FM announces 10,000 more medical seats in Budget 2025-26, but can infrastructure keep up?

In the next year, 10,000 additional seats will be added to medical colleges and hospitals as part of the goal to add 75,000 medical education seats over the next five years, Finance Minister Nirmala Sitharaman said on Saturday, while presenting the Union Budget 2025-26. 

She stated that the government has added nearly 110,000 undergraduate and postgraduate medical education seats in the past 10 years, marking an increase of 130%. While experts have welcomed the move, they pointed out that the government will have to improve the infrastructure of medical colleges and increase faculty numbers to keep pace with the growing number of students.

“Simply increasing the number of seats is not a solution. Without adequate hospitals for practical training, theoretical classes alone are ineffective. Medical science is a field that requires well-equipped hospitals and modern facilities alongside classrooms and qualified instructors,” said Arup Mitra, Professor of Economics at South Asian University (SAU) in New Delhi.

Despite the government's ambitious expansion of medical education, it remains unaffordable for many, pushing thousands of students abroad to low-cost destinations like China and Russia, government’s Economic Survey 2024-25, tabled in Parliament by Finance Minister Nirmala Sitharaman a day before budget indicated.

“Additional seats in institutions of medical sciences are a welcome move, as they will help reduce the dominance of the private sector in this field. However, job creation is equally important; otherwise, graduates will join private hospitals and focus solely on profit-making. A profession once regarded as the noblest has, over time, become increasingly commercialized,” said Mitra.

The decision to add 10,000 seats per year—an increase of nearly 5% of the current capacity.. “This will help improve the doctor-patient ratio and make both secondary and tertiary care more accessible and affordable. Every additional seat also translates to the addition of four beds to the medical college and hospital. In five years, this initiative would add 300,000 more beds, nearly one-third of the current capacity in the public sector. The government may consider expanding existing medical colleges wherever possible to optimize expenditure,” said Satyam Shivam Sundaram, Partner Strategy & Transactions, government advisory services, EY India.  .

Even as the number of doctors grows, a severe imbalance persists—rural areas remain underserved, and specialisations such as psychiatry and geriatrics are neglected. Meanwhile, low remuneration and better opportunities abroad are driving Indian doctors to migrate, creating a global workforce at India's expense, the economic survey said.

Affordability remains a key issue. While government medical colleges have lower fees, private institutions, which offer almost half of all MBBS seats, charge ‘high fees’. The Economic Survey said, "High fees in private medical colleges, often in the range of ₹60 lakh to ₹1 crore, make medical education unaffordable for many students. Efforts to cap fees for 50% of private medical seats have not significantly changed the situation. As a result, many Indian students opt for medical education abroad in countries like China, Russia, Ukraine, and the Philippines, where fees are lower.”

The survey further said, "Every year thousands of students go abroad to around 50 countries, especially those with lower fees." However, this trend not only drains financial resources but also presents uncertain career prospects. Many Foreign Medical Graduates (FMGs) struggle to pass India’s licensing exams, with the survey noting that "only 16.65% of students cleared the Foreign Medical Graduate Examination (FMGE) in 2023."

Even as the number of doctors rises, their distribution remains imbalanced. More than "51% of undergraduate seats and 49% of postgraduate seats are in the southern states," the survey said, while rural areas remain underserved. The doctor-patient ratio in urban areas is significantly higher than in rural regions. With "75% of dispensaries and 60% of hospitals in urban areas, where 80% of doctors serve," fresh graduates continue to gravitate towards cities where infrastructure, salaries, and career opportunities are more appealing. The expansion of medical education has done little to address this imbalance, leaving many rural populations without adequate healthcare, it pointed out.

There is also an imbalance in the choice of specialisations. Fields like radiology, dermatology, and gynaecology attract more students, while areas such as psychiatry, geriatrics, and emergency medicine receive less attention. The Economic Survey said, "Specialities like psychiatry, geriatrics, etc., are neglected," and warned that the shortage of specialists in these fields could grow. This is concerning, given India’s ageing population and increasing mental health needs. Without policies to encourage students to pursue these specialisations, the country may face a shortage of specialists in crucial areas.

Remuneration for doctors further complicates the situation. Fresh MBBS graduates in India earn an estimated ₹5 lakh per year, while senior doctors earn ₹12.5-18.4 lakh—salaries that can be comparable to or lower than those in other sectors. With limited financial incentives, many doctors seek opportunities abroad. The survey said, "The OECD countries reported in 2021 that there were close to 19,000 physicians from India in their workforce, and migration in 2021 alone was over 2,800 physicians." This trend raises concerns about India’s investment in medical education, as it supplies a trained workforce to foreign healthcare systems.

Meanwhile, quality control in medical education remains a challenge despite regulatory oversight. The Economic Survey said, "Despite the elaborate regulations and monitoring, issues like shortage of faculty, ghost faculty, low patient load in hospitals, etc., continue to affect the quality of training." The National Medical Commission (NMC) has introduced measures such as Aadhaar-based attendance tracking and CCTV monitoring, but enforcement remains inconsistent.