A parliamentary committee has raised concern over the uneven distribution of medical seats across India and the steep cost of medical education, pointing out that the situation makes it appear “as if there are no takers for the poor guardian to get their off-springs admitted in the medical colleges”.

In its 167th report presented to the Rajya Sabha on 11 December, the Department related Parliamentary Standing Committee on Health and Family Welfare highlighted that while some states enjoy a high concentration of seats, several others remain far below the national average of 75 MBBS seats per million population.

The committee noted that Karnataka, Telangana and Tamil Nadu have around 150 seats per million population, while Puducherry has close to 2,000 or more for a population of just about one million.

In contrast, states like Bihar have fewer than 50 seats per million, with Bihar itself accounting for only 21.

The panel urged the government to open new medical colleges in Delhi to ensure students from the national capital do not have to travel to other states or abroad for education.

Rejecting the Action Taken Report on its recommendations in the 157th report on the quality of medical education, the committee pressed the National Medical Commission to draft guidelines for establishing new medical colleges in states with fewer than 100 seats per million population.

The panel appreciated the UG-MSR 2023 guidelines that allow new colleges with intake capacities of 50, 100 or 150 MBBS seats.

It also pointed out that colleges with adequate infrastructure and faculty may be permitted to increase seats up to 250 in a phased manner.

The committee recommended prioritising the opening of medical colleges in underserved districts, suggesting that these institutions make use of locally available government medical colleges and hospitals for providing healthcare services.

It reiterated its concern over the affordability of medical education, stating that fees ranging between Rs 60 lakh and Rs 1 crore or more burden families.

It endorsed the idea that the government apply state fee structures to 50 per cent of seats in private medical colleges, with the remaining seats priced in consultation with state fee regulatory committees.

It also recommended need based scholarships for deserving students and suggested exploring options such as the PPP model for running colleges and tax benefits for companies involved.

On faculty shortages, especially in remote regions, the panel emphasised the importance of competitive salaries, job security and structured career growth instead of ad hoc or contractual appointments.

It called for clear criteria and milestones for promotions that recognise excellence in teaching, research and clinical work.

The committee noted that streamlining the sanctioning of posts and ensuring balanced reservation policies would help fill vacancies in a timely manner.

The report supported the Health Ministry’s view that ghost faculty undermine medical education. It said the recently introduced Aadhaar based Biometric Attendance System by the NMC would help curb this issue.

It further suggested strengthening administrative monitoring through face recognition and geo positioning based attendance systems.

The committee observed that limited seats and high demand compel many Indian students to pursue medical education abroad.

It pointed out that foreign medical graduates face significant hurdles in clearing licensing exams and securing permanent registration in India.

The Foreign Medical Graduate Regulation 2021 mandates a one year rotating internship in medical education hospitals or large non-teaching hospitals.

The panel stated that since foreign graduates help maintain the doctor to population ratio, the regulations should act as a facilitator by streamlining registration and internship processes while maintaining quality standards.

The panel said it would be appropriate for the government to expand medical colleges to reduce reliance on foreign trained doctors and accommodate more MBBS aspirants within the country.

It reiterated that the National Exit Test would enable universal and standardised assessment of medical graduates and lead to improved quality of education.

It agreed with the Health Ministry that the test represents a paradigm shift in teaching methods, learning approaches and assessment practices.

It recommended that the committee under the chairmanship of members of NITI Aayog submit its suggestions at the earliest to enable NExT Exam implementation as scheduled.

The panel also proposed dividing the country into zones with reputed institutions such as AIIMS serving as mentor institutes for other colleges within each zone.

It noted that mentor institutes can play a crucial role in monitoring academic standards and classroom practices in newly established or private medical colleges.