Between 2019 and 2024, an average of 17 lakh students attempted the National Eligibility cum Entrance Test (NEET). Out of this, an average of 9.8 lakh students cleared the test for admission into a medical college.
But for these 9+ lakh students, there are only an average of 90,500-odd college seats across the country to fight for. This means an average of only 10% of qualifying candidates can be accommodated for.
This is what The Quint's analysis of NEET data over the last five years from the National Testing Agency (NTA) showed.
The ongoing controversy surrounding the 2024 NEET-UG exam, one of India's toughest and most coveted medical tests, has impacted the lives of nearly 23.3 lakh students. This has brought back into conversation the struggle that aspiring doctors in the country face year after year.
The high social value placed on medical education, the huge demand-and-supply mismatch, coupled with variations in fee structures, have fueled hyper-competition in India over the last few decades.
Where do the rest 90% of students go? Is medical education in India affordable? Why do aspirants move abroad to pursue MBBS? The Quint explains.
Why Is There Tough Competition in NEET?
As of 2024, India is home to 706 medical colleges that offer 1,09,170 seats, National Medical Council (NMC) data shows. This includes seven central universities, 382 government colleges, 320 private and deemed colleges.
Ministry of Health and Family Welfare statistics reveal that between 2011 and 2024, the number of medical colleges in India more than doubled to 706 from 335.
Since its introduction seven years ago, the number of NEET aspirants have doubled from nearly 12 lakh in 2017 to 23.3 lakh in 2024. On an average, around 56% of students qualify each year.
Further, only an average of 10% of those who qualify end up getting a seat in medical colleges.
Chennai-based Dr GR Ravindranath of the Doctors' Association for Social Equality told The Quint that the rise in number of applications can be attributed to the fact that the "desire to study medicine still holds a lot of value in the Indian community."
"For years, certain communities were denied the opportunity, and finally they do have a chance at achieving significant educational status. Plus, the number increases every year, as many students re-take the exam," he said.
What's interesting to note is that though the number of colleges has increased in the last decade, the demand for medical education in India continues to outstrip the supply.
Pointing to the magnitude of the gap, Maheshwer Peri, Founder of Careers360, a publication covering the education sector, explained how the competition in India becomes even fiercer when price is factored in.
Peri told The Quint that the real fight by nearly 13 lakh medical aspirants is for seats in government colleges and central universities, which as of 2024, amounted to around 55,225 (50% of total seats).
This is primarily because the annual fees in AIIMS and other government colleges are relatively affordable from a few thousand to a maximum of a couple of lakhs for the entire course. Fees of private medical colleges can range between Rs 50 lakh and Rs 1.5 crore for a 4.5-year course.
"Most of the students want to get into government colleges, mostly because of the low cost and good, hands-on opportunities. It is because of this intense competition for these 50,000-odd government seats that paper leaks and cheating happen. People pay lakhs to get the question paper. It's because there is high value for doctors in today's society. This is socio-economic and political issue."Dr GR Ravindranath to The Quint
Another issue highlighted is the low cut-offs, which they say is creating a pool of candidates with the capacity to pay hefty MBBS admission fees in India even if their ranks are low.
In a YouTube video for Careers360, Peri claimed that seats in private and deemed universities are "reservations for the rich."
"Due to low cut-offs, those who secure a rank of 12 lakh also end up finding a seat in a private college. These 55,000 seats in private colleges have extremely high fees and not more than 2% of India can afford that. Many students may qualify NEET, but only few can afford the private colleges. The pool of students is bigger because within the pool, they find a bunch of people who can pay Rs 1.5-2 crore for education," Peri said.
"Those who cannot afford private medical colleges and do not manage to secure a government seat either re-take the exam or end up studying abroad. The number of registrations will increase over the years primarily because students re-take the exam," Peri added.
Less Competition, More Affordable: Why MBBS Aspirants Move Abroad
The rising cost of private medical education and stiff competition in India has driven many students to seek alternatives abroad in Asian and East European countries in the last six to seven years.
The number of Indian students studying medicine abroad increased from 3,438 in 2015 to 12,321 in 2019, as per the 15th Finance Commission report.
According to a 2022 report by Mumbai-based investment firm Anand Rathi, China, Ukraine, the Philippines, and Russia account for almost 60 percent of the medical student outflow from India.
*Note: There is no exact data available on the total number of students pursuing medicine abroad as of 2024.
