Published Feb 12, 2026 | 8:00 AM ⚊ Updated Feb 12, 2026 | 8:00 AM
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Synopsis: The Union government’s decision to reduce the qualifying percentile for NEET-PG to fill nearly 20,000 vacant postgraduate medical seats has led to admissions of candidates with single-digit and even negative scores. Doctors have argued that lower cut-offs undermine academic standards and patient safety, while others contend that exit examinations and supervised training matter more than entrance marks in determining clinical competence. However, the controversy has exposed something deeper: the competing needs of various stakeholders within a flawed system.
Union Minister of State for Health Anupriya Patel told the Rajya Sabha on 10 February that after two rounds of counselling for postgraduate medical seats, 9,621 seats remained vacant in the All India quota alone.
Adding state quotas and DNB programmes brought the figure to approximately 20,000 empty seats across the country. The solution, she explained, followed precedent from past academic years that had “proven effective in ensuring maximum seat utilisation.”
The government reduced the qualifying percentile for eligibility to postgraduate counselling in 2025. For SC/ST/OBC candidates, all who appeared were declared qualified. For the general category, eligibility dropped to above the 7th percentile.
What Patel did not mention in her parliamentary response was what this policy meant in practice. A candidate who scored minus 12 marks out of 800 in the National Eligibility cum Entrance Test (NEET) for Postgraduate secured admission to pursue an MD in Physiology.
Another with minus 8 marks gained entry to Government Medical College, Haldwani, for MD Biochemistry. A third candidate, with just 4 marks, obtained a seat for MS Orthopaedics at PGIMS Rohtak, a government institution.
These admissions reveal something more than administrative failure. They expose the collision of three imperatives that have pulled India’s medical education system in opposite directions: the mandate to fill seats at any cost, the insistence on maintaining standards, and the demand for social equity through reservation.
The government’s position rests on a straightforward calculation. India produces roughly 64,000 postgraduate medical seats annually. Each vacant seat represents not just a wasted training opportunity but a failure to address the country’s shortage of specialists. When thousands of seats go unfilled, the pressure mounts to do whatever becomes necessary to ensure they find occupants.
This is not the first time qualifying criteria have plummeted. In 2023, NEET-PG and super-speciality percentiles were similarly reduced to zero, though the lowest mark at that time was five. The repetition in 2026 suggests this has become policy, not an exception.
“The decision to revise the qualifying percentiles follows the completion of Round-2 counselling by MCC wherein it was reported that of the 29,476 seats offered by MCC for counselling, 9,621 seats remained vacant,” Patel told Parliament. “Hence, consistent with past academic years which had proven effective in ensuring maximum seat utilisation, the Government reduced the qualifying percentile for eligibility to PG Counselling 2025 to ensure precious PG medical seats do not remain vacant.”
The word “precious” carries weight. Each seat took years to sanction, millions to establish and faculty to appoint. Empty seats in government medical colleges mean the state has paid for infrastructure that sits idle. In private colleges, they mean revenue losses that institutions seek to recover through other means.
Yet the focus on utilisation raises questions about what these seats are meant to utilise. Dr Dhruv Chauhan, spokesperson for the IMA Junior Doctors Network, points to the pattern of where seat expansion occurs.
“High-demand clinical branches like Radiology often remain limited, while non-clinical branches such as Anatomy, Physiology, and Biochemistry see relatively easier expansion,” he said. “Establishing seats in Radiology requires a fully functional department: CT scanners, MRI machines, X-ray units, ultrasound facilities, and proper infrastructure. In contrast, expanding non-clinical departments is comparatively easier and less costly.”
The counselling data bears this out. Of the 20 candidates with the lowest scores who secured admission in the All India quota’s third round, the vast majority entered basic science subjects: Anatomy, Physiology, Biochemistry and Microbiology. Only two clinical specialities appeared, both through the NRI quota or persons with disability categories.
Chauhan adds another layer to the problem. “Every year, certain institutions repeatedly have vacant seats and require stray vacancy rounds to fill them. Despite this, approvals are granted to increase seats in the same branches in those very colleges. At the same time, institutions where seats consistently fill on merit are not expanded proportionately.”
