India's Broken Medical System: NEET, Doctor Violence & Salaries | Dr. Nachiket | FO513 Raj Shamani
Dr. Nachiket Bhatia, entrepreneur and angel investor, discusses the harsh realities of India's medical system, including the extreme difficulty and cost of becoming a doctor, poor salaries, rampant violence against doctors, and why thousands of Indian doctors are emigrating to the US. He also shares his personal journey of building and selling a medical coaching company worth 200 crore rupees.
Summary
The conversation opens with Dr. Nachiket's assertion that doctors are the worst-treated community in India. He breaks down the NEET UG process: 22 lakh students compete for just 1 lakh seats, with only 40,000 government seats available at negligible fees. Private college fees range from ₹13 lakh/year in UP (capped) to ₹80-90 lakh/year in Karnataka and Tamil Nadu with no cap. An MBBS graduate earns only ₹50,000–1.5 lakh/month, and the degree alone holds little market value without a PG specialization.
The PG (MD/MS) system is even more brutal: 2 lakh candidates compete for roughly 400 good seats, and after 8 years of education, starting salaries are only ₹70,000–80,000/month. The most lucrative specializations are Radiology (can earn ₹10 lakh/month within 5 years due to teleradiology flexibility), Dermatology (now a commercial branch with high-ticket procedures), and core branches like Medicine, Surgery, and Obstetrics. Super-specialization adds another 3 years, meaning serious earning potential only arrives after 11-12 years.
A major portion of the discussion covers violence against doctors. Dr. Nachiket states that 75% of doctors have experienced some form of violence in their careers. He describes mob attacks after patient deaths, a gunman entering GTB Hospital Delhi and shooting a patient while holding a resident at gunpoint, and the toxic culture of senior doctors harrassing and physically abusing juniors — a cycle passed down through generations. The RG Kar Medical College rape and murder case is cited as emblematic of how unsafe hospital environments are for doctors, yet little systemic action follows.
The salary disparity with the US is stark: Indian doctors start at ₹50,000–1 lakh/month vs. ₹1 crore+ in the US, with neurosurgeons earning ₹3-4 crore/year starting salaries there. US residency also offers structured hours, overtime pay, and health benefits — none of which exist in India. Dr. Nachiket explains the USMLE pathway (Steps 1, 2, 3) that Indian doctors use to qualify for US residency, noting roughly 10,000 Indian MBBS graduates attempt the USMLE annually.
The foreign medical graduate (FMG) issue is discussed at length: students go to Russia, Georgia, Uzbekistan, Philippines, and China for cheaper MBBS degrees, but face a 20-25% pass rate on India's FMG entrance exam upon return. Many colleges abroad are substandard 'box colleges' recognized on paper by India's NMC but with zero infrastructure. A recent NMC notice requiring FMG returnees to work for free for 3 years (later withdrawn after protests) is cited as an example of exploitative and irrational policy-making.
On medical scams, Dr. Nachiket discusses the organ black market (kidneys trading for ₹15-20 lakh, eyes for ₹1 lakh), quacks/compounders posing as doctors in rural areas, and the misconception that doctors over-prescribe tests for commissions — he argues most follow clinical protocols, and corporate hospitals don't set test targets for individual doctors.
Finally, Dr. Nachiket shares his personal story: his father founded India's first NEET PG coaching institute in 1996. After the company peaked at ₹100 crore revenue with 100 centers, poor management decisions, failure to adapt to digital marketing and exam changes led to near-collapse by 2019, with employees going 6 months without pay. He mortgaged his house, invested in building an app (eCuFlu/DBMCI app), and by July 2020 returned to profitability within 6 months. By 2023 the company reached ₹200 crore and was acquired by Japanese company M3 (through subsidiary Marrow/NHPL) in November 2023, with the offline business fetching ~9.7x EBITDA.
Key Insights
- Dr. Nachiket claims that 75% of Indian doctors have experienced some form of violence in their careers, and in large government hospitals a violent incident occurs in at least one department every single day — yet no legal protection act for doctors has been enacted despite being proposed for 5-7 years.
- Dr. Nachiket argues that Indian doctors starting salaries are ₹50,000–1 lakh/month while US counterparts start at over ₹1 crore/month, and neurosurgeons in the US earn ₹3-4 crore/year starting — even after purchasing power parity adjustment this is roughly 8 crore, making emigration economically rational.
- Dr. Nachiket states that Karnataka and Tamil Nadu private medical colleges charge up to ₹80-90 lakh per year in fees with no government cap, meaning a PG seat in Radiology at such colleges can cost ₹2 crore+ in donations alone on top of full fees, primarily purchased by business families wanting their children in high-earning specializations.
- Dr. Nachiket describes the FMG (foreign medical graduate) system as deeply broken: only 20-25% of students returning from abroad pass India's licensing exam, largely because NMC-recognized foreign colleges are often 'box colleges' with zero infrastructure, and a recent government notice attempted to make FMG returnees work unpaid for 3 years before receiving a license — a policy withdrawn only after protests.
- Dr. Nachiket recounts that newspaper coverage of doctor-beating incidents starting around 2014-15 inadvertently taught the public that attacking doctors was possible and consequence-free, directly accelerating the frequency of violence — a feedback loop where lack of prosecution emboldens further attacks.
Topics
Full transcript available for MurmurCast members
Sign Up to Access