While the expansion of seats continues, the severe shortage of faculty, lack of infrastructure, and poor hostel conditions raise serious concerns about the actual quality of medical education in India
Published Feb 03, 2025 | 7:00 AM ⚊ Updated Feb 03, 2025 | 7:00 AM
Representative image of a medical student
On 2 January, students of the Government Medical College in Kumuram Bheem Asifabad, Telangana, took to the streets in protest, citing a severe shortage of faculty at their institution.
According to the students, the National Medical Commission (NMC) mandates eight faculty members per subject. “We don’t even have four faculty members per department; in fact, we have only one for each department. Our classes are not conducted properly,” a student said.
Another student highlighted the lack of essential resources: “We don’t have proper laboratory equipment, technicians, or even the necessary chemicals for lab work. We’ve been requesting these for the past one and a half years, but no action has been taken.”
Fearing reprisal from college authorities, the students requested anonymity. “The principal is consulting higher authorities, but there has been no resolution so far,” one student explained, adding that they resorted to protesting after failed negotiations. The students also described the dire state of hostel facilities, with 56 students crammed into just five rooms and only two washrooms available for all of them.
This protest in Asifabad underscores a broader crisis in Telangana, where the government has set up medical colleges in every district with the vision of bringing healthcare closer to the people. However, many of these institutions lack adequate faculty and infrastructure, undermining their ability to function effectively.
Weeks later, on 1 February, during the annual budget presentation, Union Finance Minister Nirmala Sitharaman announced: “Our government has added almost 1.1 lakh UG and PG medical education seats in ten years, an increase of 130 percent. In the next year, 10,000 additional seats will be added in medical colleges and hospitals, towards the goal of adding 75,000 seats in the next five years.”
However, ground realities and parliamentary committee findings paint a different picture, revealing deep-seated issues in the country’s medical colleges. While the expansion of seats continues, the severe shortage of faculty, lack of infrastructure, and poor hostel conditions raise serious concerns about the actual quality of medical education in India.
The previous BRS government in Telangana and the YSRCP government in Andhra Pradesh took the initiative to establish government medical colleges in each district to meet the growing healthcare demands in their respective states. These colleges were entirely funded by the state governments, without any financial assistance from the Union Government.
However, in 2023, the National Medical Commission (NMC) introduced a regulation mandating a ratio of 100 MBBS seats per 10 lakh (1 million) population in a state. This regulation effectively barred states that had already exceeded this ratio from opening new medical colleges or increasing existing MBBS seats. Following protests, the NMC was forced to put this regulation in abeyance, but its initial enforcement had already created obstacles for states actively expanding their medical education infrastructure.
Telangana successfully achieved its goal of establishing a medical college in every district, but this was accomplished entirely through state government funding. Instead of facilitating this expansion, the NMC initially attempted to block approvals for new institutions, creating unnecessary hurdles in the process.
Meanwhile, the Union Government-funded AIIMS institutions present a contrasting scenario. While AIIMS centres in Telangana and Andhra Pradesh have become fully operational, AIIMS Madurai in Tamil Nadu remains incomplete. Students assigned to AIIMS Madurai are still studying in a state government medical college due to delays in construction, raising concerns about the Union Government’s commitment to ensuring functional infrastructure for its own institutions.
Additionally, two other South Indian states, Kerala and Karnataka, have repeatedly requested AIIMS-like institutions and even offered land for their construction. However, despite their willingness to provide resources, the Union Government has diplomatically denied their requests. This raises serious questions about regional disparities in healthcare infrastructure development and the political motivations behind AIIMS allocations.
AIIMS is the top and last resort for healthcare across the country. Currently, 20 AIIMS institutions are functioning in India, with the majority established after 2014. However, these institutions require adequate manpower to operate smoothly.
According to a response provided by the Ministry of Health in the Rajya Sabha on 17 December 2024, across all AIIMS institutions in 2024-25, a total of 5,799 faculty positions have been sanctioned. However, only 3,693 of these positions have been filled, leaving 2,106 vacant posts—which means one in three faculty positions remains unfilled (36.3 percent vacancy).
Similarly, in the non-faculty category, a total of 55,601 positions have been sanctioned, but only 39,451 have been filled, leaving 16,150 vacant posts—accounting for a 29 percent vacancy rate, or roughly one in three non-faculty positions remaining empty. The shortage of administrative, technical, and support staff severely impacts the overall functioning of these medical institutions.
These numbers reflect the staffing crisis within the Central Government’s premier healthcare institutions, but the issue is not limited to AIIMS alone. States like Telangana, which have undertaken massive expansions in medical education and healthcare infrastructure, are also struggling with similar shortages of medical professionals and faculty.
This widespread manpower shortage raises serious concerns about the quality of medical education and patient care, as institutions struggle to meet the required faculty strength necessary for effective teaching and clinical services. Despite ambitious expansion plans, the persistent vacancies highlight the ongoing challenges in recruitment and retention within the medical education and healthcare system.
