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The HinduAugust 7, 2026

Access paradox: On medical education in India

The scope of medical education in India has expanded so rapidly that it raises important questions about access to it. The number of seats has nearly tripled in 12 years, thanks in part to the government’s push to improve access to health care, entailing infrastructure upgrades and simplified regulations. However, much of the growth has been happening in the private sector, in addition to new government colleges attached to district hospitals. This year, for the first time, private institutions host more than half of all MBBS seats . Of the roughly 10,000 new seats, 79% are in such institutions, a sign that growth in the near future will remain concentrated thus. The increase in seats is, in and of itself, commendable as India’s students still compete fiercely for MBBS seats even as health-care centres suffer a debilitating shortage of specialist practitioners. Thousands of students also seek education abroad. Therefore, expanding domestic ‘capacity’ is a natural response and the rising number of seats ought to relieve the bottleneck and keep talent at home. But problems abound. Whereas an MBBS seat in a government college rarely exceeds ₹5 lakh for the full term, that in a private institution can cost 10 times more, sustained in part by the unflagging demand for health care. These institutions’ commercial viability is clustered in specific geographies, especially in tier-I and -II cities in the more prosperous States, where incomes are higher. Unless their students deliberately fan out after graduation, their skills also become concentrated in these clusters, whereas the paucity of health-care providers is felt more keenly in the rural areas farther away. Rapid growth also raises the risk of highly uneven quality, with institutions seeking to secure NMC accreditation with the bare minimum of facilities rather than mindfully addressing local needs. ‘Capitation fees’, which persist despite government bans, create new debt that can influence behaviour after graduation. Finally, sans competitive salaries, housing and schools, and assured career progression, graduates gravitate to private practice or abroad. Paradoxically, then, the surge in private capacity obligates the government to keep adding capacity, including opening new AIIMS-like institutions, so the number of cheap seats also keeps increasing. The NMC’s rule of having half of all private institution seats be charged at government rates should be enforced; the NMC should also embrace mechanisms that support surprise inspections and the ability to inspect records without institutions’ permission. Finally, beyond compelling rural service, governments should reward it, in addition to ensuring that the daily needs of rural health-care workers and their families and of hospitals are both well-met. Published - August 07, 2026 12:10 am IST Read Comments Copy link Email Facebook Twitter Telegram LinkedIn WhatsApp Reddit READ LATER SEE ALL Remove Related Topics medical education / India / health / medical colleges / students

Key GK Takeaways for CLAT
  • 1Healthcare and medical education fall under the Concurrent List of the Seventh Schedule, letting both Parliament and state legislatures legislate on the subject, which explains why the National Medical Commission sets central standards while states run their own colleges. Article 47 directs the State to regard raising public health as among its primary duties, giving unequal access to medical education constitutional weight. This dual structure often creates friction between central quality norms and state-level implementation capacity, exactly the tension the editorial highlights around inspections and fee regulation.
  • 2India's push to expand MBBS seats mirrors the National Medical Commission's goal of improving the doctor-population ratio toward the WHO-recommended benchmark of one doctor per thousand people. The government's Pradhan Mantri Swasthya Suraksha Yojana has funded new AIIMS-like institutions to decentralise access beyond metros and wealthier states. Yet skewed private capacity toward tier-one and tier-two cities risks reproducing the very regional health inequities these central schemes were designed to fix.
  • 3The National Medical Commission Act, 2019 replaced the scandal-hit Medical Council of India and created a Medical Assessment and Rating Board tasked with accreditation and inspections. The Act empowers the NMC to fix fees for fifty percent of seats in private medical colleges and deemed universities, the very provision the editorial urges be enforced more strictly. Despite this, capitation fees persist in violation of state anti-capitation fee laws, reflecting an enforcement gap the Supreme Court has flagged in cases such as Islamic Academy of Education versus State of Karnataka.
  • 4The editorial notes MBBS seats have nearly tripled over twelve years, with roughly 10,000 new seats added this year alone, of which seventy-nine percent are private. A private seat can cost up to ten times a government seat's cap of five lakh rupees, meaning total course fees at some private colleges can exceed fifty lakh rupees. This fee gradient, combined with India's persistently low doctor density in rural districts compared to urban clusters, means capacity growth alone will not close the access gap without targeted redistribution incentives.

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