New Delhi: The ongoing uncertainty around NEET-PG admissions is creating pressure on both medical aspirants and public hospitals, with Kerala reporting staffing concerns as the state deals with a seasonal rise in infectious diseases. At the same time, postgraduate medical admission rules continue to differ across states despite a Supreme Court ruling that residence or domicile cannot be used as a criterion for admission to state quota PG medical seats.
The issue comes as the Centre reviews the NEET-PG admission process and the Supreme Court examines questions surrounding the qualifying cut-off, counselling and allocation of postgraduate seats.
Kerala's hospital staffing problem
In Kerala, government medical colleges rely heavily on postgraduate resident doctors for day-to-day hospital services. A shortage of incoming residents can increase the workload on existing doctors and staff at a time when hospitals are dealing with additional patient loads linked to seasonal and infectious diseases.
Kerala faced a similar shortage during the delayed NEET-PG counselling cycle in 2021, when resident doctors said the absence of a new PG batch had left medical colleges short of about 1,000 resident doctors. The state appointed non-academic junior residents to partly address the gap.
The current situation comes due to delays in postgraduate medical admissions. In June, reports from Tamil Nadu said delays in the NEET-PG cycle were already affecting hospital staffing and threatening to push counselling and admissions later into the year.
Why are states following different rules?
The admission issue is also tied to a Supreme Court judgment on domicile-based reservation in postgraduate medical education.
In 2025, the Supreme Court ruled that reservation in PG medical courses based solely on residence or domicile is constitutionally impermissible. The court held that state quota seats must be filled on the basis of NEET-PG merit, while allowing reasonable institutional preference, such as preference for students who completed their MBBS at the same institution.
The ruling drew a distinction between undergraduate and postgraduate medical education. At the PG level, the court placed greater emphasis on merit and national standards because students are training as specialist doctors.
The judgment did not abolish state counselling. States continue to conduct counselling for their share of PG seats, but the question is how eligibility for those seats should be defined after the ruling.
Different rules, different opportunities
Despite the Supreme Court's ruling, states continue to have different eligibility provisions for their NEET-PG state quota counselling, according to the latest reports.
This has created uncertainty for candidates who take the same national examination but face different rules depending on the state where they seek admission. Parents and aspirants have questioned why residence-based restrictions continue to appear in state counselling frameworks after the court's decision.
The distinction between state quota and institutional preference is important. The Supreme Court has permitted reasonable preference for students trained at a particular institution, but held that simply being a resident of a state cannot be used to reserve PG medical seats.
The separate issue of vacant PG seats
The admission system is facing another problem at the same time: vacant postgraduate seats.
In the previous NEET-PG counselling cycle, the qualifying cut-off was reduced substantially to enable more candidates to participate in counselling and fill seats. The Centre said the move was intended to address vacancies. According to NBEMS, more than 95,000 additional candidates became eligible after the reduction in the qualifying threshold. The Supreme Court is examining the implications of the policy, and the Centre has constituted a high-level committee headed by the Director General of Health Services to review the NEET-PG admission mechanism.
What happens next?
The Centre's DGHS-led committee is expected to review the existing admission mechanism and report to the Supreme Court. The court is also examining challenges to the lowering of the NEET-PG qualifying threshold.
