THE MDCAT has yet again found itself embroiled in controversy. Allegations of paper leaks, cheating, and widespread mismanagement continue to cast doubt on the credibility of the exam, which determines entry into the nation’s top medical and dental schools. In Sindh, reports have surfaced of candidates from Tharparkar and Kashmore scoring 95 or even 100pc. More disturbing, however, are allegations that some students in Hyderabad paid up to Rs1.6m to take the exam at a farmhouse. Dow University of Health Sciences, which was tasked by the Pakistan Medical and Dental Council to conduct the exam in the province, has denied the paper leak claims and labelled the allegations as an effort to tarnish the varsity’s image. Similarly, in Islamabad, students have alleged that a cheating mafia within Shaheed Zulfikar Ali Bhutto Medical University manipulated the exam. Out-of-syllabus questions, inconsistent test difficulty across regions have sparked protests. Some students have demanded grace marks or a re-test, while university officials have accused the protesters of being proxies for profit-driven teaching academies. The university did, however, establish a complaint desk and a grievance committee is reviewing the matter. This situation threatens to damage the global reputation of Pakistani doctors, who are otherwise well-respected internationally. If these allegations are true, Pakistan could be on the brink of another scandal reminiscent of the pilots’ licences’ debacle, where alleged irregularities eroded trust in the aviation sector. The lack of transparency, repeated charges of paper leaks, and administrative failures highlight the urgent need for reform. The government must conduct a thorough and independent investigation, holding individuals accountable for malpractice, and exploring other ways of conducting the MDCAT. Handing over the exam to reputable institutions as suggested by the Young Doctors Association, could restore trust in the system. Introducing online tests, with stronger monitoring mechanisms, would further ensure transparency. The government must act swiftly. Delay will only deepen the crisis.