Among the top 1,000 candidates of the NEET PG, the most preferred branch is MD (General Medicine), chosen by 404 candidates, followed by MD (Radio-Diagnosis), selected by 299 candidates.
Published Nov 24, 2024 | 7:00 AM ⚊ Updated Nov 24, 2024 | 7:00 AM
A class of medical students. (AI generated)
On 20 November, the Medical Counselling Committee (MCC) announced the NEET PG Counselling 2024 round one results, which include the candidates’ allotted institutes, ranks, and the courses they selected.
Among the top 1,000 candidates, the most preferred branch is MD (General Medicine), chosen by 404 candidates, followed by MD (Radio-Diagnosis), selected by 299 candidates.
MD (Dermatology, Venereology, and Leprosy) was the option of 73 of the top 1000 candidates, while 58 chose MS (General Surgery), 49 selected MD (Paediatrics), and 44 chose MD (Obstetrics and Gynaecology)/MS (Obstetrics), MS (Orthopaedics) was selected by 14 candidates.
Additionally, through the All India Quota, 36 candidates opted for Radio-Diagnosis, and 10 candidates selected General Medicine.
The most preferred #speciality among the top 500 ranked #MBBS #doctors in #India is #radiology, close second is #medicine.
Together they constitute 93% of the top 500!
Big fall out! #dermatology & #surgical specialities#NEETPG2024Counselling #NEETPG24 #NEETPG2024Counselling… pic.twitter.com/4RY3zchhzl— Dr. Deep Dutta (@deepduttaendo) November 20, 2024
Why are General Medicine and Radio-Diagnosis in such high demand?
The NEET PG 2024 results reflect a growing preference for specialities like Radiology and General Medicine among top candidates.
Dr Sudhir Kumar, neurologist at Apollo Hospitals Hyderabad, explained that Radiology has always been a sought-after field. Historically, during the era of capitation fees and management quotas, Radiology seats were sold for exorbitant amounts, often ranging from ₹2-3 crore.
The introduction of government regulations eventually addressed this, but MD Radiodiagnosis remained one of the most expensive and coveted specialities.
“This popularity was primarily due to the fact that many radiologists, after completing their training, would establish their own diagnostic centres. These professionals often transition from practitioners to entrepreneurs, leveraging their specialisation to build independent establishments,” said Dr Kumar told South First.
In contrast, General Medicine attracts students due to its intellectual satisfaction. “Practicing medicine requires significant analytical skill,” Dr Kumar said. “For instance, in neurology, a patient may be wheelchair-bound, yet scans show no abnormalities. In such cases, the neurologist must rely on clinical acumen to diagnose the issue.”
General Medicine offers a variety of treatment options, such as choosing the right medication for conditions like diabetes and migraines, making it intellectually stimulating.
Unlike surgery, where treatment is often standardised, medicine demands continuous learning and adaptation to evolving diagnostic techniques.
“Surgical skills require initial training and practice, but once mastered, tasks become procedural. In contrast, medicine involves constant learning and adaptation,” Dr Kumar added.
The preference for General Medicine and Radiology among top-ranking NEET PG candidates has grown in recent years, says Delhi-based health activist Dr Dhruv Chauhan.
Simultaneously, interest in surgical specialities like General Surgery, ENT, and Orthopaedics has declined.
“One major reason is workplace safety. Surgical branches inherently carry higher risks due to procedural complications, which can sometimes result in patient deaths despite the surgeon’s best efforts. This makes surgeons more vulnerable to violence from patient relatives — a crisis that has been escalating. In contrast, branches like Radiology and Medicine involve fewer direct risks, making them safer options,” Dr. Chauhan told South First.
The lack of government-provided security further exacerbates these concerns.
Many doctors avoid environments where complications could endanger their safety. Radiology is particularly attractive as it focuses on diagnosis rather than direct patient care, reducing the likelihood of conflict.
Medicine, meanwhile, offers flexibility and the potential to establish private clinics, providing long-term stability.
Dr Kumar highlighted the erosion of trust between doctors and patients.
“Thirty years ago, patients rarely questioned their doctor’s advice. Today, cross-questioning is common, reflecting growing scepticism. This loss of trust disproportionately impacts surgeons, who face backlash when outcomes are unfavourable,” he said.
Surgeons also face higher risks of litigation and accusations of negligence. Surgical complications, even when managed appropriately, often lead to lawsuits and violence.
“This is evident in indemnity insurance costs. Physicians might pay ₹2,000 annually for ₹20 lakh coverage, while surgeons pay ₹5,000-₹10,000 for similar coverage,” Dr Kumar noted.
In 2016, two Indian doctors, Arun Gadre and Abhay Shukla, published their book Dissenting Diagnosis detailing the unnecessary investigations, botched procedures and expensive, often harmful medication that riddle healthcare in India, through evidence gathered from 78 practising doctors in both private and public hospitals.
