Medicine’s Broken Backbone: What the FAIMA Survey Exposes About Indian Healthcare Education

The image of a doctor in India still carries an aura of reverence and a symbol of intelligence, endurance, and compassion. Yet beneath that white coat often lies a story of exhaustion, uncertainty, and despair. The recent Review of Medical System (RMS) Survey 2025 conducted by the Federation of All India Medical Association (FAIMA) has brought this unsettling truth into the light, revealing what India’s medical students and residents endure behind hospital walls and lecture halls. It exposes the widening cracks in the country’s medical education system i.e. a framework that is producing more doctors on paper, but fewer well-trained, emotionally resilient, and confident professionals in reality.

FAIMA’s survey, carried out between September 20 and October 8 this year, collected responses from over 2,000 medical professionals across 28 states and Union Territories. 90 percent of respondents were from government medical colleges, showing the pulse of the country’s public medical education network. The findings are eye-opening, and at times, deeply troubling. They reflect a system struggling with inconsistency, where ambition runs high but execution falls short, and where those training to save lives often find their own slipping into chaos.

At the centre of the report lies a contradiction that defines much of India’s healthcare education today. On one hand, 71.7 percent of students said they have adequate patient exposure which is the very foundation of clinical learning. This suggests that hospitals continue to offer a rich ground for experience and skill-building. But what follows this number is more telling. More than 62 percent of postgraduate residents reported that their stipends are irregular. Many said payments are delayed for months, leaving them to survive on loans or family support. For a young doctor working 18-hour shifts, skipping meals, and facing daily emergencies, the absence of financial stability is a failure of the system meant to nurture them.

Equally concerning is the shortage of resources in institutions that are supposed to train India’s future healers. Only 35 percent of respondents felt that their college laboratories, OPD and IPD facilities, and essential equipment were adequate for quality training. Several newer colleges, opened in the name of expanding access, continue to function with incomplete infrastructure. Students report a lack of basic amenities like clean water, secure hostels, functioning libraries, and, in some cases, safe working environments. The expansion of medical colleges, once hailed as a triumph, now appears to have raced ahead of quality control. The RMS survey makes a clear point that increasing the number of seats or colleges cannot compensate for the declining standard of education and infrastructure.

The gaps extend beyond equipment and funds, reach into the very soul of medical training: mentorship. The survey revealed that around 39 percent of postgraduate students had no assigned guides for their research or clinical learning. Some departments, especially in newer colleges, run with just one or two senior residents or assistant professors managing the entire unit. Faculty shortage has become one of the most chronic illnesses in India’s medical education system. For students who depend on guidance to navigate complex diagnoses, surgeries, or thesis work, the lack of a mentor translates to confusion, anxiety, and in many cases, incompetence at the end of their residency.

Perhaps the most alarming revelation from FAIMA’s survey is about confidence. Over half the postgraduate students surveyed (50.5 %) admitted they do not feel confident handling patients or performing surgeries independently after completing their residency. This statistic is chilling because it questions the very output of the medical education system. It is not a reflection of student capability, but of institutional failure where students are often overworked, under-supported, and undertrained. The growing dependence on theoretical learning over clinical practice, coupled with inconsistent teaching standards, is breeding insecurity among young doctors who are soon expected to make life-or-death decisions on their own.

Beyond professional gaps, the survey draws attention to a human crisis i.e. the rising toll of mental health issues among medical students and residents. More than 70 percent of postgraduate residents said they have no fixed duty hours. Many work continuous shifts that stretch beyond 24 hours, with barely enough time to rest or eat. The exhaustion is not just physical; it’s emotional. With rising cases of suicide among medicos in recent years, FAIMA’s report calls for urgent structural reform recommending that every medical college must establish a Mental Health Committee, a 24×7 helpline, and at least two counsellors for every 500 students. It further proposes family involvement in mental health programmes, regular reviews with the National Medical Commission (NMC), and mandatory well-being sessions as part of medical training.

