When the NMC lowered the NEET-PG qualifying cut-off to zero – and effectively into the negative – it was explained as a practical response to a practical problem. Seats were going unfilled. Hospitals needed doctors. The system, we were told, could not afford waste.
Despite the arguments, it seemed like a wrong move.
Because a zero cut-off will allow admission to candidates with ZERO marks. If that was not enough, a negative cut-off will allow admission even with those with scores below zero!
With such lax criteria, entry standards weaken, training systems absorb the strain unevenly, and the long-term risk is deferred to patients and institutions rather than addressed at the policy level.
Doctor shortages and vacant medical PG seats are not unique to India. Many countries confront the same pressures, often with fewer resources and tighter capacity.
But from what we have found – they don’t respond to these problems by lowering qualifying cut-offs to zero or negative marks simply to fill seats.
Looking at how postgraduate medical admissions are handled in other countries makes one thing clear: while shortages are common, lowering the eligibility bar to this extent is not. In most cases, seats are left vacant, admissions are delayed, or intake is restricted until capacity and supervision can support training safely. The shortage is acknowledged – but the qualifying threshold is not abandoned.
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The Core Problem: Scarcity vs Standards
Every medical education system in the world faces constraints. These include:
- limited training capacity
- faculty shortages
- uneven geographic distribution of doctors
- rising healthcare demand
- political pressure to “do something” quickly
India is not unique in this respect.
What differs is how systems respond when scarcity collides with standards.
There are broadly two choices:
- Protect minimum competence and accept short-term gaps
- Lower entry thresholds to fill seats immediately
India chose the second.
To understand why this choice matters, it helps to look at how other systems handle similar situations.
What China does differently – An Example
China runs one of the world’s largest medical education and healthcare systems. Its scale rivals India’s. Its demand pressures are comparable. Its rural–urban disparities are severe.
Yet when postgraduate medical seats go unfilled, the response is not to eliminate qualifying thresholds.
China relies on:
- national entrance examinations with fixed minimum scores
- tightly controlled intake
- delayed or repeated admission rounds
- expansion of training capacity as a planning problem, not an admission workaround
Shortages are addressed through:
- bonded service
- redistribution policies
- long-term workforce forecasting
- targeted expansion of programs
What China does not do is treat minimum competence as negotiable when capacity planning fails.
The underlying logic is simple:
A shortage of doctors is a serious problem. Producing under-prepared specialists is a more dangerous one.
That trade-off is not avoided. It is confronted.
Neighbouring systems with fewer resources — and fewer excuses
It is tempting to argue that wealthy or tightly controlled states can afford higher standards, while developing countries must be flexible.
But this argument collapses when we look at India’s neighbours.
Bangladesh
Bangladesh faces:
- far fewer medical seats
- intense competition
- limited training infrastructure
Yet postgraduate admissions remain threshold-based. When seats go unfilled, the system responds with:
- additional counselling rounds
- delayed admissions
- restricted intake
The standard is not collapsed to absorb administrative failure.
Nepal
Nepal’s medical education system is smaller and more constrained than India’s. Its response to shortages is not to dilute entry criteria but to:
- strictly limit admissions
- rely on foreign training pathways
- maintain clear qualifying requirements
Seats going empty is seen as unfortunate.
Lowering standards is seen as unacceptable.
Bhutan
Bhutan trains very few doctors domestically. It relies heavily on external scholarships and foreign training. Capacity constraints are severe.
Yet there is no attempt to “solve” the problem by diluting admission criteria. When capacity is limited, entry becomes more selective, not less.
The logic is consistent across these systems: When you cannot train enough doctors safely, you reduce intake — not the qualifying bar.
What this comparison actually shows
The contrast here is not about economic strength or national ambition. It is about policy instinct.
Across very different systems — large and small, rich and poor — shortages are typically managed by:
- restricting intake
- delaying admissions
- expanding capacity slowly
- protecting minimum competence
India’s decision to lower the cut-off sharply stands out because it does the opposite.
This is not because India faces unique constraints.
It is because India chose speed over standards.
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Why minimum thresholds exist in the first place
Cut-offs are often misunderstood as ranking tools. They are not.
In professional education — especially medicine — a qualifying threshold serves a different purpose:
- it signals minimum readiness
- it certifies baseline competence
- it protects both patients and the profession
Once that threshold is removed, the exam ceases to function as a gatekeeper. It becomes a formality.
The argument that “training will fix gaps later” misunderstands how medical education works. Postgraduate training is not remedial schooling. It assumes foundational knowledge. When that foundation is weak, the burden shifts:
- to supervisors
- to hospitals
- to patients
And eventually, to society.
The hidden cost students are not told about
For students, lowering cut-offs may appear like relief. A chance that would otherwise not exist.
But the downstream costs are rarely discussed.
Students admitted far below the original qualifying level face:
- higher stress and attrition
- steeper learning curves without support
- reputational risk in future employment
- uneven evaluation in training environments not designed for remediation
Parents are told seats have opened.
They are not told what kind of seat it is.
A seat that comes at the cost of diluted certification is not an opportunity in the usual sense. It is a gamble.
Why this matters beyond one admission cycle
Medical education decisions have long tails.
A diluted cohort today:
- shapes teaching standards tomorrow
- normalises lowered expectations
- weakens the signalling value of qualifications
Once minimum competence becomes negotiable, restoring trust is difficult.
Other systems understand this intuitively. That is why they accept short-term discomfort to protect long-term credibility.
India’s choice suggests a different calculus:
that the appearance of capacity matters more than the integrity of entry.
That is a risky bet.
The uncomfortable question India must confront
No serious system pretends scarcity does not exist.
The question is how scarcity is managed.
India had other options:
- reduce seat numbers temporarily
- delay admissions
- stagger intake
- invest in capacity where supervision exists
- accept short-term shortage as a planning failure to be corrected
Instead, it chose the fastest administrative fix.
That choice reflects not desperation, but priorities.
Why this should concern everyone — not just aspirants
This is not a debate only for students writing exams.
Parents should care because:
- medical credentials lose meaning when thresholds collapse
- risk is shifted quietly onto families
Institutions should care because:
- training quality becomes harder to defend
- supervision burdens increase
- accountability diffuses
Patients should care because:
- competence is cumulative
- trust in the profession depends on credible certification
And policymakers should care because:
- credibility, once lost, is expensive to rebuild
A final, necessary question
The issue is not whether India needs more doctors. It does.
The issue is whether lowering entry standards is the only response we can imagine.
When countries with fewer resources, smaller systems, and tighter constraints choose restraint over dilution, the comparison is unavoidable.
It forces a question that goes beyond exams and cut-offs:
If even advanced medical training cannot insist on minimum competence, what does that say about how seriously we take the systems that underpin our future?This is not a rhetorical question.
It is one that students, parents, and institutions will live with long after this admission cycle is forgotten.