Earlier this year, 26 of the state’s 34 medical colleges received show-cause notices from the National Medical Commission for severe faculty shortages, which make it impossible to meet even basic teaching requirements.
Published Dec 28, 2025 | 5:31 PM ⚊ Updated Dec 28, 2025 | 5:31 PM
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Synopsis: Telangana is planning an unusual recruitment scheme called ‘You quote, we pay’ to address acute faculty shortages in its rural medical colleges, after 26 of its 34 colleges were flagged by the National Medical Commission for failing to meet basic teaching requirements. Under the scheme, the government will set remuneration at nearly three times the regular pay for senior positions such as associate professors and allow candidates to bid downwards, with the lowest salary quote winning the job.
In rural Telangana, entire departments of medical colleges are being run by assistant professors. Associate professor positions are vacant. Professors are nowhere to be found. Senior doctors have long since departed for urban postings, leaving both medical education and healthcare delivery in tatters.
Earlier this year, 26 of Telangana’s 34 medical colleges received show-cause notices from the National Medical Commission for severe faculty shortages, which make it impossible to meet even basic teaching requirements.
Now, Dr A Narendra Kumar, director of medical education for Telangana, is preparing to launch what may be the most unusual recruitment scheme in Indian medical education: ‘You Quote, We Pay’.
Here is how the scheme works: for positions that nobody wants—radiology in Adilabad, cardiology in Asifabad, anatomy and biochemistry in district colleges across Telangana’s tribal belt—the government sets a maximum consolidated salary. Typically, this ceiling is three times the regular pay. A professor who would normally earn ₹2 lakh a month might see the maximum set at ₹6 lakh.
Then comes the twist. Candidates bid downwards. If one doctor says they will come for ₹5.75 lakh, another for ₹5.5 lakh, and a third for ₹5 lakh, the lowest bidder gets the job.
“This is a demand-supply issue,” Kumar explained to South First. “Nobody is willing to go to Adilabad, Asifabad, those centres. So they will be taken against that with a good pay.”
The programme, proposed by the National Health Commission, will initially target 10 colleges, specifically those with the lowest AEBAS (Aadhaar-based attendance system) scores and at risk of NMC de-recognition. “So this we are going to implement only to those colleges because AEBAS attendance, we take that criteria.”
The criteria is brutally efficient: which colleges are haemorrhaging faculty so badly that students are not getting adequate teaching time?
The target specialities reveal the depth of the crisis: radiology, cardiology, neurology, obstetrics and gynaecology, paediatrics, and the basic sciences that form the foundation of medical education—anatomy, biochemistry and physiology.
The desperation driving ‘You Quote, We Pay’ becomes clearer when one considers what the government has already tried, and failed, to do to solve this crisis.
A massive recruitment drive is under way. Around 2,000 assistant professors are being recruited, with results for 607 candidates about to be released and another 1,300 still awaiting results. But there is a structural problem that makes even this inadequate: assistant professor is the only entry point in the Directorate of Medical Education. Associate professor positions are promotional posts. They cannot be hired directly from outside.
“Professors are there. Assistants are there. Bottleneck is in the associates,” Kumar said, his frustration evident.
The promotion pipeline is clogged. The system can be flooded with fresh assistant professors, but if they are not eligible for promotion, the middle ranks remain empty. Medical colleges, meanwhile, need experienced associate professors to anchor departments, supervise juniors and maintain teaching standards.
Then there is the peripheral allowance of 30 percent to 50 percent of basic pay for doctors willing to work in nine identified tribal districts. “The file is already in circulation,” Kumar noted, though he could not say when it would actually be implemented. “But the government is firm to implement.”
Telangana produces over 9,000 MBBS graduates annually, well above national averages on paper. But this numerical adequacy masks profound geographic inequality. The concentration around Hyderabad is intense; the void in districts such as Nirmal, Kamareddy and Nizamabad is correspondingly deep.
Parliamentary reports have noted the paradox. Telangana exceeds national averages for doctor-to-population ratios, yet fails spectacularly at equitable access. The problem is not shortage; it is distribution.
And distribution, ultimately, is about incentives, or the lack of them.
The scheme attempts to create an incentive where none existed. It acknowledges what traditional government recruitment often refuses to admit: that some postings are so undesirable they cannot be filled at standard rates, and that in a market economy, labour goes where it is valued most.
Kumar’s responsibilities extend beyond staffing. He recently inspected MGM Hospital in Warangal following an incident in which a 27-year-old patient recovering from a leg amputation was bitten by a rat. It was part of a series of rodent attacks at the 75-year-old facility.
“Some hospitals are 30 years, some 50 years, some 100-year hospitals,” Kumar explained. “They are meant for a particular number of patients, but they are serving since decades together. So the infrastructure is same, but footfalls are increasing.”
MGM will shift to the new Warangal Health City, a 1,750-bed facility estimated to be ready in six to 18 months. Osmania General Hospital will move to a new 2,000-bed complex at Goshamahal.
The IHFMS (Integrated Hospital Facilities Management Services) scheme, which governs sanitation, security and patient care, is being revised. Introduced in 2017 at ₹5,600 per bed and revised to ₹7,500 in 2022, the proposal now stands at ₹9,500 per bed, with tighter qualification requirements. These include certified pest control personnel and nursing-qualified staff for patient care.
All 35 medical colleges will establish geriatric centres, with the National Institute of Medical Sciences serving as the centre of excellence. This responds to demographic shifts as Telangana’s population aged 60 and above grows, though the State currently has only two dedicated geriatric facilities.
Four IVF centres have been identified. Gandhi Hospital and Peta Alburru are operational; MGM Health City and Adilabad are planned.
At TIMS Sanath Nagar, a new cardiac, cardiothoracic and organ transplant facility is expected to be handed over in January. It will initially be staffed temporarily by NIMS doctors until autonomous recruitment is complete.
The ‘You Quote, We Pay’ scheme proposals are ready and awaiting government approval. Kumar said the scheme would be presented to the minister before year-end, followed by finance approval since it involves increased employee numbers and tariffs.
“It may take around two to three weeks,” Kumar estimated, referring to the finance approval process once ministerial clearance is obtained.
