Five years on, NEP 2020’s medical education reforms reveal a system in flux—expanding in scale, nudging towards equity, yet still grappling with entrenched divides
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This essay is part of the series “Five Years of NEP 2020: From Vision to Reality”
India introduced the National Education Policy (NEP) in 2020, an aspirational initiative to reimagine India's education system for the 21st century. It promised to have an inclusive, responsive, and student-focused framework grounded in Indian ethos and complementary to international trends. NEP 2020 rests upon five pillars: access, equity, quality, affordability, and accountability, and seeks to place education as an integral driver of national development.
For medical education, this policy came at the right time. India is facing shortages of trained health workforce, rural-urban inequalities, and increasing calls for digital and interdisciplinary skills. Recognising these challenges, NEP 2020 set out to transform professional education, including medicine, not only as a pathway to employment, but as a means to promote social justice, ethical behaviour, and public health. Five years on, it is important to look at how the policy has changed the way India prepares its future doctors.
NEP 2020 calls for many improvements in professional education to make it more transdisciplinary, practical, ethical, and responsive to society. The policy advocates a shift away from rote learning towards competency-based learning that includes hands-on training, ethics, communication skills, and technology use.
NEP 2020 also strongly supports education that focuses on skills and careers. It advises making the required rotational internship for MBBS (Bachelor of Medicine, Bachelor of Surgery) students better and adding early clinical exposure to the curriculum.
One of the strongest suggestions is shifting towards a multidisciplinary and integrated system. NEP foresees the mingling of subjects such as biotechnology, data science, and public health in the curriculum. NEP also proposes having a foundation phase common to all undergraduate students in science, before specialisation in medicine, dentistry, or allied sciences, aimed at fostering interdisciplinary education. NEP 2020 also strongly supports education that focuses on skills and careers. It advises making the required rotational internship for MBBS (Bachelor of Medicine, Bachelor of Surgery) students better and adding early clinical exposure to the curriculum. The goal is to provide graduates with the skills and confidence to deal with real medical problems, especially in rural and underserved areas.
The other important commitment is consolidating India's plural health systems, such as AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homoeopathy). The policy advises students to be allowed to take cross-system electives, promoting each system to honour the other. This aligns with India's native medical pluralism and help foster culturally sensitive care. The policy also addresses quality assurance and regulatory reform, recommending accreditation of nursing institutions every five years and creation of Nurse Practitioner courses across India to help address rural and primary care gaps. Figure 1 summarises some of the key points that NEP promises for medical education.
Figure 1: What NEP 2020 Promises for Medical Education
Finally, NEP says that technology should be used in both teaching and learning. It says that medical colleges should use artificial intelligence, online platforms like SWAYAM (Study Webs of Active-learning for Young Aspiring Minds) and DIKSHA (Digital Infrastructure for Knowledge Sharing), and virtual simulations to help students learn better.
In the last five years, India has made much progress towards achieving the goals of NEP 2020 in medical education. Infrastructure development and expanding intake capacity have yielded the most tangible advancements. Between FY19 and FY25, MBBS seats increased from 70,012 to 1,18,137 and post-graduate (PG) seats from 39,583 to 73,157, reflecting a 130-percent overall expansion in medical education capacity. Over the same period, the number of seats in postgraduate programmes has also grown by more than 125 percent. These developments show that the government is still focused on making sure that the workforce is ready for healthcare jobs that meet NEP goals.
The National Exit Test (NExT) will be released in August 2025. This is a big change in the structure of the National Education Policy (NEP). NExT will replace final-year MBBS exams, NEET-PG (the National Eligibility cum Entrance Test for Post-Graduation), and the Foreign Medical Graduate Examination (FMGE) from August 2025. It will be a one-window national licensure and postgraduate entrance test from 2025. This will bring in uniform standards and accountability in all medical institutions.
Over the same period, the number of seats in postgraduate programmes has also grown by more than 125 percent. These developments show that the government is still focused on making sure that the workforce is ready for healthcare jobs that meet NEP goals.
In places like Madhya Pradesh and Rajasthan, medical education is now available in regional languages like Hindi. This is meant to make it easier for children from rural areas to get to school and to make it easier for doctors and patients to talk to each other in the community. More than 300 medical schools have embraced AI-based digital anatomy and simulation labs, which let students study without having to use real bodies or live patients all the time. The Ministry of Education now says that government platforms like SWAYAM and DIKSHA are being utilised to teach medical ethics, soft skills, and clinical reasoning online. These are real efforts towards following NEP's rules on access, quality, and cost. The speed and rhythm of these changes vary in different states and institutions. This suggests that the process has only just begun and that there is still much work to be done before it is fully completed.
Although NEP 2020 has initiated revolutionary changes in medical education, several challenges continue to affect implementation at full capacity. The most significant of these is the absence of infrastructure and faculty-staffed faculties, particularly at new or rural medical colleges. Proper labs, clinical exposure, and trained faculty have not always kept pace with the rapid expansion in seats and institutions. This disparity compromises the quality of medical graduates.
The digital divide is also an enormous concern. While we encourage digital learning and AI technologies, very few rural colleges have stable internet and updated hardware. As a result, the NEP agenda for equity and access stalls, leaving lower-income student groups behind. Affordability is still a constraining factor. NEP has suggested increasing expenditure on education to 6 percent of Gross Domestic Product (GDP), yet India is still lagging. There are not enough spots in government medical colleges for all the deserving applicants, and private colleges are still too expensive for most families. Low scholarships and rising out-of-pocket costs are making medical school incredibly expensive for many people.
The digital divide is also an enormous concern. While we encourage digital learning and AI technologies, very few rural colleges have stable internet and updated hardware.
Also, academic systems are resistant to reform. Traditional teaching methods are still used, and the faculty does not know how to use competency-based or interdisciplinary teaching methods. Institutions cannot change the design of courses, accurately analyse outcomes, or add AYUSH or digital health topics.
India needs to work on a few important areas in order to get the most out of NEP 2020's ability to change medical education.
India can make sure that NEP 2020 expands medical education and makes it better, more accessible, and more useful for future healthcare requirements by working on these areas.
India is on track to meet the WHO doctor-patient ratio of 1:1000 by 2030, with a current workforce of 13.86 lakh registered doctors and an annual addition of 50,000. The introduction of NExT, tech-enabled learning resources, and regional language teaching indicates that the system is on the correct path. Nevertheless, there are still large gaps in the areas of infrastructure, development of faculty trainers, resources, and equity. The true test is not only in increasing access but also in enhancing the quality and relevance of medical education for a new generation. With committed investment and collaborative partnership, India can create a future-proofed healthcare talent pool that serves all its citizens.
Dr. K. Madan Gopal is a Senior Health Sector Expert and is currently working as Advisor & Head, Public Health Administration Division at the National Health Systems Resource Centre (NHSRC), a premier think-tank for the Ministry of Health and Family Welfare, Government of India.
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Dr. K. Madan Gopal is a senior public health expert with over three decades of experience in health sector reforms and health systems strengthening in ...
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