Union finance minister Nirmala Sitharaman on Saturday announced a proposal to add 75,000 medical seats over the next five years, raising concerns among sections of physicians about what they view as growing headcounts of doctors alongside falling quality of education.

“In the next year, 10,000 additional seats will be added in medical colleges and hospitals, towards the goal of adding 75,000 seats in the next five years,” Sitharaman said in a section of her 2025-26 budget speech titled “Expansion of medical education”.

The Narendra Modi government has added almost 1,10,000 undergraduate and postgraduate medical education seats in 10 years, a 130 per cent increase, she said. Government data show that between 2014 and 2024, undergraduate (UG) MBBS seats increased from 51,000 to over 1,12,000, while postgraduate (PG) MD and MS seats rose from 31,000 to 72,000.

Although the announcement did not specify what proportions of the extra 75,000 seats would be UG and PG seats, it has prompted some doctors and faculty to predict a further decline in the quality of medical education and dilution of patient care.

The National Medical Commission (NMC), the country’s apex regulator for medical education, has proposed relaxed rules that will make non-teaching consultants and specialists with at least four years of experience and diploma holders with six years of experience in government colleges eligible for faculty posts in medical colleges.

“The NMC proposals relaxing the requirements for faculty appointments appear aligned with this plan to add 75,000 seats,” said Kabir Sardana, a professor of dermatology at the Atal Bihari Vajpayee Institute of Medical Sciences and Ram Manohar Lohia Hospital, New Delhi.

Sardana and others have cautioned that faculty eligibility relaxations — one of which would effectively allow doctors who have never produced a thesis to guide students into generating a thesis — would adversely impact the quality of education that medical students receive.

The faculty shortages are evident even at the AIIMS, among the most prestigious government teaching hospitals. The Union health ministry had told Parliament in August 2023 that among 5,500 faculty positions sanctioned in AIIMS across the country, 2,161 posts were then vacant. Even AIIMS New Delhi had 347 faculty positions vacant, or 28 per cent of sanctioned faculty strength.

An assessment of 246 medical colleges by the NMC in 2022-23 found that no medical college had adequate faculty. Many colleges had so-called ghost faculty — on records, but absent in reality.

The Centre’s 2024-25 Economic Survey released on Friday also flagged such concerns, referring to the expansion of medical education without strong regulatory oversight on the quality of education.

The Economic Survey said faculty shortages, ghost faculty, and low patient load in hospitals impact the quality of medical education and suggested that there may be a need to revisit regulatory measures, including incentives and disincentives to improve compliance.

Some predict that the extra 75,000 medical seats would add to the glut of doctors in urban areas. Studies suggest that nearly 80 per cent of the country’s MBBS-qualified doctors work in and around urban areas.

“If the additional seats could help combat the lack of doctors in rural areas, such an exercise could be justified, but getting doctors to serve in rural areas is going to remain a challenge,” said a faculty member in a central government medical college who requested anonymity.

“A surplus of MBBS doctors without opportunities for advanced training will lead to underemployment and dilution of patient care,” said Suvrankar Datta, the president of the Federation of the All India Medical Associations, an umbrella body representing postgraduate residents.

The proposed Union budget outlay for health for 2025-26 is ₹95,957 crore, a 10.7 per cent increase over ₹87,656 crore for 2024-25.