Government clinics and hospitals across rural and urban India continue to grapple with shortages in doctors and specialists with collectively over 23,000 sanctioned medical posts vacant, despite the doubling of undergraduate and postgraduate seats over the past decade.

The latest report on human resources and infrastructure in government hospitals released by the Union health ministry’s statistics division on Monday has also shown vacancies in multiple other categories of healthcare workers, including anaesthesiologists, nursing staff, lab technicians and radiographers.

More than 9,000 posts of doctors or medical officers in primary health centres (PHCs) in rural areas were vacant on March 31, 2023, against some 41,900 sanctioned posts, according to the report. Against over 46,600 sanctioned posts of rural PHC nursing staff, over 10,800 were vacant.

The report said over 8,900 posts of medical specialists — gynaecologists, paediatricians, physicians or surgeons — in rural community health centres (CHCs), a tier above PHCs, were vacant against 13,232 sanctioned posts.

Government healthcare centres in urban areas also had gaps — 1,796 vacant posts of doctors or medical officers in urban PHCs against 9,412 sanctioned posts and 1,415 vacancies of specialists’ posts in urban CHCs against 3,256 sanctioned posts.

The patterns of vacancies in government healthcare centres persist despite more than two-fold increases in medical college seats since 2014. The count of MBBS seats has increased from 51,000 in 2014 to over 1,12,000 in 2024, while postgraduate medical seat counts rose from around 31,000 to over 72,000.

Public health analysts tracking government investments in healthcare have said it is not surprising that the increase in medical seats has not been accompanied by a commensurate drop in the proportions of vacant posts in government healthcare institutions.

Sections of doctors and health economists familiar with the annual rural health statistics have long cautioned that given the current levels of government investment in healthcare and infrastructure in rural areas, the vast majority of medical graduates will continue to opt for urban areas.

Over 2,400 nursing staff posts in urban PHCs were vacant against over 6,500 sanctioned posts, while 2,276 nursing staff posts in urban CHCs were vacant against their 11,600 sanctioned posts.

Sections of doctors, including resident doctors who have been campaigning for stringent laws to curb violence against healthcare workers, have said gaps in human resources pose a big challenge in many government healthcare centres and at times contribute to the violence against healthcare workers.

Such shortages alongside other constraints in government hospitals contribute to “frustration among patients and their attendants, leading to tense situations that pose safety risks for doctors and other healthcare staff,” said a resident doctor in a Delhi hospital.