Medical education in India is at a crossroads, facing a complex mix of challenges that range from systemic flaws in the admission process to concerns over safety for women in medical colleges. The recent controversies surrounding the National Eligibility-cum-Entrance Test (NEET) and the tragic case of a postgraduate trainee doctor’s rape and murder in Kolkata have brought these issues to the forefront.
Here is a closer look at the medical education system in India, costs, seats, infrastructure, and controversies.
NEET exam, challenges and controversy
The National Eligibility cum Entrance Test (NEET), the gateway to medical education in India, has been marred by controversies, including paper leaks and administrative mishandling by the National Testing Agency (NTA). The exam was introduced in 2013 to replace multiple medical entrance exams conducted by states and universities. The aim was to streamline the process.
The 2024 NEET controversy arose due to multiple discrepancies during the NEET-UG exam, India’s primary entrance test for medical programmes. Allegations of question paper leaks surfaced, leading to arrests in Bihar and Gujarat. In Patna, individuals were accused of paying large sums to access the paper early, while in Godhra, a teacher was caught aiding students during the exam.
Despite claims of impossible scores and demands for a re-examination, the Supreme Court ruled on July 23 that there was no widespread issue or systemic failure, and no re-examination would take place.
How much does medical education cost in India?
According to data from the Ministry of Health and Family Welfare, as of August 2023, there are 70 medical colleges in India offering 107,948 seats.
The number of seat distribution can vary every year. Some reports suggest that roughly 55,000 seats are in government colleges, while around 50,000 are in private institutions. The skewed ratio between government and private seats already highlights the challenge of accessibility.
Government colleges have fees ranging from Rs 10,000 to Rs 50,000 per year for MBBS, which remain the most sought-after due to their affordability. In contrast, private colleges charge anywhere between Rs 3 lakh to Rs 25 lakh per year, making medical education a distant dream for many.
How long is an MBBS degree in India?
The Bachelor of Medicine and Bachelor of Surgery (MBBS) is an essential undergraduate medical programme in India, which spans 5.5 years. The course is divided into 4.5 years of academic study followed by a mandatory one-year internship.
After completing the MBBS degree, doctors can begin practising or choose to pursue specialisations through Doctor of Medicine (MD) / Master of Surgery (MS), which are typically three-year-long programmes, or pursue a two-year diploma programme.
How many MBBS seats are there?
As of December 2023, there were 1,08,848 MBBS seats available, but the demand far outstrips supply, with over a million applicants. The situation is even more dire at the postgraduate level, where only 68,000 seats are available for over 200,000 applicants.
This stark demand-supply imbalance not only drives up the cost of education but also forces many aspiring doctors to seek education abroad in countries like Russia, Ukraine, and China.
In an interview with Hindustan Times earlier this year, Mamta Purbey, in charge of international student acquisition at International at Manipal’s American University of Antigua (AUA) College of Medicine said that around 20,000 to 25,000 Indian students go to study medicine. These students look beyond “traditional Anglophone nations”, opting for lesser-known medical education options, due to the unavailability of seats in India.
Quota and reserved seats in MBBS education
In the All India Quota (AIQ), up to 15 per cent of seats in each government medical college are reserved and allocated through counselling by the Medical Counselling Committee (MCC). In 2021, the government announced that 27 per cent of AIQ seats would be reserved for Other Backward Classes (OBC) students and 10 per cent for Economically Weaker Section (EWS) students.
Seats are also allocated through a state quota.
The NTA reserves seats for Scheduled Castes (SC) (15 per cent), Scheduled Tribes (ST) (7.5 per cent), and Other Backward Classes (OBC) (27 per cent) candidates in the NEET, the qualifying exam for most medical courses in India. The NTA also reduces application fees for candidates in these categories.
Rising costs of medical education: An alarming trend
The cost of medical education in India is rapidly escalating, according to a recent report by CNBCTV18. Quoting analysts from Anand Rathi, a Mumbai-based financial services firm, the reports predicted that the cost of an MBBS degree could rise from the current average of Rs 5 lakh to Rs 11 lakh by 2035, while postgraduate degrees could see similar increases.
Despite a 110 per cent increase in MBBS seats over the past decade, the cost of medical education has risen by 11-12 per cent annually, outpacing inflation.
The high cost of private medical education and the limited availability of government seats exacerbate the problem. Many students who don’t secure a spot in government colleges end up in private institutions where the fees are significantly higher. This, in turn, subsidises the cost of healthcare provided at the mandatory hospitals attached to these colleges.
Women safety in medical colleges: A growing concern
The recent rape-murder case of a postgraduate trainee doctor at RG Kar Medical College in Kolkata has sparked outrage and concern over the safety of women in medical institutions.
Several protests have broken out across hospitals in the country, demanding safety measures and speedy justice for the victim’s family.
The situation was further exacerbated when a medical college in Assam released guidelines for female students and staff to follow, which included avoiding unpopulated and dimly lit areas. Students were upset that the notice put the onus of safety on women instead of addressing the issue at hand. The college quickly withdrew its order.
Infrastructure of medical colleges and hospitals
Many staff and students took to social media to highlight the lack of infrastructure and facilities available for doctors at medical institutions. This included having no staff room to rest in while doctors and staff were on duty spanning more than 24 hours. Doctors complained of having to sleep on patient beds, if available, or resort to the lobby, cafeteria, or look for empty rooms. Staff also complained about the lack of washrooms for staff and amenities, saying the places were not properly maintained or cleaned.
Many docotrs also recalled experiences of violence and unrest they faced from patient families and the lack of security or trained guards available.
Govt initiatives and the way forward
In his Independence Day speech today, PM Narendra Modi announced plans to add 75,000 medical seats over the next five years. This move aims to make India a global education hub, attracting international students while also alleviating some of the pressure on the current system.
However, merely increasing the number of seats may not be enough. There needs to be a comprehensive approach that includes reforms in the NEET system, stricter regulations to prevent malpractices, and significant investments in safety and infrastructure in medical colleges.
