MADEHA I think that you are confusing yourself with the whole GCE system and admission in Pakistan medical college.....I researched a little and found out that GCE is actually for studying in UK only, and that is for higher education studies that give you oppertunity to study and take courses as an under-graduate after completing A level, but you still have to complete your pre-medical requirements to be able to go to a medical school....you can't directly get an admission in US or UK after completing A levels.

I think since A level is something like 12/13 grade so i suppose that in Pakistan you can probably get an admission after giving the entry test or since you are US citizen applying to IBCC for admission. Here is the link to British Council Pakistan where i found the information regarding GCE and O, A Levels...also they have given the link to IBCC where it tells you what are the requirements to apply for medical college if you have finished A levels in Pakistan. Please read and hopefully it will clear the perception that you have.