Increased Intake, Neglected Infrastructure
The recent announcement by the National Medical Commission to increase the intake capacity of medical colleges across the country has sparked widespread excitement. In Jammu and Kashmir, social media overflowed with congratulatory messages as many newer medical colleges set up after 2019, received an increase of MBBS seats. While the older institutions with established infrastructure truly deserve this expansion, the same cannot be said for the newly established colleges that were district hospitals converted into medical colleges. The increase in seats for these new colleges is premature and misplaced. This decision might have been commendable if it came after substantial improvements in the infrastructure of these colleges and their associated hospitals. Unfortunately, the reality is starkly different. The government’s effort to upgrade district hospitals into medical colleges was intended to improve healthcare access in remote areas of Jammu and Kashmir. But in most cases, only the signboards have changed.
The buildings, equipment, wards and facilities remain almost the same as before. The old structures, overburdened staff and limited diagnostic capacity continue to define healthcare in these areas. Even years after being designated medical colleges, these institutions still refer patients to SKIMS and GMC Srinagar for specialized care. The promise of decentralizing healthcare remains unfulfilled as these colleges often operate more like outpatient centres than teaching hospitals.
Adding to this misplaced enthusiasm, MD and DNB seats have also been allotted to these new colleges. However, this move is largely symbolic and mocks the very idea of progress since the essential infrastructure and faculty needed to run postgraduate programs are missing. This is a token gesture rather than a real effort to enhance medical education and training. The absence of critical diagnostic and interventional facilities is glaring. Most of the colleges do not have fully functional departments and many face severe faculty shortages. Junior doctors are often placed as in-charge heads of departments which undermines the quality of training. Laboratories are under-equipped and clinical exposure for students remains limited, often below the national standard. None of these new colleges can currently claim to have all the departments or infrastructure needed to operate as a full teaching hospital yet. This harms patient care and jeopardizes the quality of medical education for future doctors. Mere press releases, photo opportunities and superficial accolades cannot compensate for this deficiency.
The deeper concern is that this reflects a pattern seen before. When engineering colleges were rapidly opened across the country a few years ago, they too lacked adequate laboratories, faculty and industry linkages. Thousands of engineering graduates today struggle with unemployment or underemployment because their colleges were ill-equipped to prepare them for real challenges. The same mistake is now being repeated in the medical sector. Expanding seats without building infrastructure risks producing a generation of doctors who are poorly trained and unprepared for clinical realities. This will burden an already overstretched healthcare system and degrade both education and patient care. In most developed countries expansion in medical education happens only after a thorough evaluation of infrastructure, faculty strength and hospital capacity. The World Federation for Medical Education clearly states that expansion should follow infrastructure development, not the other way around.
Sadly, in Jammu and Kashmir the process is reversed. Intake has been increased first and infrastructure is expected to catch up eventually, without clear timelines or accountability. This approach weakens the foundation of medical education and public health planning and risks turning medical colleges into under-resourced institutions struggling to meet basic standards.
While increasing seats seems like a good idea to address the doctor shortage, intention alone is not enough. The government must make infrastructure development the core priority. Hospitals should have modern diagnostic and treatment facilities before intake is increased. Faculty recruitment must be strengthened and proper teaching and residential facilities for staff and students ensured. Without this the new colleges will remain upgraded district hospitals only in name. Every medical college in Jammu and Kashmir should be a self-sufficient healthcare hub serving its local population. A patient in Kupwara or Rajouri should not have to travel to Srinagar or Jammu for specialized care. That was the purpose behind converting district hospitals into medical colleges. Until this vision is realized with actual infrastructure and services, these conversions remain symbolic. Increasing seats on paper will not save lives in emergency wards.
If this trend continues Jammu and Kashmir will have more medical colleges but very few capable of producing competent doctors. The Union Territory will continue to depend on a few tertiary institutions for specialized care. Real progress cannot be measured by the number of colleges or seats but by the quality-of-care patients receive and the ability of doctors to serve effectively.
Jammu and Kashmir stands at a critical crossroads. The people deserve hospitals that heal and colleges that truly teach, not institutions that exist only on paper. Infrastructure is not a luxury in medical education but the foundation everything else depends on. Increasing seats without upgrading infrastructure is like building more floors on a weak foundation. The structure may stand for a while but will eventually collapse. The government must recognize infrastructure development is not an afterthought but the first step toward quality healthcare and education. Only then will the dream of accessible and reliable healthcare for every citizen of Jammu and Kashmir become a reality.
Peerzada Mohsin Shafi hails from Anantnag and is an infrastructure columnist.
