Just 4,413 specialists were available at rural Community Health Centres against a requirement of 21,964, highlighting an almost 80% shortfall in specialist doctors
New Delhi: India continues to face a significant shortage of doctors, particularly specialist physicians in rural areas. Yet thousands of Indian students who pursue medical education abroad are struggling to enter the country’s healthcare system, with only 12.77% of candidates clearing the mandatory Foreign Medical Graduate Examination (FMGE) held in June 2026.
According to the National Board of Examinations in Medical Sciences (NBEMS), a total of 37,448 candidates registered for the June 2026 FMGE. Of these, 36,288 candidates appeared for the examination, while only 4,635 candidates were successful.
The low pass rate has renewed concerns over the quality of some overseas medical programmes, particularly the adequacy of clinical exposure and the ability of foreign-trained medical graduates to meet medical education and practice standards in India.
India Faces a Severe Shortage of Rural Specialists
The FMGE results come against the backdrop of a major shortage of specialist doctors across rural India.
According to the Health Dynamics of India report, as of March 2023, rural Community Health Centres (CHCs) had only 4,413 specialist doctors, compared with a requirement of 21,964.
This represented a shortage of nearly 80% in specialist doctors at rural CHCs.
The disparity highlights a major challenge for India’s healthcare system: while the country needs more qualified doctors, a large number of foreign-trained medical graduates are unable to clear the screening examination required to practise medicine in India.
High Cost of Medical Education Drives Students Abroad
A resident doctor at the All India Institute of Medical Sciences (AIIMS), New Delhi, speaking on condition of anonymity, said the demand for doctors remains extremely high, but the high cost of medical education in India forces thousands of students to pursue MBBS degrees overseas.
More than 2.2 million students appear for the National Eligibility-cum-Entrance Test (NEET-UG) every year, while India had around 1.30 lakh undergraduate MBBS seats in 2026.
The availability of government medical seats is also limited compared with the overall demand.
According to Aman Singh, co-founder of overseas education consultancy Graderight, government medical colleges account for around 63,700 seats, where tuition fees are considerably lower than those charged by private and deemed medical universities.
Singh said medical education at private medical colleges can cost approximately ₹80 lakh to ₹1 crore, making an MBBS degree financially difficult for many middle-class families.
Thousands of Indian Students Choose Medical Colleges Abroad
Education consultants estimate that around 25,000 to 30,000 Indian students travel abroad every year to pursue medical education. Some estimates, however, put the number at nearly 50,000 students annually.
Countries such as Russia, the Philippines, Georgia, Bangladesh, Kazakhstan and Kyrgyzstan are among the preferred destinations for Indian medical aspirants.
Lower tuition costs and the availability of English-medium programmes are among the factors attracting students to these countries.
The Russia-Ukraine war also altered the pattern of overseas medical education among Indian students. Before the conflict began in 2022, more than 18,000 Indian students were studying in Ukraine.
Following the war, Central Asian countries gained popularity among Indian students seeking alternatives.
According to Singh, medical education in several of these destinations can cost between ₹15 lakh and ₹30 lakh, significantly lower than the cost of studying medicine at many private institutions in India.
Clinical Exposure Emerges as a Major Concern
The FMGE data also highlights the importance of repeated attempts and clinical preparedness.
Government data shows that around 88% of candidates appearing for the June 2026 FMGE had previously attempted the examination.
Among candidates appearing for the first time, the pass percentage was 35.74%. In contrast, only 3.29% of candidates who had appeared more than five times were able to clear the examination.
According to an NBEMS official, the pattern was similar in December 2025. The pass rate among first-time candidates was 47.53%, compared with just 5.58% among candidates who had appeared more than five times.
The figures suggest that the overall pass rate is significantly affected by the large number of repeat candidates. However, experts caution against attributing the low success rate solely to the difficulty of the examination.
Quality of Clinical Training Under Scrutiny
The Economic Survey 2024 had also linked concerns over low FMGE pass rates to the quality of medical education received by students studying abroad, including issues related to inadequate clinical training.
Abizer Mankad, Consultant Physician and Diabetologist at Saifee Hospital, Mumbai, said inadequate clinical exposure is one of the major factors contributing to the low pass rate.
The AIIMS resident doctor also pointed out differences in clinical exposure between Indian and some overseas medical institutions.
In Indian medical colleges, students generally get opportunities to interact with large numbers of patients and participate in clinical rounds. In contrast, students at some foreign institutions may have fewer opportunities for direct patient interaction.
Language barriers can further complicate the process of taking patient histories, communicating with patients and participating effectively in clinical training.
Doctor-Patient Ratio Does Not Reflect Uneven Distribution
India’s combined doctor-to-population ratio for practitioners of modern medicine and AYUSH systems is around 1:811.
However, the national ratio does not fully reflect the unequal distribution of doctors across the country.
Doctors are concentrated disproportionately in urban areas, while rural and remote regions continue to face shortages, particularly of specialists.
This uneven distribution remains one of the central challenges facing India’s healthcare system.
NBEMS Opposes Lowering FMGE Standards
The NBEMS has opposed suggestions to lower the qualifying standard for the FMGE.
A senior official said FMGE is a screening examination rather than a competitive examination, and maintaining a minimum competency standard is essential because doctors entering the Indian healthcare system must be capable of handling potentially life-threatening medical emergencies.
The argument is that lowering the qualifying threshold could compromise patient safety and clinical standards.
Proposal for Additional Clinical Training
Some experts have suggested an alternative approach for candidates who narrowly miss the FMGE qualifying score.
Under such a model, candidates who fall only slightly short of the passing marks could potentially be provided with structured clinical training at Indian hospitals, followed by another attempt at the examination.
Such a system, experts suggest, could help address gaps in practical clinical exposure while ensuring that candidates meet the competency standards required to practise medicine in India.
Balancing Doctor Shortages With Patient Safety
The FMGE results highlight a complex policy challenge for India.
On one hand, the country needs substantially more doctors, particularly specialists in rural and underserved areas. On the other, medical practitioners must possess adequate theoretical knowledge, clinical skills and practical experience before being allowed to treat patients independently.
The debate therefore extends beyond the FMGE pass percentage. It raises broader questions about the quality, consistency and clinical orientation of overseas medical education, as well as the affordability and availability of medical education within India.
For policymakers, the challenge will be to expand the country’s medical workforce while ensuring that every doctor entering the healthcare system meets a consistent and robust standard of competence.