What happens, he suggests, is that additional approvals often come in high-demand, high-fee branches such as Radiology and Medicine. “These added seats are eventually filled at very high costs. This creates a perception that the system is becoming less about healthcare education and more about financial gain.”
Against the push to fill seats stands the medical community’s insistence that some thresholds cannot be crossed. The Federation of All India Medical Association and the United Doctors Front have both filed legal challenges, taking the matter to the Supreme Court.
Dr Lakshya Mittal, Chairperson of the United Doctors Front, discovered the extent of the problem through deeper analysis of the counselling data. “This was under the All India quota, where we saw even negative scores getting admissions. And this is only the beginning. The real problem lies in the state quota.”
His prediction proved accurate. Documents from Telangana’s Competent Authority Quota counselling, dated 9 February 2026, revealed admissions at scores that made even the All India quota appear stringent. A candidate with just 1 mark out of 800 secured MS Orthopaedics. Another with 12 marks obtained MD Forensic Medicine at Osmania Medical College, Hyderabad, under the SC category.
“When MD Biochemistry or Orthopaedics are being allotted to candidates with four marks, or even minus eight marks, it raises serious questions,” Mittal said. “At that point, a candidate who does not even attempt the exam would score better.”
The criticism focuses particularly on foundational subjects. Dr D Srinath Dubyala, National President of the Federation of All India Medical Association, frames the concern in terms of cascading effects.
“Biochemistry, Physiology and Anatomy are not minor or dispensable branches. They form the foundation of medical education. A person with an MD in Biochemistry will become a professor tomorrow, responsible for teaching first-year MBBS students. That individual will shape the academic foundation of future doctors. We need to seriously ask what kind of base we are creating.”
Dubyala insists the debate is not about reservation but about minimum thresholds. “This is not about judging candidates based on their background. Many of these candidates belong to OBC, SC, and ST communities, and we are not questioning reservation. We are questioning the absence of a minimum academic standard. Asking for another exam attempt is not discrimination; it is about patient safety and medical standards.”
FAIMA has proposed conducting NEET-PG twice a year instead of repeatedly lowering cut-offs. “Instead of repeatedly reducing the cut-off and diluting merit, NBEMS should conduct NEET-PG twice a year. Vacant seats from the first round can be filled in the second attempt. With lakhs of candidates appearing every year, aspirants deserve another chance to prepare and score better, rather than being pushed in with extremely low marks.”
He contrasts India’s approach with both international precedents and domestic exceptions. “AIIMS and other INI institutions have not reduced their cut-offs, even when seats remain vacant, because they prioritise standards. Internationally too, examinations like the USMLE do not allow even a one-mark relaxation. Either you qualify or you do not.”
In a formal statement, FAIMA declared: “Merit is the cornerstone of medical education and the backbone of a robust healthcare system. Lowering the qualifying standards for postgraduate entrance exams not only compromises the integrity of the selection process but also threatens the very foundation of clinical excellence and patient safety.”
Dr Sudhir Kumar, a neurologist based in Hyderabad, challenges the entire framework of the debate. He argues that the medical community has become fixated on entrance examination scores that bear little relationship to clinical competence.
“In most debates, we start with a basic assumption that higher marks automatically mean better knowledge and better competence. We assume that someone who scores 100 percent is more intelligent and will be a better doctor than someone who scores 60 or 70. That assumption, however, is only partly true and not absolute,” Kumar said.
He draws on personal experience to make his point. “I know many excellent doctors, including some of my own teachers, who did not clear their exams on the first attempt. One of the most respected neurologists at CMC Vellore, a doctor for whom patients travelled from across the country, failed his DM Neurology exam twice and cleared it only on the third attempt. He shared this with me himself.”
Kumar argues that entrance examinations test theoretical knowledge and memory under pressure, not practical skill, judgement or temperament. “Many capable doctors perform poorly in exams due to anxiety, poor recall under pressure, or an exam format that does not reflect real clinical work.”
He points to what he sees as the real quality control mechanism. “For every MD, MS, DM, or DNB course, the pass mark is 50 percent, with no relaxation for any category, including SC, ST, or OBC. Reservation applies only at the entry stage, not at the exit stage. Four independent examiners assess the candidate, most of them from outside institutions. If the candidate is not competent, they fail and must reappear.”
