No Family Doctors, No Continuity of Care: Dr. Paul Flags Dangerous Gap in India's Healthcare System

Time of India

4 hours ago

New Delhi: In a bold call for transformation,
Dr. V. K. Paul
, Member (Health),
NITI Aayog
, outlined a sweeping blueprint to revamp India's medical education system, stating that the country must train not just for adequacy but for ambition, as part of its journey toward becoming a developed nation.
Speaking at a policy dialogue hosted by the Centre for Social and Economic Progress (CSEP), Dr. Paul addressed critical issues of medical manpower, quality of postgraduate training, and structural reforms needed to match the healthcare needs of 2040 and beyond.
'We must shed the illusion that we're anywhere close to sufficient,' Dr. Paul said. 'A ratio of one doctor per 1,000, the WHO norm, may suffice for low-income nations. For India, aiming to be a global leader, we need three per 1,000—this must be our goalpost by 2040.'
India's Specialist Shortage is 'Alarming'
Citing data on specialist shortfalls, Dr. Paul painted a sobering picture stating that the current rate of producing 5,500 general surgeons per year, India will take 34 years to match the average for lower-middle-income countries and 69 years to meet high-income benchmarks.
For psychiatrists, the country has 0.7 per 100,000 people, compared to the LMIC average of 2, and would require 23 years to close the gap.
For cardiologists, India lags drastically—with projections of an 82-year wait to meet international standards.
'This is not just a workforce issue; it's an issue of national health resilience,' he said.
Dr. Paul called for an overhaul of the MBBS curriculum to better prepare graduates for real-world care. He stressed the need for deeper exposure to internal medicine, geriatrics, psychiatry, and chronic disease management—areas that often receive less than four weeks of training under the current system.
'Our internship structure is broken. How can a student become proficient in schizophrenia or diabetes management with three weeks of exposure?' he asked. 'In high-income countries, becoming a family physician takes 10 years. We try to compress all that into five and a half.'
Urgent Need to Mainstream Family and Emergency Medicine
Perhaps the most impassioned part of Dr. Paul's address was his plea to mainstream Family Medicine—a specialty largely ignored in Indian medical training.
'If we continue on our current path, by 2035 we will be a country with only specialists and barely any generalists,' he warned. 'That's a broken healthcare model. Family physicians are critical for managing chronic diseases, elderly care, mental health, and ensuring continuity of care.'
Despite national policy backing and global best practices, India has less than 100 Family Medicine postgraduate seats. Dr. Paul urged the National Medical Commission (NMC) to urgently expand these, including adopting the All India Institute of Medical Sciences (AIIMS) model, where Family Medicine training is delivered without needing a standalone department.
He also highlighted the neglect of Emergency Medicine, which he called 'the face of healthcare' and critical for equitable access. 'Emergency departments in most medical colleges are grossly underdeveloped.
A single resident, 30 patients, and no consultant oversight—that's the reality today,' he said, advocating mandatory emergency medicine departments in new colleges.
Dr. Paul urged policymakers to view health not as a cost but as a driver of economic development. 'Healthy people drive innovation, productivity, and growth. The healthcare workforce must be seen as a core part of India's human capital strategy,' he said.
He concluded with a call for collaboration across ministries, private sector participation, and a shift in mindset: '
Medical education reform
is no longer optional. It is foundational to India's ambition to become a developed, equitable nation.'