The irony is hard to ignore where those who are trained to heal others are rarely given the tools to care for themselves. The emotional distress that builds up from academic pressure, long working hours, lack of recognition, and fear of failure can be devastating. For many young doctors, burnout begins long before they graduate. The medical profession, often idealized as a noble calling, is in danger of becoming synonymous with suffering, especially when the system fails to value the mental and emotional stability of its students as much as their clinical skill.

Dr. Sajal Bansal, FAIMA’s Chief Advisor and the lead coordinator of the RMS Survey, summed it up aptly in his interaction with the media; India’s medical system needs reform from the inside out. He emphasized the importance of creating an ecosystem that values mentorship, research, and wellness equally with academics. FAIMA’s survey doesn’t just highlight the cracks; it proposes solutions like stricter monitoring for timely stipends, transparent reporting of faculty strength, evaluation of college infrastructure, and stronger accountability from both the National Medical Commission and state authorities.

The role of the NMC in this entire narrative is crucial. As the apex regulatory body, its decisions and policies shape the entire landscape of medical education. FAIMA’s delegation recently met NMC Chairman Dr. Abhijat Sheth, presenting these findings and urging that recommendations from the RMS Survey be considered in upcoming policy decisions. Dr. Sheth acknowledged the concerns and assured that the Commission would review FAIMA’s suggestions. The meeting also revived discussions around the proposed National Exit Test (NEXT), which Dr. Sheth confirmed will not be implemented immediately. Instead, mock trials will be conducted over the next three to four years to assess feasibility. It was a small but significant step toward engaging with the medical community before imposing sweeping reforms.

India’s healthcare future depends on the doctors being trained today. The FAIMA report should be seen not as criticism but as a mirror reflecting both achievements and alarming neglect. Despite all the challenges, the resilience of India’s medical students and residents remains admirable. They continue to serve tirelessly in overcrowded wards, rural outposts, and emergency units, even as their own needs are neglected. Their dedication to their patients remains unwavering, but the institutions that train them must match that commitment with reform.

Medical education is not just about degrees or exams; it’s about shaping doctors who can diagnose, empathize, and lead. It demands not just skill but emotional intelligence and ethical grounding. When those pillars are weakened by administrative apathy, financial delays, or mental distress, the entire structure of healthcare begins to tremble. The FAIMA survey is a call for introspection for policymakers, administrators, and the medical fraternity alike to revisit the purpose of education in medicine.

Doctors are the backbone of every healthcare system, but even the strongest spine can fracture if burdened without support. India’s expanding network of medical colleges has brought hope to millions aspiring to join this noble profession, yet without accountability and empathy, the dream risks turning into disillusionment. The RMS findings underline that quantity without quality leads to collapse, and expansion without mentorship leads to emptiness.

If India wishes to truly strengthen its healthcare delivery, it must begin with strengthening its doctors not through slogans or ceremonial appreciation days, but through concrete reforms that protect their financial stability, mental health, and learning environment. Regular stipend payments, functional infrastructure, qualified faculty, and mental health safeguards must become the norm, not the exception. The NMC’s involvement must go beyond policy announcements; it must ensure that every medical college functions with dignity, discipline, and compassion.

The future of Indian medicine cannot rest on the shoulders of overworked and under-supported doctors. It requires a system that stands by them as firmly as they stand by their patients. FAIMA’s RMS Survey 2025 is a wake-up call that demands action. If ignored, the cracks will widen, and the cost will be paid not just by doctors but by every patient who looks to them for care.

Medical education is a lifelong journey, but its foundation is laid during those formative years in classrooms and hospitals. When that foundation is shaky, the entire structure of healthcare risks instability. It is time for the authorities to ensure that doctors are not broken in the process of learning to heal. The survey’s findings are a reminder that reform in medical education is not a luxury it is a necessity.

For a nation that prides itself on its doctors serving across the world, the question is no longer whether India produces enough doctors. The question is, are we taking care of the ones we already have? Until that answer changes, the white coats that symbolize healing will continue to carry the invisible scars of a system that forgot to heal its own healers.

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