How India risks doctors trained on compromised qualifying cut-offs
The Supreme Court has stepped in as furore builds over the National Board of Examinations in Medical Sciences fixing the PG medical entrance qualifying cut-off at minus 40 out of 800 marks
The court has taken up a public interest litigation that argues that the minimum eligibility criteria to fill up seats has been slashed without caring about the integrity of the medical profession and patient safety at the hands of doctors emerging from such a system.
As things stand, after the second round of NEET-PG counselling, some 18,000 PG seats in medical colleges remain vacant. There is also serious concern over the sharp decline in standards of medical education due to the launch of a spate of medical colleges despite faculty crunch. This is precisely how standards of engineering education in India are thought to have nosedived.
The past seven years have seen a decline in the cut-off percentile in medical PG. From 2019 to 2025, it was 44, 30, 35, 25, 0, 15 and 7 for the general category. For general (EWS-PWD), it was 39, 25, 30, 20, 0, 10 and 5. For OBC/SC/ST, it was 34, 20, 25, 15, 0, 10 and 5.
A zero percentile equals minus 40 marks for someone who has an MBBS degree. This has made many argue that unfilled PG seats after the first round of counselling be opened to all. Since the new cut-off for reserved categories are extremely lower than for general candidates, the controversy has also snowballed into one about reserved versus general categories.
For many doctors, this symbolises the final surrender of merit in a critical profession where standards used to be by and large good till a decade ago. For others, it reflects a desperate attempt by regulators to fill up seats amidst the mushrooming of medical colleges, which has impacted the quality of education, both in private and government colleges.
So, to frame the controversy as merely a clash between merit and reservation is to miss the larger story. The truth is that India now has way more medical colleges than these can find teachers, training capacity or supportive regulatory discipline. Letting many medical colleges have affiliation with their own private universities has added to the decline in teaching standards.
It is argued that teaching medicine is not like teaching humanities or management. The faculty must be experienced clinicians and specialists with years of practice, research exposure and teaching credentials. The situation is such that AIIMS institutions and new government medical colleges across states routinely report 30-50 per cent faculty vacancies, especially in core clinical departments such as medicine, surgery, anaesthesia and radiology.
In many colleges, senior residents are doubling up as teachers. In others, departments exist on paper but not in practice. Regulators have quietly relaxed norms, inspections have become episodic, and temporary arrangements have turned permanent, warn experts. The inevitable result: training quality has collapsed even before medical students reach the postgraduate level.
Why are PG seats going vacant? The minus 40 cut-off exposes an uncomfortable reality: even after reservation, thousands of postgraduate medical seats remain vacant. This is happening for several reasons. There has been rapid expansion of seats without matching faculty and hospital infrastructure. Declining training quality is producing medical graduates unprepared for the PG rigour. Then, PG in private colleges is highly expensive, making it unattractive even when seats are available. In government colleges, there are service bonds to contend with besides debatable working conditions and the spectre of quick burnout that drives students away from certain specialities.
There is another major concern: the brighter students are not opting for branches that were once much sought after. General surgery is one example. Many want radiology as it is considered more lucrative and less stressful. Instead of correcting these distortions, regulators have chosen the easier route: lower the bar until seats fill up.
It is politically convenient to attribute the falling cut-offs entirely to caste-based reservation. That explanation is misleading. Reservation policies have existed for decades, including in medicine, without producing negative cut-offs. What has changed is scale. The system has been expanded beyond its absorptive capacity, say experts.
Even among general-category candidates, the number of students adequately trained to clear rigorous PG thresholds has not kept pace with the creation of seats. This is why merit itself is thinning. Lowering the cut-off to negative territory does not empower marginalised students. It sets them up for failure by pushing them into programmes where supervision, exposure and mentorship are already compromised.
The impact of all of this will be on healthcare in the future. Clinical competence will suffer, especially in high-risk specialities. This will erode public trust in doctors, accelerating litigation and violence against medical staff. Doctors’ salaries are already coming under pressure as oversupply meets declining quality. Elite institutions will hoard talent, widening the gap between premier hospitals and the rest.
India has gone through this already. Two decades ago, engineering education followed a similar trajectory. Colleges multiplied, faculty quality dipped, cut-offs fell and degrees became devalued. The market eventually corrected itself, but at the cost of thousands of unemployable engineers and near-collapse of large segments of private engineering education.
The number of engineering colleges surged from around 1,200 in the early 2000s to over 13,000 by 2010. Enrolments ballooned from around 440,000 students in first-level programmes (2004-05) to hundreds or thousands, with states like Tamil Nadu, Andhra Pradesh and Maharashtra leading the private engineering expansion.
The downturn began around 2012-15, triggered by IT hiring slowdowns, skill-job mismatches and over-supply. By 2015-16, intake stagnated despite over 3,500 colleges being in the picture. Sharp enrolment drops (30-50 per cent in many states) led to mass closures. The All India Council of Technical Education (AICTE) de-affiliated around 400 colleges by 2017-20, with over 800 shuttered or merged by 2023 amidst a 70 per cent vacancy rate in tier-2/3 institutes.
Medicine cannot afford such a correction. The cost here is not unemployment—it is patient safety. The question regulators must answer is why India created a medical education system that needs a negative cut-off to survive. The answer perhaps lies in uncontrolled college expansion, faculty shortages, diluted inspections and the political economy of medical seats. No cut-off—high or low—will restore credibility. Lowering standards may fill classrooms but it won’t get India better doctors. And in a country already struggling with uneven healthcare delivery, that is a risk to be ill-afforded.
