There are challenges in the medical education system in India and certain gaps needs to be addressed, the Economic Survey noted. Fees across private medical colleges, which hold nearly 48 per cent of the seats, “still remain high”, it said.

Although the regulatory framework has made progress, there is “opportunity to evolve and keep pace”.

One challenge mentioned is affordability. Unlike other professional education streams, medical education fees are highly regulated, but they “still remain high.”

“If universal coverage is the goal, prioritising cost and equity in medical education will be key to achieving it,” the Survey said adding that .

The consequence is that, every year thousands of students go abroad to around 50 countries especially those with lower fees such as China, Russia, Ukraine, Philippines, Bangladesh.

It also pointed out that the subsequent regulatory issues in addressing the difficulties faced by foreign medical graduates and the need to maintain standards in allowing them to practice in India “has been a challenge”.

The very low pass percentage of foreign medical graduates in qualifying exam (16.65 per cent -odd) indicates sub-par quality of medical education abroad including lack of clinical training.

“As policy intervention to dissuade medical education abroad is crafted, keeping costs is India within reasonable limits is essential,” it was suggested.

Fee structures

In government medical colleges, the respective state governments are responsible for the fixation of fees. In the case of private unaided medical colleges, the fee structure is decided by a committee set up by the respective state government under the chairmanship of a retired High Court Judge.

The National Medical Commission (NMC) has issued guidelines for determining  fees and all other charges in respect of 50 per cent of seats in private medical institutions deemed to be universities.

“Despite such measures, fees remain high – at ₹60 lakh to one crore or more in the private sector which holds 48 per cent of MBBS seats,” it said adding that “this highlights the opportunity to make medical education more accessible and affordable for all.”

Skewed In favour of Southern States

Also noted was the fact thatavailable opportunities for medical education appear to be geographically skewed, with 51 per cent of undergraduate seats and 49 per cent of postgraduate seats are in the southern states.

“Further, the availability is skewed in favour of urban areas with the urban to rural doctor density ratio being 3.8:1,” it noted adding the imbalance in distribution can be attributed to the state/region level of economic development, demand for and expansion of healthcare services, and increasing market for medical value travel.

Rural areas remain underserved, too.

The number of candidates aspiring to study MBBS increased from around 16 lakh in 2019 to 24 lakh in 2024.

The National Eligibility cum Entrance Test – Under Graduate (NEET-UG) is the single mode of entry through which students enter into medical education, MBBS courses in India and abroad.

Since FY19, the number of medical colleges has grown from 499 to 648 in FY23 to 780 in FY25, during which time the MBBS seats increased from 70,012 (FY19) to 96,077 in FY23 ; and to 1,18,137 in FY25. Post-graduate seats increased from 39,583 (FY19)to 64,059 in FY23; and to 73,157 in FY25.

There are 13.86 lakh practitioners of modern medicine registered as of July 2024, or a ratio of 1:1263.

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