As we see, for decades , government MBBS education in India has been a highly praised and sought after lawn as one of the world’s most affordable pathways of becoming a doctor.
But evidence suggests that new medical graduates are frequently underpaid and under-prepared for practical roles, pointing toward a major gap in the promise versus reality of medical education.
With its disconnect between engagement of a major chunk of most productive age of life, government investment & cost,real outcome, and true job readiness, the wide gap between education and employability leaves many young doctors entering the healthcare workforce with
– inadequate hands-on skills
– low confidence
– minimal industry awareness
Despite students investing nearly a decade of their early and most productive life in medical training yet graduate feeling unprepared, who is accountable ? Our education system that don’t want to get updated with time or willingness of a Medical student..?
The Post MBBS Salary Paradox
In most Indian cities, a shop helper, a unskilled Labour earns ₹20,000–₹25,000 per month—and they deliver value from day one.
Yet thousands of MBBS graduates—after 5.5 years of training—accept the same salary for junior doctor roles.This is not because doctors lack intelligence or dedication. It is because the system fails to either equip them with real clinical skills or competition is so high that a role with such money even feels a sign of relief.
The National Medical Commission (NMC) itself reported that only 30–35% of medical interns felt confident managing common emergencies independently.
Where the root lies..?
Across India, over 60% of medical colleges lack fully functional skill labs, despite being mandatory.
In internship trainings there is minimal exposure to real healthcare settings specifically ICU rounds, emergency triage and critical care even patient counselling
As well as Over-reliance on theoretical textbook teaching which greatly different from real world management though they guide for so.
Interns often waste long hours in clerical work like filing documents , sample transport, paperwork so often they do not receive consistent bedside teaching, structured, supervised skill training activities actually required as a Clinician .When such unproductive & long hour workload is combined with lack of emotional support, it becomes a mental health crisis.
Age vs Skill which is ultimate Dowry …. ?
As a Medical Graduate we invested
✅ Coaching fees from class 9 to NEET UG Preparations.
✅ If gets government colleges it’s okay otherwise ₹11–20 lakh for private MBBS in government quota even 1 Cr for private medical colleges
✅ 5–7 years of most productive and skill learning time of youth
✅ Ambitions and Aspirations of Families specifically for 1st Gen doctors.
At the end of Graduation what we get….?
We are still uncertain about real-world responsibilities
We are still unaware of healthcare industry functioning
We are still underconfident in independent patient care
We are forced to work low-paying jobs just to learn emergency or critical care skills.
MBBS training does need a Benchmark
Skill benchmarks
why always a student or intern have to show willingness to learn and depend on faculties or PG trainees to learn basic skills. Why it is not mandatory…?
Required competencies
NMC takes its responsibilities out by just publishing required competencies but who is to check and implement correctly…?
Dilemma of Prestige
From +2 standard study to NEET coaching to MBBS first year to final year to sitting for PG Entrance the cycle of STUDIOUS BEE repeats
Memorize information > Write exams > Forget > Memorize > Repeat
We often forget practical real world learning remains life time in brain as well as muscle memory
Career pathways after graduation
As a MBBS graduate you get 4-5 yr theoretical exposure then 1 yr internship and suddenly you are cut off from hospital settings. You either again mugging up theories for PG or wandering aimlessly wishing you get a Housephysician or non academic Junior Resident role in govt hospital or RMO role in private hospitals.
You can’t get Ward RMO roles as maximum private hospitals engage AYUSH Graduates with less pay for such roles. And you got some ICU, ITU, ICCU offers for which you are not even prepared or exposed properly in internship trainings.
Why is simulation training not included in standard training to learn ICU, ICCU procedural skills…?
Rigidity vs Flexibility : life or a Trum Track..?
When India’s healthcare market urgently requires practitioners with problem-solving, procedural, and digital first health skills fit for real-world practice, the system’s failure to offer robust career guidance and exposure beyond doctor roles further narrows opportunities for MBBS pass outs to engage themselves in meaningful activities.
The rigid, one-track design of MBBS education means that switching careers or retraining later is far less accessible than it should be.
While Digital First Healthcare is evolving do actually our colleges making ready for that..? There is no clarity on whether students are being prepared for any of evolving fields like
Clinical Research, Insurance & Pharmacovigilance Medical Research industry
Public Health & Administration
Healthcare industry or digital health
Emergency & critical care
Community & Occupational medicines
Telemedicine roles, health tech & AI Training
When HEALTH is not only an individual issue, it involves a community, then why training related to public health, occupational medicine, epidemiology, and community-based health skills is limited..? And for that MBBS graduates are un/under prepared to conduct health assessments in workplace or community or play such role.
Reforms as I think of
First year of MBBS
Regular weekly engagement in Simulation labs, basic procedure training, emergency drills, BLS Training
Second year of MBBS
Discussion on career pathways, introduction to Clinical Research
Introduction to clinical research & trial ethics, Pharmacovigilance & Drug Safety Physician Training
Injection techniques (IM, IV, SC) on mannequins
Third year of MBBS
Public health & Patient Relations
Hospital Operations, workshop on hospital administration & quality control
AI, Data Management & Digital health,
Research Opportunities & Research Methodology with Biostatistics integration
Forensic Science & Intelligence training, Medical ethics orientation
Final year of MBBS
First-aid, wound dressing, suturing practice (via simulation lab)
learning Vital signs monitoring: BP, pulse, SpO₂, temperature in ward
Taking independent patient histories & Writing admission notes under supervision
Accessment training for Critically ill and Post Op patients.
Introduction to radiology (X-rays, ultrasound basics) & POCUS
Airway management simulation (bag-mask ventilation) & Basic ECG interpretation for Tachy & Brady arrhythmias, ACS
Internship
Treatment of Patients in OPD Conditions
Perform key procedures on patient independently : IV cannulation, Suturing, Basic emergency stabilization, CPR & ACLS
Assist confidently in ward procedures : Thoracocentesis, Ascitic tapping, Lumbar puncture (simulation & human )
Learn BMW Use, Hospital quality & NABH module
Career Discovery discusses like How to run a clinic, How to work in corporate hospitals with importance of documentation , How to enter public health & drug safety physician , How to build a non-clinical medical career (clinical research, insurance, health-tech, Telemedicine )
Indian Medical Education Regulatory body as well as we proud doctors need to come out from the dilemma that Doctor is essentially and only a Savior, a Physician, a Clinician.
Final take : World is evolving
World is evolving and Healthcare is so. World don’t need streamlined doctors with medical degrees anymore they are expecting beyond that. And for that we need a change, a change of perspectives, a change of understanding the filed and a change in role.
When we step outside the Government Hospital set up we no longer treat only a patient or a disease, we no longer remain a Physician who only gives medicine , we become a multipurpose clinician with a major chunk of physician & a more or less chunk of non clinical & industry need understanding
We now have to treat everyone, everything and every possible hierarchy of what a healthcare pharma industry wants or expects to as doctors no longer control the healthcare industries ;
So its only under control of Business tycoons , Industry Leaders who are essentially not doctors, MBA & Finance guys & Investment Firms and Insurance Companies on doctor . And to stay safe we need to learn beyond government set up but the reality of industry as emoluments are limited.
