Critics argue that the NMC's guidelines infringe on state autonomy, with leaders from Tamil Nadu and Karnataka expressing concerns. They claim the regulations undermine federalism by limiting states' ability to establish new medical colleges and expand MBBS seats
Published Dec 24, 2024 | 7:00 AM ⚊ Updated Dec 24, 2024 | 7:00 AM
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The National Medical Commission (NMC) has placed the Gazette Notification section in abeyance for the academic year 2025-26 that could have otherwise halted the establishment of new MBBS seats in the southern states.
According to the commission’s Extraordinary Gazette Notification dated 16 August 2023, the Guidelines for Undergraduate Courses under the Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses & Assessment and Rating Regulations, 2023 mandate that medical colleges must adhere to a ratio of 100 MBBS seats for every 10 lakh population in a given state or Union Territory (UT).
This stipulation placed the southern states, which already have a high number of MBBS seats, in a difficult position. If the formula of 100 MBBS seats per 10 lakh population is enforced, states like Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, and Telangana would be unable to establish new medical colleges, as they have already exceeded this threshold.
For the academic year 2024-25, the NMC permitted the establishment of new medical colleges and additional seats in existing institutions. However, on 5 December 2024, when the notification for new medical colleges and seat increases was issued, the NMC explicitly stated that the regulations outlined in the UG-MSR 2023 Gazette Notification would be followed.
In a subsequent development, the NMC issued another notification on 19 December 2024, placing this section of the guidelines in abeyance once more. Additionally, it introduced a cap of 150 seats per medical college.
“The following Objective mentioned under Chapter-I of UG-MSR 2023 notified on 16/08/2023, are kept in abeyance for Academic year (AY:2025-26): (i) College seeking increased number of seats cannot exceed a total of 150 MBBS students from the year 2024-25. Provided that the medical college shall follow the ratio of 100 MBBS seats for 10 lakh population in the state/U.T,” said the NMC in the notification.
Since the notification was first issued in August 2023, southern state governments, Members of Parliament, and health ministers have raised concerns with the Union government, under whose jurisdiction the NMC operates.
In July, Telugu Desam Party (TDP) MP Magunta Sreenivasulu Reddy brought up the issue in Parliament, urging a review of the capping. In response, Union Health Minister JP Nadda stated that the government is also prioritising the quality of doctors graduating from these medical colleges.
#Parliament: @JaiTDP MP @magunta_msr raised the issue of capping the number of medical seats in states, especially southern states, which will be impacted by the NMC policy.
In response, Health Minister @JPNadda said they are looking into the issue and are also considering the… pic.twitter.com/ag55hXMxBH
— South First (@TheSouthfirst) July 26, 2024
In Andhra Pradesh, MBBS courses will commence at Dr. YSR Government Medical College in Pulivendula and Government Medical College in Markapuram. Meanwhile, Government Medical College Adoni and Government Medical College Madanapalle were initially scheduled to begin courses this year, but have been deferred to the next academic year, as confirmed by the state government.
In Karnataka, the government had planned to start MBBS courses at Kanakapura and Ramanagara medical colleges this year. However, the necessary permissions were not granted, and the courses are now slated to begin next year.
In Tamil Nadu, the government is planning to establish six new medical colleges in a phased manner. These colleges are proposed in Mayiladuthurai, Tirupattur, Tenkasi, Perambalur, Ranipet, and Kancheepuram.
Critics argue that the NMC’s guidelines encroach on the autonomy of state governments to oversee their own educational and healthcare systems. Leaders from states like Tamil Nadu and Karnataka have expressed concerns, asserting that these regulations undermine the principles of federalism by restricting their ability to establish new medical colleges and expand MBBS seats in response to local demands.
There is apprehension that limiting the growth of medical education could impede the social and economic progress of southern states, widely regarded as benchmarks for healthcare delivery in India. Critics warn that the NMC’s restrictive policies might deter investment in human resource development and medical education, ultimately compromising healthcare accessibility.
While the NMC maintains that capping medical seats will improve education quality and prevent overcrowding, many experts challenge this stance. They argue that increasing the number of medical colleges and seats is essential to addressing India’s persistent shortage of doctors. More medical institutions, they contend, would lead to better healthcare outcomes, as a larger pool of trained professionals could serve communities nationwide, not just their native states.
Supporters of the NMC guidelines argue that an overabundance of medical seats could lead to unemployment among graduates. However, critics contend that this view neglects the larger issue of India’s critical doctor shortage, particularly in underserved areas.
The guidelines place a strong emphasis on ensuring that medical graduates meet specific competencies, which standardises training across institutions. This approach aims to produce well-rounded doctors equipped with the skills and knowledge to address a wide range of healthcare challenges effectively.
By regulating the establishment of new medical colleges and capping the number of MBBS seats based on population metrics, the NMC seeks to prevent an oversupply of medical graduates in certain regions. This strategy is intended to maintain the relevance of medical education and ensure that graduates have adequate opportunities for employment in their field.
Additionally, the NMC’s efforts to align India’s medical education system with international standards are widely regarded as a step forward. This alignment enhances the global competitiveness of Indian medical graduates, enabling them to excel both within the country and on the international stage.
“There may be a perception that new medical colleges are not of high quality, but here, our systems are modern, and our faculty members come from top institutions like Osmania Medical College and Gandhi Medical College,” Dr K Ramesh Reddy former Director of Medical Education in Telangana, and the Principal of newly established Government Medical College at Yadadri-Bhuvanagiri told South First. “I am certain these students will receive an education that rivals any other institution.”
Dr Reddy highlighted a recent guideline requiring students to adopt families in nearby villages, allowing them direct patient interactions from their first year.
“These students will engage first-hand with rural patients, who represent 70 percent of India’s population. This experience will be invaluable — not only for training them in clinical skills but also in communication. Learning to connect with patients on a human level is vital, and by the time they graduate, these students will be exceptional doctors,” he said.
Dr Reddy also noted that AIIMS Bibinagar, a prestigious national medical institution, initially began operations on this very campus with just 50 seats.
“In the same way, Yadadri-Bhuvanagiri Medical College is starting on a solid foundation and will soon stand as a competitive institution on par with the best in the country,” he said.
On 22 December, the Supreme Court emphasised India’s acute shortage of doctors while directing the Medical Counselling Committee (MCC) to conduct a special round of counselling to fill vacant medical seats for National Eligibility cum Entrance Test (NEET) undergraduate courses.
A Bench comprising Justices BR Gavai and KV Viswanathan issued the directive in response to a plea seeking an additional counselling round for seats that remained vacant even after the fifth round of admissions.
“Considering the peculiar facts and circumstances, and the need to ensure that precious medical seats are not wasted at a time when the country is grappling with an acute shortage of doctors, we are inclined to extend the admission period as a last opportunity,” the Court stated.
The Bench directed the Admission Authorities to hold a fresh stray or special counselling round for the remaining vacant seats and complete the process by 30 December 2024, under all circumstances.
(Edited by Ananya Rao)
