Unnecessary restriction

Limits on medical colleges in some states should be reconsidered

Medical education in India should be the last location for partisan and inter-regional bickering. Raising medical capacity in this country, particularly after a devastating pandemic, should surely be a national priority — one above politics. But a new regulation of the National Medical Commission (NMC), which oversees medical education in the country, has stopped the expansion of the medical college network. New colleges will not be allowed, and existing colleges are no longer allowed to add seats in states that have 100 medical education seats for each million in their population. The reasoning from the NMC is that medical education in the country needs to spread geographically, and access to medical seats should be available to all states. There is considerable regional disparity in the availability of doctors, and the NMC believes this regulation will bring down this sort of disparity. The regulator has said the courts have remarked on this regional imbalance and so it is incumbent on the NMC to address it.

It should be plainly obvious that in fact the NMC’s regulation will do nothing of the sort. It will hurt the medical profession. It will hurt patients in both advanced and deprived parts of the country. It will set back the cause of deepening medical capacity in India. Indeed, the opening of new medical institutions in areas that do not have enough should be prioritised, incentivised, and supported. Governments should work on improving access to medical education in states in deficit. But penalising certain areas will not lead to the opening of colleges in others. This also betrays a misunderstanding of how centres of higher education function. Naturally, there will be some clustering in areas where it is easier to hire faculty or that are better connected. And students will travel for an education if necessary. So the size of the problem itself is exaggerated. The central effort can and should be to increase the number of seats for medical students wherever possible and extend regulation to ensure that the quality of new colleges is up to par. In fact, extending existing colleges is likely the best way to manage a certain minimum quality in new seats. As in many other cases of regulatory overreach in India, it is far from clear whether any rigorous analysis of the reasons for and consequences of this change was conducted — and why, if so, it was not made public.

It is also unfortunate that such regulatory decisions are taken without considering the impact on federal relations within India. These are already under considerable political stress. Regional identity politics has begun to play a significant role; southern states are always on the lookout for issues that demonstrate a federal bias against southern aspirations and developmental success. This regulation, which penalises the southern states, among others, has the potential to create yet another federal fault line and a divisive political issue ahead of the national elections. The Prime Minister has been called upon to intervene, and it seems important from the point of view of national integration and cohesion that the Union government intervene and address the issue in a manner that does not harm this critical branch of education.