The latest Parliamentary Standing Committee Report on the Quality of Medical Education in India highlights significant challenges in infrastructure, faculty shortages, curriculum reforms, and quality control mechanisms.
The report emphasises that despite India’s rapid expansion of medical colleges and seats, serious quality concerns persist, raising doubts about the effectiveness of the country’s medical education system.
One of the most alarming issues highlighted in the report is the acute shortage of faculty across medical colleges, particularly in AIIMS institutions. As of 2024-25, 36.3 percent of faculty positions remain vacant, severely affecting the quality of education. The report criticises long delays in recruitment—ranging from two to four years—which leave institutions struggling to fill critical teaching roles.
Additionally, it exposes the widespread issue of ghost faculty, where institutions falsely report faculty members to meet accreditation standards.
A recent assessment of 246 medical colleges in 2022-23 by the Undergraduate Medical Education Board (UGMEB) under the National Medical Commission (NMC) found that no medical college had adequate faculty members or senior residents, and all failed to meet the minimum 50 percent attendance requirement.
“Most medical colleges either had ghost faculty and senior residents or had yet to employ the required faculty at all. While none of the institutions met the minimum 50 percent attendance requirement, zero attendance of faculty was common in most medical colleges.”
Another major concern is the unequal distribution of medical colleges, leading to poor access to medical education in rural and underserved regions. While the government has significantly increased the number of medical colleges, their placement is often politically influenced rather than based on healthcare needs.
The report criticises the haphazard expansion of medical colleges without ensuring adequate faculty, infrastructure, and hospital facilities. Many newly established institutions lack proper teaching hospitals, laboratories, hostel facilities, and essential medical equipment. The committee calls for a more strategic approach to expansion, emphasising the optimal use of existing resources before establishing new colleges.
The commercialisation of medical education is another major issue in the report. It highlights how private medical colleges charge exorbitant fees while failing to provide quality education, forcing students into expensive alternatives or pursuing degrees abroad. While government medical colleges offer highly subsidised education, there are only 56,193 MBBS seats available, leaving more than 10 lakh aspirants with no choice but to opt for private or foreign institutions. The report urges the government to regulate private college fees, introduce scholarship programs, and promote public-private partnerships to make medical education more affordable and accessible.
The lack of a uniform accreditation system for medical colleges is another serious regulatory failure identified in the report. Many medical colleges, especially private institutions, evade scrutiny by not participating in ranking and accreditation programs. The current inspection system is superficial, allowing substandard colleges to continue operating without consequences.
The report also criticises inconsistencies in the treatment of Foreign Medical Graduates (FMGs), many of whom struggle to secure permanent registration and internship placements upon returning to India. While India depends on foreign-trained doctors to meet its doctor-patient ratio, state-level bureaucratic hurdles create additional barriers for FMGs.
Another critical shortcoming identified in the report is India’s poor investment in medical research. Despite having over 700 medical colleges, research output remains low due to limited funding, lack of incentives, and outdated curricula. India’s health research expenditure is just 0.02 percent of GDP, significantly lower than countries like the US and UK.
The expansion of medical seats in India has sparked a mix of support and concern among experts.
Dr. Shekhawat underscores the urgent need to increase medical seats, considering the growing demand from aspiring students, policymakers, and the general public. However, he cautions that this should not come at the cost of compromised medical education. He stresses that alongside seat expansion, the government must focus on infrastructure development and resolving pay-related issues for medical professionals. He warns that public trust in doctors is gradually declining, and compromised medical education could worsen the situation.
United Doctors Front President Dr. Lakshya Mittal echoes similar sentiments, welcoming the addition of 10,000 medical seats insists that merely increasing intake capacity without improving infrastructure, faculty strength, and clinical exposure will not solve the underlying challenges in medical education.
“Government to first strengthen existing medical institutions, ensure fair stipends for interns and residents, and address issues related to medical bonds. Bond-free medical education, better working conditions, reasonable duty hours, and fair remuneration should be prioritized alongside increasing seats. A holistic approach, balancing both quantity and quality, is essential to truly strengthen India’s medical education system,” he told South First.
On the other hand, some medical professionals are concerned about systemic imbalances that could arise from this rapid expansion.
Dr. Suvrankar Datta warns that increasing MBBS seats without a proportional rise in Postgraduate (PG) seats could destabilise the healthcare system. He explains that in today’s evolving medical landscape, specialised training is not just an advantage but a necessity, especially with the growing influence of Artificial Intelligence (AI) in diagnostics and treatment. AI-assisted Clinical Decision Support Systems (CDSS) may introduce errors, and only specialists can effectively identify and mitigate these risks.
Dr. Datta further highlights the growing dependence on AI-based tools like ChatGPT among medical students, which, if not properly regulated, could lead to errors in patient care.
He stresses the need for clear and accessible pathways for specialisation, warning that a surplus of MBBS doctors without adequate postgraduate training could lead to underemployment and a dilution in the quality of healthcare delivery. “If we do not ensure proper avenues for specialisation, we are looking at an impending crisis,” he cautions.
(Edited by Ananya Rao)
