India has witnessed a dramatic rise in the number of MBBS seats and new medical colleges across the country. On paper, this looks like a dream for thousands of medical aspirants. More doctors, more opportunities, more healthcare access.

But inside teaching hospitals and classrooms, another story unfolds — one of strained faculty, overworked residents, inconsistent infrastructure, burnout, ethical dilemmas, and fear that quantity may overtake quality.

As a clinician and medical teacher, I see both sides — the hope, and the concern.

The Promise of Expansion

The intent behind increasing MBBS seats is noble and necessary:

• Reduce doctor–population ratio

• Improve healthcare access in rural and underserved districts

• Create future specialists, researchers and educators

• Reduce the extreme competition and psychological toll of entrance exams

But just adding seats is not medical reform. A doctor is not produced by admission alone — but by mentorship, clinical exposure, ethics and mental stability.

Where the System is Struggling

1. Faculty Shortage — The Heart of the Crisis

• Many new medical colleges are functioning with minimal faculty, especially in Anatomy, Pharmacology, Psychiatry and General Medicine.

• Senior residents and junior doctors are often unofficially used to “fill gaps” in teaching, while also managing large patient loads.

• Faculty burnout is real — between academic duties, thesis guidance, hospital rounds, paperwork and NMC inspections, teaching becomes secondary.

Result: Students get degrees, but not mentorship.

2. Infrastructure Without Soul

Some colleges have impressive buildings, digital lecture halls and simulation labs, but:

• Low patient inflow = poor clinical exposure.

• Shortage of cadavers affects anatomy teaching.

• Library subscriptions and journals remain outdated.

• Psychiatry, palliative care and family medicine units often exist only “on paper”.

Medicine cannot be learnt only from PowerPoints and OSCE checklists. It needs patients, empathy and lived experience.

3. Research – Mandatory but Mechanical

The new guidelines encourage research and publications for faculty promotions and PG eligibility — a positive move, but:

• Many institutions lack training in research methodology.

• Plagiarism, paid journals, ghostwriting and “rush work” near appraisal time are becoming normalised.

• Residents complete dissertations as a formality, not as scientific curiosity.

Research should produce questions and answers — not just certificates.

4. Student Mental Health — A Silent Emergency

With increased seats, more students are entering medicine — but:

• Ragging may have reduced, but loneliness, imposter syndrome and academic pressure are rising.

• Many struggle with language barriers, financial stress, relocation and fear of failure.

• Suicide, substance use, depression and burnout are increasingly reported among medical students and residents.

• Very few colleges have accessible counsellors or confidential support systems.

We train students to save lives, but rarely teach them how to protect their own.

5. Rural Posting — Still a One-Way Ticket

The expansion aimed to produce doctors for rural India, but in reality:

• Many graduates aim only for NEET-PG, USMLE or PLAB.

• Bonded rural service is often seen as punishment rather than purpose.

• Lack of safety, accommodation, equipment and support in PHCs makes young doctors feel abandoned by the system.

We cannot expect compassion from doctors who feel neglected by the very system they serve.

So, What Should Be Done? A Way Forward

✅ Strengthen Faculty, Not Just Buildings

Better salaries, academic freedom, protection from administrative harassment and opportunities for training and research will attract quality teachers.

✅ Mandatory Student Support & Counselling Cells

Every medical college must have a functional mental health unit, peer support groups and compassionate mentorship.

✅ Quality-Focused Accreditation

Approval of colleges should not depend only on infrastructure but on:

• Patient numbers

• Faculty–student ratio

• Research ethics

• Student satisfaction and well-being

• Transparent exit exams and competency assessments

✅ Promote Primary Care and Family Medicine

Encourage young doctors to see rural healthcare as nation building — not a temporary punishment.

Final Reflection

Increasing MBBS seats is a milestone — but education is not about numbers, it is about nurturing human beings who will sit beside a suffering patient at 2 AM and make the right decision.

India does not just need more doctors.
India needs better doctors — ethical, empathetic and well-trained.

And that requires not just expansion, but transformation.

👨‍⚕️ Written by

Dr. Srinivas Rajkumar T
MD (AIIMS, New Delhi), DNB, MBA (BITS Pilani)