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The court has taken up a public interest litigation that argues that the minimum eligibility criteria to fill up seats has been slashed without caring about the integrity of the medical profession and patient safety at the hands of doctors emerging from such a system.
As things stand, after the second round of NEET-PG counselling, some 18,000 PG seats in medical colleges remain vacant. There is also serious concern over the sharp decline in standards of medical education due to the launch of a spate of medical colleges despite faculty crunch. This is precisely how standards of engineering education in India are thought to have nosedived.
The past seven years have seen a decline in the cut-off percentile in medical PG. From 2019 to 2025, it was 44, 30, 35, 25, 0, 15 and 7 for the general category. For general (EWS-PWD), it was 39, 25, 30, 20, 0, 10 and 5. For OBC/SC/ST, it was 34, 20, 25, 15, 0, 10 and 5.
A zero percentile equals minus 40 marks for someone who has an MBBS degree. This has made many argue that unfilled PG seats after the first round of counselling be opened to all. Since the new cut-off for reserved categories are extremely lower than for general candidates, the controversy has also snowballed into one about reserved versus general categories.
For many doctors, this symbolises the final surrender of merit in a critical profession where standards used to be by and large good till a decade ago. For others, it reflects a desperate attempt by regulators to fill up seats amidst the mushrooming of medical colleges, which has impacted the quality of education, both in private and government colleges.
So, to frame the controversy as merely a clash between merit and reservation is to miss the larger story. The truth is that India now has way more medical colleges than these can find teachers, training capacity or supportive regulatory discipline. Letting many medical colleges have affiliation with their own private universities has added to the decline in teaching standards.
It is argued that teaching medicine is not like teaching humanities or management. The faculty must be experienced clinicians and specialists with years of practice, research exposure and teaching credentials. The situation is such that AIIMS institutions and new government medical colleges across states routinely report 30-50 per cent faculty vacancies, especially in core clinical departments such as medicine, surgery, anaesthesia and radiology.
In many colleges, senior residents are doubling up as teachers. In others, departments exist on paper but not in practice. Regulators have quietly relaxed norms, inspections have become episodic, and temporary arrangements have turned permanent, warn experts. The inevitable result: training quality has collapsed even before medical students reach the postgraduate level.
Why are PG seats going vacant? The minus 40 cut-off exposes an uncomfortable reality: even after reservation, thousands of postgraduate medical seats remain vacant. This is happening for several reasons. There has been rapid expansion of seats without matching faculty and hospital infrastructure. Declining training quality is producing medical graduates unprepared for the PG rigour. Then, PG in private colleges is highly expensive, making it unattractive even when seats are available. In government colleges, there are service bonds to contend with besides debatable working conditions and the spectre of quick burnout that drives students away from certain specialities.
There is another major concern: the brighter students are not opting for branches that were once much sought after. General surgery is one example. Many want radiology as it is considered more lucrative and less stressful. Instead of correcting these distortions, regulators have chosen the easier route: lower the bar until seats fill up.
It is politically convenient to attribute the falling cut-offs entirely to caste-based reservation. That explanation is misleading. Reservation policies have existed for decades, including in medicine, without producing negative cut-offs. What has changed is scale. The system has been expanded beyond its absorptive capacity, say experts.
Even among general-category candidates, the number of students adequately trained to clear rigorous PG thresholds has not kept pace with the creation of seats. This is why merit itself is thinning. Lowering the cut-off to negative territory does not empower marginalised students. It sets them up for failure by pushing them into programmes where supervision, exposure and mentorship are already compromised.
The impact of all of this will be on healthcare in the future. Clinical competence will suffer, especially in high-risk specialities. This will erode public trust in doctors, accelerating litigation and violence against medical staff. Doctors’ salaries are already coming under pressure as oversupply meets declining quality. Elite institutions will hoard talent, widening the gap between premier hospitals and the rest.
India has gone through this already. Two decades ago, engineering education followed a similar trajectory. Colleges multiplied, faculty quality dipped, cut-offs fell and degrees became devalued. The market eventually corrected itself, but at the cost of thousands of unemployable engineers and near-collapse of large segments of private engineering education.
The number of engineering colleges surged from around 1,200 in the early 2000s to over 13,000 by 2010. Enrolments ballooned from around 440,000 students in first-level programmes (2004-05) to hundreds or thousands, with states like Tamil Nadu, Andhra Pradesh and Maharashtra leading the private engineering expansion.
The downturn began around 2012-15, triggered by IT hiring slowdowns, skill-job mismatches and over-supply. By 2015-16, intake stagnated despite over 3,500 colleges being in the picture. Sharp enrolment drops (30-50 per cent in many states) led to mass closures. The All India Council of Technical Education (AICTE) de-affiliated around 400 colleges by 2017-20, with over 800 shuttered or merged by 2023 amidst a 70 per cent vacancy rate in tier-2/3 institutes.
Medicine cannot afford such a correction. The cost here is not unemployment—it is patient safety. The question regulators must answer is why India created a medical education system that needs a negative cut-off to survive. The answer perhaps lies in uncontrolled college expansion, faculty shortages, diluted inspections and the political economy of medical seats. No cut-off—high or low—will restore credibility. Lowering standards may fill classrooms but it won’t get India better doctors. And in a country already struggling with uneven healthcare delivery, that is a risk to be ill-afforded.
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