Economic Survey 2025 highlights challenges in medical education, calls for lower fees

New Delhi: The Economic Survey 2024-25 warned about problems Indian medical education faces, such as remuneration gaps, migration, regulating fees of private colleges, and the increase in the number of ghost faculty.

The report also called for reducing medical education fees, which are as high as ₹1 crore in the private sector, which accounts for 48% of MBBS seats. It called on policymakers to intervene to keep costs reasonable and prevent students from going aboard to study medicine.

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In 2021, countries in the Organization for Economic Co-operation and Development (OECD) said in a report that there were almost 19,000 physicians from India in their collective workforce and around 2,800 had migrated there for work. 

Low pay leading to migration

The survey said fresh graduates receive a remuneration of around ₹5 lakh a year and senior doctors earn between ₹12.5 lakh and ₹18.4 lakh a year in cities, which causes many to migrate to urban areas. “This is almost similar or lower to the packages that are available to other graduates at the entry level,” the survey said. It added that migration trends need to be factored in while calibrating incentives for serving in the public health system to ensure doctors are available in rural areas.

Lack of faculty, high fees

The survey also highlighted issues such as shortage of faculty, ghost faculty, and low patient load in hospitals, which continue to affect the quality of training.

Unlike in other professional education streams, fees for medical education are highly regulated. State governments are responsible for fixing fees of government medical colleges, while fees of private medical colleges are regulated by the National Medical Commission (NMC).

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“Despite such measures, fees remain high – at ₹60 lakh to ₹1 crore or more in the private sector, which holds 48% of MBBS seats. This highlights the opportunity to make medical education more accessible and affordable for all, particularly, for those from less privileged backgrounds. By reducing the cost of medical education, we can contribute to lowering healthcare service costs,” it said. Because of high fees, thousands of Indian students travel to around 50 countries for medical education, especially those with lower fees such as China, Russia, Ukraine, the Philippines, and Bangladesh.

“The very low pass percentage of FMGs (foreign medical graduates) in the qualifying exam indicates sub-par quality of medical education abroad, including lack of clinical training. In 2023, only 16.65% of students qualified in the FMG exam, indicating sub-par quality of medical education abroad, including lack of clinical training,” it said. FMGs are required to complete 12 months of internship in India after receiving their degree.

Uneven distribution of seats

The survey also highlighted the uneven distribution of seats in favor of specialisations such as radiology, dermatology, gynaecology and cardiology at the cost of fields such as psychiatry and geriatrics. It said 51% of undergraduate seats and 49% of post-graduate seats are in south India. 

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“Further, the availability is skewed in favour of urban areas with the urban-to-rural doctor density ratio being 3.8:1. These patterns tend to follow the pattern in availability of healthcare services in general. It has been estimated that 75% of dispensaries and 60% of hospitals are in urban areas, where 80% of doctors serve. 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,” it said.