Gaurav Tyagi, founder of consulting firm CareerXpert, told The Quint that there is a brain drain in medical education in India, with West Asian, South American, and Eastern European countries (like Kazakhstan, Georgia, Russia, Ukraine, and Turkey) emerging as options for Indian students.
"If you want to study MBBS in India, you have to arrange around Rs 60-70 lakh minimum. Most families cannot afford this but also can't let go of their MBBS degree dream. But when you go to these countries, the amount is only around Rs 20-22 lakh for five years, which is 75% lesser than what you pay in India."Gaurav Tyagi to The Quint
The cost of medical graduation in war-torn Ukraine, for example, stands at about Rs 15 to 20 lakh for the entire duration of six years.
In Bangladesh, the total cost ranges between Rs 25 lakh and Rs 40 lakh, while in Philippines, it is around Rs 35 lakh.
In Russia, students can complete their medical education for about Rs 20 lakh, including hostel expenses.
Those who have deep pockets prefer Singapore, the US, the UK, Canada and Australia, Tyagi added.
Not just lower fees, these foreign varsities also demand NEET qualifying marks for admission. Their cut-off is as low as 110, but for the leading medical colleges in India, the cut-off range is 715-720.
"There is a prestige when your child goes abroad to study. Most don't see the quality of education. Many students select medical colleges in countries that are easy to get admission to, irrespective of whether these institutes are famous for their medical education or not," he said.
Peri, however, says that most of these students typically end up returning to India. "Many students return to India and take the FMGE examination to practice here," he adds.
FMGE or Foreign Medical Graduates Examination is a compulsory screening test that a foreign MBBS holder must undertake in order to be eligible to practise in India.
Rise in FMGE Registrations but Low Pass Percentage
So as to ensure quality, the Union Ministry of Health and Family Welfare conducts the FMGE exam twice a year.
According to the National Board of Examination (NBE) that conducts this exam, the number of medical graduates who took the test doubled from 28,597 in 2019 to 61,616 in 2023. But an average of only 21% pass the exam.
In 2023, while an all-time high record of 61,616 MBBS graduates took the test, only one-sixth or 10,261 students passed the test.
While roughly around 30% of Indian MBBS students from Bangladesh cleared FMGE in 2023, only 17% from Ukraine were able to pass the test.
"In India, both practical and theory learning takes place together. But this isn't the case in many countries abroad. The curriculum and the training quality in a majority of these foreign universities are not as good as in India, except for in Nepal or Bangladesh. There are certain skill benchmarks required for practice in India which not everyone can qualify."Gaurav Tyagi to The Quint
Meanwhile, former Union Health Secretary Sujatha Rao told The Quint: "I am glad that the exam is tough as in most of the countries like China, education is very poor. So, one can't blindly have these students start practice here."
How Can This Be Resolved?
According to a February 2024 report by Anand Rathi Investment Firm, the cost of medical education in India is likely to double in the coming years.
Experts told The Quint that more capacity needs to be created within India. "India has a huge population and it needs doctors, but the NMC is holding on to it because that's the only way you can price your qualification better," they said.
Rao said, "I believe we have enough colleges and admissions, but half is sub-par in quality. Instead of opening more colleges, it is important to improve quality... at least ensure minimum faculty."
In 2022, when thousands of MBBS students were stuck in Ukraine during the war, Prime Minister Narendra Modi urged the private sector to invest in the field of medical education.
"Our children today are going to small countries for study, especially in medical education … Can our private sector not enter this field in a big way? Can our state governments not frame good policies for land allotment regarding this?"PM Modi in 2022
While experts believed that there is a need to increase the number of colleges and seats per college, they said that it was equally important to "keep the feed affordable."
"The capacity of existing medical colleges needs to be increased, and the number of colleges need to double faster. We need to increase the cut-offs, reduce the number of people who qualify. Plus, private medical college fees need to be regulated and fixed. You can't have Rajasthan levy a fee of Rs 10 lakh, Rs 8 lakh in Karnataka, and Rs 7 lakh in Kerala. Make it uniform."Gaurav Tyagi to The Quint
Meanwhile, Dr Ravindranath said: "The demand should be reduced by ensuring that more colleges are being set up by Central and state governments. It is the responsibility of the state to provide medical education and health care. The fees of the private colleges should be fixed in nominal way."
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