facilities in rural areas, appointing highly qualified teachers in rural areas in government sector to help those unable to pay fee to coaching centers or to move towards urban areas for better education.

The mindset of the people is dominated by the culture  of the area they live as cultural values didn't change. In rural areas of Balochistan and KPK people have limited social life and males and females don't communicate with each other and if so they struggle a lot to cope.20 That's why it was a main concern of the parents that boys and girls were gathered in the same place. However, not all of them admit it seriously and didn't like it. They said "Mix gathering is out of our norms and culture that boys and girls gathering is not our culture. Our daughter does parda and due to a huge crowd and students sitting mixed in test it is not possible to continue their cultural norms." For such conditions, the administration should prepare a hall for those who feel uneasy in a mixed environment.

Transport was another obstacle21 during the Aptitude Test. Parents belong to rural areas and those of low income feel it difficult to reach the test center at times. Rickshaws ask for too much charges for this route, they take unfair advantage of parent's compulsion. The government, administration BUMHS and BMC combinely provide transport buses for those who didn't have access to reach the center. The administration should announce specific locations where parents and/or students reach the time to come to the test center free of cost. This will reduce the parental pressure on reaching timely at the test center and many of them send their children by bus by sure.

It was the first study that assessed parental concerns regarding challenges and obstacles during the Aptitude Test and professional education of their children. It also provides recommendations to stakeholders (BUMHS, BMC and Government) to solve the obstacles and resolve challenges faced by parents. This study assesses parental experiences of a large population (around 5000, in 2024)22 of the students appear in Aptitude Test.

LIMITATIONS

However, as the study was qualitative it focused on a very small group of participants in a single institution (BMC) which may limit the generalizability of results. For more reliability in results, views of parents from other provinces of Pakistan may be included. Additionally, the reliance on self-reported data from parents introduces the possibility of response bias.

SUGGESTIONS FOR FUTURE RESEARCH

Further studies could explore the impact of suggested initiatives and limitations including i. financial, ii. language and iii. literacy variables by incorporating data from multiple centers where the Aptitude Test will be conducted by PM&DC, broadening the sample size and implementing of quantitative study design to include a more diverse representation of participants to reduce parental concerns. Expanding the study to incorporate qualitative methods, such as focus groups or interviews, would deepen understanding of parental perspectives on societal and institutional barriers.

CONCLUSION

The study highlights parental concerns regarding challenges and obstacles including illiteracy, lack of waiting areas, availability of basic human needs during Aptitude Test and language as a barrier. Financial constraints, lack of educational resources in rural areas and safety are the major obstacles parents face during the Aptitude Test and in the professional education of their children in MBBS and BDS at BMC. Notably, illiterate parents living in periphery face more challenges as compared to those living in urban areas of the city. The findings underscore the need for targeted measures, such as enhancing safety measures and transportation options and promoting education programs in periphery and/or rural areas, to address the structural barriers.

RECOMMENDATIONS

1. During Aptitude Test:

• Translators to overcome the language barrier
• Waiting Room along with Wash Rooms availability (separate for males and females), water coolers and snacks shops.
• Transport for students and parents

2. Parental Illiteracy:

Educational programs for the elderly (Taleem-e Balghan) and primary schools for each district and tehsils

3. Financial Issues and Safety Measures:

• Low-cost educational resources at the periphery, free Education with scholarship for Poor Candidates
• Proper safety measure within the center of the Aptitude Test.

4. Teachers Training Programs for Rural Areas

ACKNOWLEDGMENT

The researchers acknowledge the cooperation and participation of parents of BMC's students for providing their experiences despite their busy schedules and rural accommodation.

FUNDING RESOURCES

None

 CONFLICT OF INTEREST

The authors declare no conflict of interest.

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