Over the past eleven years under the leadership of Prime Minister Narendra Modi, the nation has reimagined its health workforce — expanding capacity, reforming regulatory structures and galvanizing educational ecosystems to meet the challenges of today and the promises of tomorrow.
India’s health professional workforce today is vast and diverse, comprising nearly a 1 crore professionals across various categories. This includes 13.9 lakh doctors, 7.5 lakh AYUSH practitioners, 3.8 lakh dental professionals, and 39.4 lakh nurses—the largest segment of the workforce. Pharmacists number around 17.6 lakh. Approximately 15 lakh Allied and Healthcare Professionals (AHPs) further support critical clinical, technical and diagnostic services. This diversity reflects India’s commitment to a robust, community-embedded workforce capable of addressing the varied healthcare needs of over 1.4 billion people. For a population of 1000, on the average, Bharat has nearly one allopathic doctor (equaling WHO norm), 0.5 Ayush doctor and 2.8 nurses.
The transformation of India’s health workforce is not just about numbers. In the last eleven years, the country has seen a strategic surge in medical and nursing colleges. This expansion has sharply increased undergraduate and postgraduate seats, ensuring that more young Indians than ever before can pursue careers in healthcare. Between 2014 and 2024, medical colleges grew from 387 to 780 (increase of 102 per cent). The under graduate (MBBS) seats have grown by 130 per cent (from 51,000 before 2014 to over 1,18,000 at present) and post graduate (PG) seats by 135 per cent (from 32,000 before 2014 to over 74,000 now).
Nursing education programs have witnessed a similar increase. B.Sc. (Nursing) institutions grew by 45 per cent and seats by 53 per cent, while M.Sc. (Nursing) programs saw a 29 per cent increase in institutions and a 39 per cent rise in seats. Dental education advanced as well, with BDS seats growing by nearly 10 per cent and MDS seats by 34 per cent.
Nursing capacity
Importantly, many of the new medical are nursing colleges are strategically established in rural and underserved districts, creating local centres of excellence that produce health professionals embedded in their communities. Doctors and nurses trained in these settings are far more likely to remain and serve there, helping address India’s longstanding urban-rural divide in healthcare delivery. Equally importantly, the medical college hospitals provides multi-specialty care in these geographies saving lives.
A huge development in Bharat’s health workforce is the deployment of a new cadre of over 1,25,00 Community Health Officers (CHOs) in the primary health care system across the country since 2018. The erstwhile sub-health centres, responsible for about 6,000 population have been upgraded as Ayushman Arogya Mandirs (previously called health and wellness centres). In these comprehensive primary health care facilities, the existing team of multipurpose health workers (male and female) and Accredited Social Health Activists (ASHAs) now has, in addition, a CHO each who is typically a graduate nurse with special training. Addition of CHO at the cutting edge of health system allows expanding services to include non-communicable diseases (screening, referral and continuing care of hypertension, diabetes and cancers), mental health, care of the elderly, eye and oral health.
Archaic regulations plagued India’s health professions, retarding their progress. The government has now overhauled the regulatory architecture to build a more transparent, accountable and effective system. Four major legislations—the National Medical Commission (NMC) Act, National Commission for Allied and Healthcare Professions (NCAHP) Act, National Dental Commission Act, and National Nursing and Midwifery Commission Act—have replaced outdated regulatory bodies, establishing a modern governance framework.
Quality focus
Capacity alone is not enough. Recognizing this, India has made quality a central pillar of reform. The introduction of Competency-Based Medical Education (CBME) for undergraduates and 79 competency-driven postgraduate curricula ensures that medical graduates are not only well-versed in theoretical knowledge, but also proficient in clinical skills, communication, ethics, and decision-making. Digital tools, simulation labs, and e-learning modules are being leveraged. The Bachelor of Dental Surgery (BDS) Course Regulations (2022) and the revised B.Sc. Nursing Program Regulations similarly modernize health education across the board. Innovative nurse practitioner courses are being initiated.
The National Board of Examinations in Medical Sciences (NBEMS) that oversees postgraduate (PG) medical courses in existing hospitals (and is contributing over 15,000 PG seats), have initiated diploma courses in priority specialties (such as family medicine, pediatrics, obstetrics-gynaecology and anesthesiology). The network of district hospitals is being utilized as training institutions and joint courses spanning two hospitals are being allowed – opening pathways for greater range and capacity of PG training through this pathway as well.
One innovation in the training of specialists, namely, the district residency program, deserves a special mention. Under this compulsory requirement, the NMC has mandated that all PG students will rotate for three months each in district hospitals in the second year of their training. During this posting, the future specialists work as full-time residents at district hospitals under supervision of local specialists.
This achieves two purposes.
First, the future specialist learns to provide care in the real-life setting of this pivotal layer of the health system and gains expertise in health conditions that dominate there.
Second, the services at district hospitals improve significantly because the existing teams get a boost with residents being posted there. Potentially, at any given time almost 10,000 PG residents are now injected into district-level hospitals across the nation augmenting workforce by an average 8-10 doctors at each one of those hospitals. Medical colleges also have an opportunity to increase PG seats (without any additional faculty/ infrastructure requirement) in lieu of the constant posting out of a quarter of the annual batch of residents. The program converges the health services and medical education departments of the state governments. it is for their administrative leaderships to make the best of this win-win opportunity by supporting, motivating, hand-holding and encouraging the young residents posted in district hospitals.
We need to enhance the family medicine programs in a big way as mandated in the National Health Policy and the NMC Act. India needs a balanced mix of family practitioners and specialists.
Other branches requiring urgent augmentation in training pipeline are the specialties of psychiatry, emergency medicine and critical care. In nursing, training programs in nurse practitioner courses should be launched. The NCAHP is taking progressive steps in filling the void of courses, capacity and quality in a wide range of allied health professions (e.g. medical lab, dialysis and radiology technicians, physiotherapists, dieticians, psychiatric social workers, optometrists, perfusionists etc.) which have a huge demand.
Going forward, the momentum of reform, perform and transform in the health professional education ecosystem of the past eleven years will be further accelerated. Indian health professionals must have the highest level of competence, and hence, quality of training must be a core focus. We need our health workforce to deliver services that meet expectations of the people, and match the highest benchmarks of the art and science of respective professions.
The writer is member, NITI Aayog. Views are personal