India’s MBBS Vacancy Paradox: Seats of Promise, Seats of Waste

Despite record expansion in medical colleges, thousands of MBBS seats remain vacant, exposing cracks in policy, affordability, and access.

By P SESH KUMAR

NEW DELHI, September 11, 2025 — India’s medical education system presents a bewildering contradiction. On one hand, the government proudly showcases an unprecedented expansion in medical colleges and MBBS seats. From 83,275 seats in 2020–21, the figure has risen to nearly 1,16,000 in just four years, a leap of almost 40%. On the other, the system stubbornly allows thousands of MBBS seats to remain vacant every year, despite an ocean of aspirants battling the brutal gauntlet of NEET.

In the last four years alone, 11,966 MBBS seats—precious gateways to producing badly needed doctors—have gone waste. Evidently, an ambitious expansion in strength of medical education has collided with structural inefficiencies, inequities, and a regulatory regime that has yet to match vision with execution.

I seek to delve deeper on ‘What ails Indian Medical Education’ in my forthcoming book-due for release in October 2025.

A Narrative of Contradictions

When the Union Minister of State for Health, Anupriya Patel, rose in the Lok Sabha this August to announce that nearly 12,000 MBBS seats had gone unfilled in four years, it was not a routine disclosure of statistics—it was a public admission of systemic failure.

The seats were not in obscure corners of the system but across India’s sprawling medical education network, excluding only AIIMS and JIPMER. The academic year 2022–23 stood out with a stunning 4,146 vacancies, a figure that mocked both the rhetoric of expansion and the desperation of students who had mortgaged their adolescence to crack NEET.

The government points to a glittering matrix of new seats and new colleges. Uttar Pradesh expanded its intake from 7,428 to 12,325; Tamil Nadu from 8,000 to 12,000; Karnataka from 9,345 to 12,194; Maharashtra from 9,000 to 11,844. Nagaland, which once had no MBBS seats, now has 100.

Manipur more than doubled its tally, while Meghalaya tripled. It is a story of expansion on paper, a map dotted with new opportunities. Yet, behind the arithmetic lies a darker truth—thousands of these opportunities go unclaimed, exposing a gaping disconnect between demand, accessibility, and execution.

Why Do Seats Go Vacant?

The government would have us believe that every additional seat is a victory for the poor patient in rural India who today struggles to find a doctor. But the pattern of vacancies suggests otherwise. Seats remain unfilled not because there are no takers, but because the design of the system erects insurmountable barriers.

The NEET examination, touted as a great equaliser, often operates as a cruel sieve. Many aspirants score close to the cut-off but fail to secure admission because of the rigid layers of central and state quotas, reservation rules, and fee structures that tilt the playing field in favour of the privileged.

Private colleges, emboldened by demand, slap on astronomical tuition fees. For a middle-class family, even clearing NEET is no guarantee of entry—affordability becomes the final, brutal filter.

Vacancies also cluster in states where private-sector dominance is overwhelming. A large number of seats in high-fee private colleges simply find no buyers. Add to this the reluctance of students to take up seats in colleges with poor infrastructure, dubious faculty arrangements, or inadequate clinical exposure.

The National Medical Commission’s Minimum Standard Requirement Regulations of 2023 may mandate 220 beds, child-care centres, museums, and eight patients per student per day, but on the ground many colleges are paper tigers, unable to inspire confidence. Students vote with their feet.

The Regulatory Labyrinth

The National Medical Commission, born amid much fanfare to replace the scandal-ridden Medical Council of India, is still finding its feet. Its regulatory zeal has produced elaborate guidelines but not necessarily better outcomes. The insistence on structured rural postings, research centres, and full-time faculty reads well in a notification but collapses under the weight of poor monitoring.

Even when colleges fall short, approvals often arrive with a nod and a wink, leading to the peculiar Indian paradox of “vacant seats in a country of shortages.”

Meanwhile, government schemes continue at full throttle. One hundred and thirty-one new colleges have already opened under the Centrally Sponsored Scheme of upgrading district hospitals. Super-specialty blocks under PMSSY have mushroomed.

Twenty-two AIIMS have been approved. Yet, the haunting question remains—are we building shells that cannot fill their own classrooms?

The Wasted Opportunity

Consider the irony: India produces one doctor for every 1,457 people, far worse than the WHO’s recommended 1:1,000 ratio. Rural areas remain chronically underserved, with many villages never seeing a qualified doctor. The COVID-19 pandemic laid bare the fragility of India’s health manpower.

And yet, in the very same years, nearly 12,000 MBBS seats lay vacant, a waste of national resources and a betrayal of those who could have worn the white coat.

The situation also exposes deep regional inequities. While some states expand aggressively, others stagnate.

Himachal Pradesh still has 920 seats, the same as in 2020–21. Chandigarh has not added a single seat.

In Delhi, paradoxically, the number of seats has shrunk from 1,422 to 1,346. The uneven spread means that opportunities concentrate in a handful of states, leaving others dependent on private options outside their borders.

It is little wonder that a family from Bihar or Odisha often faces the prospect of sending their child thousands of kilometres away—if they can pay.

Reform or Relapse?

India’s medical education saga is thus a tale of scale without symmetry. Expansion is real, but so is exclusion. Vacant MBBS seats are not mere statistical anomalies; they represent wasted doctors, wasted investments, and wasted hope.

Unless the government confronts the root causes—sky-high private fees, rigid quota systems, inadequate infrastructure, and a flawed admissions process—the country will continue to simultaneously expand and waste its capacity.

The way forward demands not just building more colleges but ensuring that the seats are accessible, affordable, and credible. Scholarships, fee regulation, transparent counselling, and ruthless enforcement of NMC standards are not optional; they are survival imperatives.

India cannot afford the luxury of waste in the middle of a health manpower crisis. Every unfilled MBBS seat is not just a bureaucratic statistic—it is a patient untreated, a community neglected, a doctor lost to the nation.

(This is an opinion piece, and views expressed are those of the author only)

MBBS Admissions: Between Govt Narratives and Ground Realities

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