NMC defers decision to limit MBBS seats to 100 per 10 lakh population after opposition from south states

Following opposition from southern states including Tamil Nadu, Karnataka, and Puducherry, the National Medical Commission (NMC) has deferred by a year its decision to limit the number of MBBS seats to 100 per 10 lakh population in every state. The regulation is likely to be implemented from academic year 2025-26 after consultation and meetings with stakeholders and states.

The decision was taken after the Union health ministry asked the medical education regulator to re-examine the provisions of the ratio of 100 MBBS seats per 10 lakh population in states.

The NMC has now notified that following the ministry of health and family welfare's letter dated 1 November, the provisions of the ratio of 100 MBBS seats per 10 lakh population in states have been re-examined by the Undergraduate Medical Education Board (UGMEB).

“It is informed that a decision has been taken by the Undergraduate Medical Education Board, National Medical Commission that the ‘objective’ clause under Chapter-1 of ‘Guidelines for Undergraduate Courses under Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses and Assessment and Rating Regulations, 2023″ (notified by UGMEB on 16 August 2023) shall be implemented from academic year 2025-26,” said the commission.

The notification, which was released on 16 August, had stated that medical colleges shall follow the ratio of 100 MBBS seats for every 10 lakh people in any state or Union territory (UT). Titled 'Guidelines for undergraduate courses under the establishment of new medical institutions, starting new medical courses, an increase of seats for existing courses, and assessment and rating Regulation 2023', it stated that a letter of permission would be required to start new medical colleges with an annual intake capacity of 50/100/150.

This meant colleges would only have 50-150 seats if they followed the ratio of 100 seats per 10 lakh people in a state or UT. The regulation would have added approximately 40,000 MBBS seats, but only in states like Bihar and Jharkhand, which face a high deficiency in terms of new seats-to-population ratio.

In a reply to a question in the Lok Sabha regarding the seats in medical colleges and the projected population until 31 March 2023, Union minister of state for health and family welfare Dr Bharati Pravin Pawar said all south Indian states had more seats than the NMC’s new norm.

In Andhra Pradesh, the projected population was 5.34 crore, which meant that the state could have 5,346 seats, whereas the state now has 6,435 MBBS seats. Telangana, which has been adding MBBS seats over the past few years, has plans for another 800 seats next year. It has a projected population of 3.8 crore, so the seats should number around 3,809, but it currently has 8,540 MBBS seats, nearly 5,000 more than the NMC-prescribed number.

Karnataka, with a projected population of 6.76 crore, has 11,695 seats — the highest in the country. According to the NMC norm, the state should have only 6,770 seats.

Kerala, with a projected population of 3.57 crore, has 4,655 seats, which is much higher than the 3,577 that the NMC norm would mandate.

The NMC notification put the number of seats in Tamil Nadu — with a projected population of 7.68 crore — at 7,686, when there are 11,600 existing seats in the state.

According to NMC data, Andhra Pradesh had 1,05,799 registered doctors as of June 2022, while Karnataka had 1,34,426, Kerala had 42,596, Tamil Nadu had 1,48,217 and Telangana had 14,999.

This means one doctor was available for 505 people in Andhra Pradesh, 503 people in Karnataka, 839 in Kerala, 600 in Tamil Nadu and 2,540 in Telangana. It should be mentioned that registration for doctors in Telangana began only after the formation of the state in 2014, and doctors practising in Telangana before 2014 are registered in Andhra Pradesh.

The largest state in India, Uttar Pradesh, whose projected population was around 23.5 crore, has just 9,703 seats — around 14,000 less than the 23,568 seats as per NMC norms.

On 4 October, Tamil Nadu chief minister MK Stalin urged Prime Minister Narendra Modi to instruct the health ministry to keep the notification in abeyance and initiate a consultative process to address the matter.

“I wish to draw your kind attention to the regressive scenario created by the recent notification issued by the NMC to restrict the opening of new medical colleges,” Stalin wrote in a letter. He underscored that the notification was a “direct encroachment” on the rights of all state governments and penalisation of those who have invested more in their public health infrastructure over the years.

Andhra Pradesh health minister Vidadala Rajini met Union health minister Mansukh Mandaviya in October and demanded relaxation in two conditions set by the NMC.