Too many medical college seats in some states, too few in others: Why the central regulator wants this corrected

The notification has angered the southern states, none of which are now eligible for any more medical education seats. The NMC has argued that the guidelines will bring down regional disparities in the availability of doctors, and ensure effective quality education for all.

“With this ratio, there will be still potential for the addition of about 40,000 MBBS seats in the country if the medical colleges are evenly distributed,” the NMC said in a statement on October 9.

How are medical college seats currently distributed among states?

The table shows the number of seats in medical colleges in all states and Union Territories, as against their projected populations. The data show that it isn’t just states in South India that have exceeded the NMC’s new recommended population-to-seats ratio.

Table 1

Table 2

At least 13 states and UTs have more than 100 seats/ million population and are not eligible to increase capacity. Tamil Nadu — whose Chief Minister M K Stalin has said the NMC guidelines are a “direct encroachment” on the state’s rights and “legally untenable”, and asked the Prime Minister to intervene — has the most seats (11,225), followed by Karnataka (11,020) and Maharashtra (10,295). However, while TN and Karnataka have exceeded the NMC’s norm by 46% and 63% respectively, Maharashtra, with its estimated 12.6 crore population, is well below the threshold.

The deficiency of medical college seats in relation to population is the most acute in Meghalaya, Bihar, and Jharkhand, all of which are in deficits of more than 75% from the NMC’s recommended ratio. Meghalaya has only 50 seats for an estimated 33.5 lakh people; these numbers for Bihar and Jharkhand are 2,565 and 12.7 crore, and 980 and 3.9 crore respectively. Uttar Pradesh, the most populous state, has 9,253 seats, a deficiency of 61%.

The stark deficiencies in some states are in spite of a push from the government to increase the number of seats. Over the last nine years, the government has doubled the numbers of both undergraduate and postgraduate medical seats. (Critics say this has come at the cost of the quality of education.)

Will states with an excess of medical college seats have to start shutting colleges or cutting seats?

No. The notification by the undergraduate medical board says the ratio will be applicable only if new medical colleges are sought to be established or seats in existing colleges are sought to be increased from the 2024-25 batch onward.

So is there merit in the NMC’s argument?

With the increasing numbers of private medical colleges, experts agree there is a need to rationalise. Prof Vivek Saoji, vice-chancellor of Bharati Vidyapeeth, Pune, and a former VC of KLE Academy of Higher Education and Research of which Jawaharlal Nehru Medical College, Belagavi, is a part, said: “This move was necessary to ensure a good distribution of medical colleges across the country. Places such as Puducherry, Mangalore, or Pune have several medical colleges but a state like Meghalaya has only one college.” Opening of more colleges in, say Bihar, could result in a reverse migration of staff from the southern states, he said.

Dr Nandini Sharma, a former dean of Delhi’s Maulana Azad Medical College, said the NMC’s ratio is based on the World Health Organisation’s recommended number of physicians per unit of population. “We have seen what happened with dentistry. With a very high number of dental students graduating, many don’t really practise. They get into some government programme or an allied field,” she said.

Dr Sharma pointed out that despite the number of medical colleges and seats having increased in the last few years, there is a shortage of faculty even at hospitals like MAMC and AIIMS in the capital.

NMC has said it has been cautioned by courts earlier to ensure colleges are not bunched together. “With an objective of providing the right teaching environment…and improving the overall quality of education, the provision of limiting UG seats in each state to 100 per million populations has been included. It is expected that this will reduce regional disparities in the availability of healthcare professionals and will go a long way in ensuring effective quality of education,” it has argued.