By Dipak Kurmi
Strengthening medical education and research lies at the very core of strengthening a nation’s healthcare system, and nowhere is this linkage more evident than in India. A rapidly rising population, an epidemiological transition marked by the coexistence of communicable and non-communicable diseases, and widening regional disparities in healthcare access together place extraordinary pressure on the country’s medical infrastructure. In such a context, the establishment of more medical colleges, the expansion of research capacity, and sustained public investment are not optional policy choices but urgent national imperatives. Without adequate and sustained budgetary allocation by both the central and state governments, the structural weaknesses that afflict medical education and health research will persist, undermining the goal of building a resilient and equitable healthcare system capable of meeting present and future challenges.
The central government has sought to project an encouraging picture by highlighting a 47 per cent increase in allocation for Health Research in the Union Budget, rising from Rs. 2,663 crore in 2021–22 to Rs. 3,900 crore in 2025–26. While this increase in absolute terms is significant, the Parliamentary Standing Committee on Health and Family Welfare has rightly cautioned against reading too much into headline figures alone. The Committee has observed that spending on health research by both the government and medical colleges has remained stagnant as a percentage of Gross Domestic Product over the past several financial years. Official data shows that actual health research expenditure has consistently remained at an alarmingly low 0.02 per cent of GDP since 2021–22. In a country aspiring to global leadership in pharmaceuticals, biotechnology and clinical innovation, such a meagre share of national income devoted to health research represents not merely fiscal conservatism but a strategic blind spot.
The Committee’s emphasis on research as an integral component of medical education is both timely and necessary. Medical education divorced from research risks becoming stagnant, overly protocol-driven and insufficiently responsive to emerging health challenges. In contrast, research-oriented medical institutions foster critical thinking, innovation and evidence-based practice among students and faculty alike. Yet, in India, research remains peripheral to the daily functioning of many medical colleges, particularly those outside major metropolitan centres. Limited funding, lack of research infrastructure, and inadequate incentives for faculty to engage in scholarly work have together constrained the growth of a vibrant research culture. Without systematic support from governments and institutional leadership, medical colleges cannot realistically be expected to contribute meaningfully to the country’s research output or to the development of context-specific solutions to India’s health problems.
Among the most pressing challenges identified by the Parliamentary Standing Committee is the acute shortage of faculty in medical colleges, a problem that is particularly severe in remote and underserved areas. The rapid expansion of medical seats over the past decade, while commendable in intent, has not been matched by a commensurate expansion of qualified teaching staff. This imbalance threatens the quality of medical education and, by extension, the competence of future generations of doctors. The Committee’s recommendation to prioritise competitive salaries, job security and structured career progression over ad hoc or contractual appointments strikes at the heart of this issue. Faculty members who face professional uncertainty and limited opportunities for advancement are unlikely to commit themselves fully to teaching, mentoring and research, especially in challenging locations.
The suggestion to offer special incentives such as housing support, educational facilities for children and rural service allowances to attract and retain faculty in distant and difficult areas reflects a pragmatic understanding of ground realities. These measures acknowledge that professional motivation alone cannot offset the personal and social costs of serving in remote regions. However, implementing such incentives requires substantial financial outlays and the creation of supporting infrastructure, from staff housing to quality schools. The political and administrative complexities involved are evident in states like Assam, where the issue has been debated repeatedly in the Assembly with consensus across party lines on the need for incentives to strengthen rural healthcare. Yet, governments often hesitate to implement differential incentive structures, fearing that offering enhanced benefits to doctors may demoralise employees in other departments who also serve in challenging environments.
Addressing this dilemma requires a broader societal and administrative consensus that healthcare occupies a unique and foundational position among public services. Doctors and medical educators not only provide immediate clinical care but also shape the quality of healthcare delivery for decades through the training of future professionals. Recognising this multiplier effect can help justify targeted incentives without undermining morale in other sectors. Moreover, non-monetary forms of recognition can play a powerful motivational role. The institution of awards, honours and public recognition for doctors and healthcare professionals who have served with dedication in remote and difficult areas can reinforce the social prestige associated with such service. By celebrating these contributions, governments can inspire new medical graduates to view rural and underserved postings not as professional setbacks but as opportunities for meaningful impact.
The affordability of medical education represents another profound concern flagged by the Committee, with far-reaching implications for equity and healthcare outcomes. The cost of medical education in India, particularly in private institutions, often ranges from Rs. 60 lakh to Rs. 1 crore or even more, effectively excluding students from economically weaker backgrounds. Such prohibitive costs distort the social composition of the medical profession and risk creating a healthcare workforce disconnected from the lived realities of large sections of the population. A robust medical education and research ecosystem must draw talent from all socio-economic strata, ensuring diversity of perspective and a deeper commitment to serving disadvantaged communities.
In this context, the Committee’s recommendation that private medical colleges adhere to the government fee structure for 50 per cent of seats, while allowing the remaining 50 per cent to be priced in consultation with state fee regulatory committees, offers a balanced regulatory approach. This model seeks to reconcile the need for affordability with the financial viability of private institutions, curbing the unchecked escalation of fees without stifling private investment. Effective implementation of such regulation, however, will require strong oversight, transparency and political will at the state level to resist pressure from vested interests.
Equally critical is the problem of uneven distribution of medical seats across the country, which exacerbates regional disparities in healthcare access and faculty availability. The Committee’s observation that while the national average stands at 75 MBBS seats per million population, some states far exceed this figure while others fall drastically short, highlights a structural imbalance that cannot be ignored. States with limited medical education capacity not only struggle to produce sufficient doctors but also face chronic shortages of teaching faculty, perpetuating a cycle of underdevelopment in healthcare infrastructure. Bridging this gap is essential to ensuring that all regions of the country can build self-sustaining medical education systems aligned with local health needs.
The Union Budget announcement of adding 10,000 medical seats in 2025–26 and a total of 75,000 seats over the next five years signals an intent to address shortages of medical graduates and to curb the outmigration of Indian students seeking medical education abroad. While expansion is necessary, it must be accompanied by parallel investments in faculty development, infrastructure and research capacity to avoid diluting educational quality. The responsibility of the National Medical Commission in this regard is pivotal. The Committee’s insistence that the Commission actively promote equitable, high-quality medical education grounded in evidence-based practice, scientific advancement and critical thinking deserves urgent and sustained attention from the central government.
Ultimately, strengthening India’s healthcare system requires more than incremental budget increases or isolated policy interventions. It demands a coherent, long-term vision that recognises medical education and research as public goods essential to national well-being. Adequate funding, equitable regulation, faculty empowerment and a renewed commitment to research excellence together form the foundation of such a vision. Without addressing these interconnected challenges in a comprehensive manner, India risks undermining its own healthcare aspirations. With decisive action, however, the country can transform its medical education system into a powerful engine for health security, social equity and scientific innovation.
(the writer can be reached at dipakkurmiglpltd@gmail.com)