This is where standards are genuinely maintained, Kumar insists. “A trainee who scored poorly in the entrance but clears the final university examination has demonstrated competence equal to anyone else. Entrance exams matter, but exit exams and supervised training matter more.”
He also challenges the notion that these candidates lack basic qualifications. “These candidates have already completed MBBS. They are already licensed doctors under NMC regulations. An MBBS doctor can legally treat patients, perform surgeries, conduct deliveries, and manage emergencies. If such a doctor does not enter PG, they can still open a clinic and practise independently.”
Kumar adds a reality check about patient behaviour. “Patients do not choose doctors based on entrance exam marks, because there is no mechanism for the public to know those marks. Today, patients are already consulting doctors who may have failed exams earlier in their careers. Marks are not displayed, nor should they be the sole determinant of trust.”
For Kumar, the focus on entrance scores is misplaced. “If we genuinely want to protect patients, the solution is not obsessing over entrance marks. The solution is periodic re-licensing exams, as followed in many developed countries, and rigorous exit assessments. That is where competence should be judged.”
Dr RV Asokan, former National President of the Indian Medical Association, locates the problem in the examination system itself. He traces the current crisis back to policy decisions made without sufficient understanding of ground realities.
“NEET-PG is a high-pressure, multiple-choice examination with negative marking. Candidates must answer a large number of questions within limited time. Fifty wrong answers can wipe out fifteen correct ones. It becomes a strategic exercise rather than a test of clinical aptitude. It heavily favours recall and speed under pressure rather than bedside judgement or practical competence,” Asokan said.
He contrasts this with postgraduate university examinations. “There are long cases, short cases, spotters, bedside discussions, practical demonstrations, and viva examinations before multiple examiners. This process evaluates communication skills, diagnostic reasoning, and clinical maturity. That format, in my view, is more aligned with real medical practice.”
The reduction in percentiles, Asokan argues, stems from deeper structural problems that the COVID period exposed. “During the pandemic, we made many compromises across the system. Medical students, interns, and house surgeons were pulled into service. Teaching was disrupted. Large portions of training shifted online. These are the batches that are now appearing for postgraduate entrance examinations. Naturally, their academic preparation was affected.”
But the issue runs deeper than pandemic disruptions. Asokan points to the seat distribution system. “Certain branches—Radiology, Dermatology, some high-demand clinical specialties—are extremely aspirational. After these seats are filled, what remain are the so-called non-fancy branches. Many candidates prefer to wait another year rather than accept a seat they do not desire. Economically weaker candidates who secure private college seats may not be able to afford the fees. So vacancies persist.”
The negative marking system compounds the problem. “With negative marking, a candidate who attempts 100 questions, gets 20 correct and 80 wrong, may end up scoring zero. If you convert that to a simple percentage without negative marking, he has effectively demonstrated 10 percent knowledge. The percentile system can dramatically alter perception.”
Asokan traces the complexity back to the expansion of private medical education. “When medical education was largely government-run, admission processes were more straightforward. With the rapid increase in private colleges and postgraduate seats—from around 36,000 to nearly 64,000 in recent years—competing financial and institutional interests entered the system. Many of these new seats are in private institutions. Pressures from these stakeholders influence policy decisions at the ministerial level.”
Underlying all these debates is a question about who should control medical education. Asokan frames this in constitutional terms.
“We must understand that medical education and health services function within a federal framework. The health needs of Kerala are not the same as those of Chhattisgarh. One state may require more infectious disease specialists, another may need more diabetologists or community physicians. These are decisions best understood at the state level.”
The move towards a single national examination, he suggests, was driven by ideology rather than practical necessity. “The move toward a ‘one nation, one examination’ model may have been driven by an ideological push for uniformity. But India is a federal country with diverse realities. Health was constitutionally placed under the states for a reason. When centralisation increases without accommodating regional needs, distortions arise.”