Dr Kiran Madhala, Professor of Critical Care Medicine at Gandhi Medical College Hyderabad, warned of a mismatch between societal needs and medical career choices.
“The demand for specialists in Pediatrics, Family Medicine, and Gynecology is growing, but the supply isn’t keeping pace, which may impact healthcare delivery in India,” he told South First.
Dr Kumar highlights that many doctors now prioritise work-life balance, a significant cultural shift from earlier generations.
“As a physician, I can set a predictable schedule. For instance, I can decide to see patients from 10 am to 4 pm, with only minor deviations. Surgeons, however, often lack this control due to two primary reasons,” he said.
The unpredictability of surgical complications is one challenge. A single procedure can extend by two to three hours if complications arise. Additionally, surgical emergencies are particularly time-intensive.
“If a surgeon is called at midnight, they must prepare the patient, coordinate with anaesthetists and nurses, perform the surgery, and manage post-operative care. By the time the process concludes, the entire night may be lost,” Dr Kumar explained.
This shift is fueled by younger doctors who are increasingly unwilling to tolerate the gruelling 14–16-hour workdays accepted by previous generations.
They perceive such schedules as exploitative and advocate for fairer working conditions.
“This reflects a positive trend. Doctors today are recognising the importance of personal well-being. Inspired by other professions, like software engineering —with its defined work hours and better leave policies — many now demand similar respect for their time,” said Dr Kumar.
For instance, earlier generations often worked through festivals, prioritising patient care. In contrast, today’s doctors choose specialities or roles that provide more control over their schedules.
Dr Madhala seconded the opinion, “Today’s doctors are more practical. They want to balance personal time, minimise risk, and avoid heavy investments. The profession now focuses more on achieving work-life balance.”
Dr Chauhan also noted that surgical specialities are often associated with toxic departmental cultures and high workloads in medical colleges, further discouraging interest in these fields.
Dr Chauhan has raised concerns about the proliferation of short-term diploma courses in cosmetics, aesthetics, and PRP (platelet-rich plasma) therapy. These programmes, often lasting only six months, are enabling individuals —including non-medical professionals such as salon workers — to perform invasive procedures on patients.
“This is a serious issue because such individuals lack the comprehensive clinical knowledge and training required to manage complications or provide holistic patient care.
A dermatologist spends over a decade in education and training to master these procedures. It is highly problematic that someone with a six-month diploma is allowed to perform similar work, often with no understanding of the underlying clinical science,” said Dr Chauhan.
Dr Chauhan also highlighted that professionals from unrelated fields, such as dentists (BDS graduates), are taking up these courses and performing PRP and cosmetic procedures that fall outside their area of expertise.
“These procedures are not covered in their core curriculum, yet they are able to practice due to the availability of certification courses. Allowing such practices undermines the credibility of dermatology as a specialised field,” he said.
He warned that this trend devalues the rigorous education dermatologists undergo, reducing it to superficial knowledge.
“By this logic, anyone — even a compounder — could claim to be a dermatologist simply by gaining superficial knowledge of medications and procedures. This is fundamentally different from making accurate diagnoses and providing proper treatment,” he added.
Dr Chauhan criticised the government and the National Medical Commission (NMC) for failing to address this issue effectively.
Quacks and underqualified individuals posing as dermatologists continue to operate unchecked, jeopardising patient safety and the integrity of the profession.
“This lack of regulatory oversight is a clear failure of the administration, the government, and the NMC. Their inaction has compromised dermatology as a field and reflects a broader neglect of medical education standards in the country,” he said.
In recent years, there has been a noticeable decline in the number of top-ranking medical students pursuing specialisations like Obstetrics and Gynaecology (OBG). Dr Madhala points out that despite the ongoing demand for gynaecologists in India, only about 7 percent of female top 1000 rankers are opting for this speciality.
“One surprising trend is the decline in preference for branches like OBG and Gynaecology. Despite the critical need for gynaecologists in India, especially considering the country’s maternal mortality challenges, fewer women are choosing this field,” said Dr Madhala.
While gynaecology remains essential to the healthcare system, the demand for gynaecologists is not being met by top students. Dr Madhala suggested that financial stability and ease of practice may be driving this shift in preferences.
Gynaecology is primarily a surgical field, with around 80 percent of the work involving surgical procedures. Dr Chauhan added that women gynaecologists face the same risks of workplace violence as their male counterparts due to the surgical nature of the job.
“Gynaecology is predominantly a surgical branch, and women in this field are just as prone to workplace violence as male surgeons,” Dr Chauhan said.
He also cited the tragic case of a gynaecologist in Rajasthan who died by suicide after an FIR was filed against her following a delivery complication.
“The incident underscores the immense pressure faced by gynaecologists, particularly women, who often deal with criminal charges and threats after surgical complications.”
“If gynaecologists, especially women, feel unsafe in their work environment and are constantly at risk of being blamed for surgical outcomes, it discourages them from pursuing this field or other surgical specialities,” said Dr Chauhan.
