No proposal for paediatric surgery units in medical colleges: Centre

Despite a significant ramp up of the number of medical colleges and postgraduate seats in the last decade, paediatric surgery remains a neglected segment with experts pointing to a continued crisis in specialised surgical care for children across the country.

In a written response to a Rajya Sabha question in Parliament this week, Minister of State for Health and Family Welfare Anupriya Patel stated that the number of medical colleges in India had nearly doubled — from 387 in 2014 to 780 in 2025 — and postgraduate medical seats increased from 31,185 to 74,306 during the same period.

That said, experts argue that these numbers paint a misleadingly optimistic picture at least insofar as paediatric surgery discipline goes.

“Paediatric surgery is not even mandatory in the MBBS curriculum, so medical colleges aren’t required to appoint paediatric surgeons,” said Dr Vikesh Agarwal, Secretary of the Indian Association of Paediatric Surgeons (IAPS), who has been raising the issue of shortage of qualified paediatric surgeons.

“Out of over 750 medical colleges, only about 25-30 per cent have a paediatric surgery unit. That’s alarming in a country where nearly 40 per cent of the population are children,” Dr Agarwal told The Tribune.

Paediatric surgeons in India manage a wide range of complex conditions — from congenital anomalies and tumors to trauma and neonatal surgeries — spanning various specialties such as neurosurgery, urology, thoracic and gastrointestinal care for children up to 14 or even 18 years.

With over 400 million children under 14 and 23 million births annually, the clinical burden is immense. Nearly 2 per cent of babies are born with congenital defects, and around 1.72 million die before their first birthday. Yet, with limited children’s hospitals, specialists and less than 7 per cent insurance coverage, many paediatric cases are handled by adult surgeons, often without specialised training.

District hospitals and even many teaching institutions lack pediatric surgical departments. To address this issue, the IAPS wrote to the National Medical Commission (NMC), requesting that paediatric surgery be made a minimum requirement for medical college recognition, and also sought approval for a six-year MCh Paediatric Surgery course directly after MBBS.

“The six-year course would allow deeper training and open up the field to more applicants,” Dr Agarwal said. “Currently, the three-year route requires candidates to complete an MS first, which narrows the intake,” Dr Agarwal said.

However, the Health Ministry clarified in Parliament that “no such proposal is under consideration” by the NMC.

Reacting to the government’s reply, Dr Alpana Prasad, senior paediatric surgeon and faculty member at Sir Ganga Ram Hospital, said: “Just increasing the number of medical institutions won’t help. The problem is systemic. There is no dearth of paediatric surgeons in Delhi and NCR, but in tier-2 and tier-3 towns, there is an acute shortage.”

Children, she pointed out, aren’t miniature adults. “They need specialised care. Most paediatric surgeries are for congenital defects that require early intervention and expertise. In smaller districts, general surgeons, often without paediatric specialisation, end up operating on newborns, sometimes with serious consequences.”

She stressed that while AIIMS and major hospitals do offer training programmes — Delhi alone has at least seven such institutions — the lack of infrastructure and job opportunities in smaller towns makes it difficult to retain specialists.

“The government needs to mandate posts for paediatric surgeons at the district level, especially where deliveries and NICUs exist,” she said.

“Nowadays, birth defects are being picked up during pregnancy, and mothers are being asked to deliver in referral centres. Why can’t we make paediatric surgical care accessible in district hospitals?” she asked.

The ministry response also mentions relaxing norms for starting MCh Paediatric Surgery courses, allowing institutions to begin with just two faculty members and 20 beds. While this may ease entry barriers, Dr Prasad raised concerns about quality.

“Increasing training seats is fine,” she said, “but we need to ensure these surgeons are exposed to the full range of paediatric surgical procedures. Without strong case load and infrastructure, quality suffers,” she said.