He points to the Justice AK Rajan Committee’s findings on NEET in Tamil Nadu. The committee found that state board students’ share of medical seats fell from 86 percent pre-NEET to 23 percent by 2020-21, while CBSE students rose from 7.7 percent to 33.3 percent. Government school students’ MBBS share dropped from 14.44 percent to just 1.7 percent. Rural student admissions fell from 65 percent to 49.9 percent.
“Coaching culture further amplifies inequality,” Asokan said. “Students who can afford high-end coaching centres gain a competitive edge in a highly academic, MCQ-based examination. That format tends to favour the urban, English-speaking, well-resourced segment of society.”
Asokan’s solution involves returning authority to those who understand the system. “Medical education should primarily be managed by medical professionals, not dominated by administrative bureaucracies unfamiliar with clinical realities. Regulatory bodies should have stronger representation from practising doctors and teachers.”
He also advocates meaningful devolution to states. “Powers should be meaningfully delegated to state governments. States understand their own workforce needs and demographic priorities better than a distant central authority. Decentralisation would allow flexibility while maintaining national standards through broad regulatory oversight.”
One aspect of the system stands apart from these controversies. The Institutes of National Importance—AIIMS, JIPMER, PGIMER and NIMHANS—continue to conduct their own entrance examination, the INI-CET, twice yearly. They have not reduced their cut-offs despite vacant seats.
Chauhan explains why this separation persists. “INI-CET has largely avoided the repeated controversies we see elsewhere—whether it is exam scheduling, counselling delays, or allegations of irregularities. Their pattern, speed of results, and counselling process have been relatively streamlined.”
These institutions operate under statutory autonomy granted by separate Acts of Parliament. That autonomy has allowed them to maintain standards even when seats go unfilled. “My view is that instead of merging everything into a single centralised structure, which could create even bigger administrative complications, we should adopt the efficiency and transparency seen in the INI-CET model across other institutions,” Chauhan said.
The contrast reveals what happens when institutions prioritise standards over utilisation. INIs accept that some seats may remain vacant rather than compromise on candidate quality. The rest of the system, under pressure to fill every seat, has moved in the opposite direction.
What emerges from these competing perspectives is not a simple story of right and wrong, but a system caught between imperatives that cannot all be satisfied simultaneously.
The government needs to fill seats that took years to create and millions to fund. Private colleges need revenue to survive. States need autonomy to address their specific healthcare requirements. The medical profession needs to maintain standards that ensure patient safety. Marginalised communities need access to opportunities that have historically been denied to them. And somewhere in this tangle of competing needs, a candidate with minus 12 marks has entered the postgraduate medical education system.
The real question is not whether entrance examination scores matter. The question is what kind of system produces a situation where they simultaneously matter too much and too little—where coaching classes determine who gets to study medicine, where negative scorers can secure seats through counselling, where Institutes of National Importance maintain standards by remaining separate, and where 20,000 seats go vacant even as lakhs of candidates compete for entry.
Dr RV Asokan puts it plainly. “If there is chaos, it is not because the concept of a single entrance examination is flawed. The idea of standardisation was sound. The problem arises when administrative interference, fear-driven decision-making, and structural weaknesses disrupt what was otherwise a reasonably stable system.”
The candidate with minus 12 marks will now undergo three years of training in Physiology. Whether that training will transform an entrance examination failure into a competent doctor depends not on the score that secured admission but on the system that will shape them—the same system that is now debating whether that admission should have happened at all.
Mittal warned about state counselling rounds months before the Telangana data emerged. “I am waiting to see what unfolds in the state counselling rounds, because that is where the real extent of the problem will become evident.”
The Telangana mop-up counselling document, showing admissions with scores as low as 1 mark for MS Orthopaedics and widespread single-digit and double-digit admissions to government colleges, confirmed that the crisis extends far beyond the All India quota and into state-controlled admission systems. It also confirmed that all the competing imperatives—utilisation, standards, equity and autonomy—have collided not in theory but in the actual allocation of medical training seats.
For now, the Supreme Court petitions continue. FAIMA calls for conducting NEET-PG twice a year. Dr Kumar argues for focusing on exit examinations rather than entrance scores. Dr Asokan advocates returning control to medical professionals and devolving power to states. The government insists the priority is filling seats.