Meanwhile, paediatrics presents its own set of challenges. Dr Kumar emphasised the unique difficulty of diagnosing children, who cannot articulate their symptoms.
“In paediatrics, the primary challenge is that children cannot articulate their symptoms. Unlike adults, who can describe what they feel, infants and young children cry, leaving the diagnosis to the clinician’s observation and interpretation,” said Dr Kumar.
In addition to the physical demands of paediatric care, Dr Kumar pointed out that treating children often requires extensive counselling of parents, as they are deeply concerned about their child’s health.
“Simple procedures, like inserting an intravenous (IV) line, are much more complicated in children. The small veins and their movements require significant precision. It’s also emotionally taxing, as paediatricians often find themselves reassuring parents for much longer than the time spent on the actual medical treatment,” he said.
This emotional and physical toll can lead to burnout, as paediatricians often face high levels of stress in their daily practice.
“Pediatrics is emotionally and physically taxing, leading to higher rates of burnout among practitioners. Each case requires not only medical care but also emotional labour to reassure anxious parents,” Dr Kumar added.
These challenges highlight the complexities of both specialities, illustrating why some medical students may be steering away from them despite the critical need for healthcare professionals in these fields.
Dr Madhala said that currently, the supply of medical professionals is not aligned with the actual healthcare needs of the population.
For example, the maternal mortality rate in India is still higher than the world average, which points to a significant shortage in specialities like OBG and Gynaecology.
However, students are still not choosing these fields at a rate that reflects the country’s needs.
“To address this, it is crucial to reframe the way medical branches are structured and promoted. There is a pressing need for a more holistic approach, where fields like Family Medicine — which is well-developed in countries like the USA —could be integrated more effectively into India’s medical curriculum. Family Medicine encompasses a broad range of medical specialities and could help address many of the gaps in primary care,” Dr Madhala said.
Dr Chauhan said that Surgical seats do get filled. For instance, candidates with lower ranks, say around 10,000, might still choose a surgical speciality if someone with a higher rank did not opt for it at a top-tier college.
Many individuals are willing to take the risk associated with the field because, for them, it’s an opportunity to secure a seat in a competitive branch.
However, Dr Madhala said that while we have a sufficient number of MBBS graduates, the number of specialists across all fields, not just surgeons, is significantly inadequate. The doctor-to-patient ratio is already below the ideal standard, and the gap is even more pronounced when it comes to specialists.
Addressing this shortage requires systemic changes, including improving working conditions, ensuring safety, and incentivising specialisation to make these fields more appealing to aspiring doctors.
Irrespective of the branch, one noticeable trend is the correlation between anaesthesia and surgery.
These two fields go hand in hand, as anaesthesia is crucial for surgeries and also plays a significant role in critical care situations. However, it is evident that top-ranking candidates are not opting for anaesthesia as frequently.
Dr Madhala also said that in rural India, a significant number of surgeries are being postponed due to a lack of money, healthcare facilities, and access to specialised doctors.
A report indicates that there is an 80 percent shortfall in specialist doctors in rural areas, which is leading to the delay or cancellation of many surgeries. People in these areas are often forced to wait for long periods, sometimes until their conditions worsen, due to these shortages.
Some branches, such as general surgery, require further specialisation (super-speciality training) after postgraduate studies to advance in their careers.
This extended period of study and training can be a deterrent. For example, an MS in surgery often necessitates super-speciality training to work on vital organs, whereas fields like paediatrics are considered terminal branches, meaning no additional specialisation is required.
“Fields like medicine and paediatrics provide more immediate opportunities for practice after postgraduate studies, without the need for further training. Additionally, surgery is increasingly becoming saturated in metropolitan cities, making it less appealing to some candidates. On the other hand, branches like internal medicine remain less saturated, with ample vacancies and opportunities for growth,” said Dr Chauhan.
“People today are drawn to instant results,” said Dr. Rahul Kommu, President of the Telangana Junior Doctors Association to South First. “Surgeons don’t start earning early, even after completing their post-graduation and super-specialization. When it comes to surgery, patients tend to choose experience over specialisation.”
He added, “In recent times, people are adopting a ‘live in the moment’ lifestyle, influenced by declining life spans. This shift in mindset is one reason surgical branches are becoming less popular. Surgeons often begin earning significantly only when their hair turns grey—but in today’s uncertain world, who knows if we’ll live long enough to see our hair turn grey?”
“Another major issue is the financial and professional challenges faced by doctors after graduation. Many doctors struggle to settle early in their careers, often facing a delay in achieving financial stability. By the time they are fully qualified, they are typically in their early 30s, and it can take several more years to achieve professional success. This delayed settlement, combined with financial struggles, is pushing many doctors to reconsider their choices and even seek opportunities abroad,” said Dr Madhala.
(Edited by Rosamma Thomas.)
