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Despite an over 100 per cent increase over the last 10 years, undergraduate and postgraduate medical seats in India, continue to be in short-supply.
The annual influx is approximately 2 million (medical students) at the undergraduate level and only 1/20 times of the seats are available across colleges. The number of available seats at PG level, is further less than the demand, it was noted in a report by the Parliamentary Standing Committee on Health and Family Welfare.
The Committee report said, there is a need to significantly increase medical seats in both undergraduate and postgraduate courses.
As per the Centre’s estimates, there are 702 medical colleges in the country in FY24, up by 81 per cent from 387 in 2013-14. While the number of seats for an undergraduate course (MBBS), stood at 1,08,990 for the fiscal, up 110 per cent from 2014, when it was 51,348.
The postgraduate seats increased to 68,073 ,up 118 per cent on a 10 year period. In the 2013-14 period, it was 31,185.
The latest data by the National Testing Agency, show 20,87,462 candidates registered for the exam this year, out of which 20,38,596 candidates appeared and 11,45,976 candidates cleared the NEET UG examination.
“The government’s existing scheme, which focuses on establishment of new medical colleges attached to district or referral hospitals, can be instrumental in achieving this goal,” the report said, adding “By expanding this initiative, the Government can create more opportunities for aspiring medical students”.
Private Investments
It was recommended that there needs to be a push towards “encouraging private investment in medical education”. Policy support was also required.
There needs to be work on providing incentives and regulatory support to private institutions who would look at establishing medical colleges. This will increase seat availability and also introduce healthy competition and innovation in medical education.”
The report on “Quality of Medical Education in India” has been tabled in both Houses of the Parliament.
Shortage of doctors
Shortage of doctors is a global problem (barring a few countries), the Committee noted. But developed countries are able to meet this shortfall, by serving as attractive destinations for medical graduates from developing countries and by easing the process for the practice of medicine by the international medical graduates.
Faculty shortage and existence of ghost faculty have been identified as areas where attention needs to be given.
A recent assessment of 246 medical colleges in 2022-23 by the Undergraduate Medical Education Board, revealed no medical college had adequate faculty members or senior residents and all failed to meet the 50 per cent attendance requirement. The assessment brought to light that most of the colleges had either ghost faculty or senior residents, or had yet to employ the required faculty at all.
The report stated, average MBBS course fees across Government colleges here (both centrally funded, and State Government funded) can reach up to ₹50,000 per annum (₹1,350 in AIIMS, New Delhi).
However, such subsidised medical education can only be availed by a select few, who perform exceedingly well in the NEET UG exam, it said, pointing out that where there were 56,193 Government seats in MBBS, and over 11 lakh candidates qualified for the NEET UG exam in 2023. “Therefore, more than 10 lakh MBBS aspirants are left either to opt for MBBS seats in private medical colleges where the course fees can range up to ₹1.5 crore or to pursue their dream in countries like China, Ukraine, and Russia, where the cost is lower in comparison to private colleges in India,” the Committee observed.
It was also suggested that there was a need to maintain a national database of resident doctors “on a real-time” basis and akin to the GME Track of the USA.
Practice in underprivileged areas
The Committee suggested that an India-specific approach needs to be worked out that considers the healthcare needs for the next 20-25 years and also look at the possibility of providing incentives to doctors who work in underprivileged areas.
The Centre should identify specialisations such as pediatricians, ophthalmologists, neurosurgeons, critical care specialists and infectious disease specialists that would be required “rather than just randomly increase the general surgery, pharma and anatomy seats”.
The report mentioned, “….distribution of doctors’ workforce across the country, especially in the underprivileged areas can be worked out by offering incentives, monetary or otherwise.”
The Committee pointed out that, quality in medical education has a direct impact on the quality of healthcare services.
Adoption of Flexner Model
The Parliamentary panel has recommended that the National Medical Commission, which it said, is already at par with international peers - should take up a comparative study of the best practices of its parallel organisation in various countries.
The Committee mentioned that the Flexner Model has been adopted across counties and are also “changing it suitably whenever required”.
“The Committee recommends that the National Medical Commission undertake a comparative study of best practices of its parallel organisation in various countries…. this measure, can help NMC to usher in best practices followed around the world,” the report said.
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