When the Soul Slipped Away

By January 2026, medical education in India had expanded beyond anything my generation could have imagined. The National Medical Commission had pressed hard on the accelerator. New colleges kept appearing on the map, approvals came in quick succession, and the country now had hundreds of medical colleges and well over a lakh MBBS seats. The numbers looked impressive—like a nation announcing, with pride, that it had built enough runways for the future.

Around the same time, I stepped down from the administrator’s chair and returned fully to the department. For years I had worn two hats—Medical Superintendent and Professor—and each day had demanded a different version of me. Now I wore only one. It should have felt like relief. In many ways it did. But it also gave me a clearer view of something I had sensed for a while: while the numbers had grown, the soul of the profession had quietly thinned.

The shift, of course, did not begin in 2026. It had begun much earlier, and like many large changes in India, it arrived under the banner of reform. In 2013, NEET—the National Eligibility cum Entrance Test—entered our lives. A single national entrance examination replaced the patchwork of state and institutional tests. On paper, it sounded fair and clean. One exam, one merit list, one rulebook for everyone.

But MGIMS was not like everyone else.

For four decades, MGIMS had marched to a different drummer, not out of arrogance, but out of conviction. We ran our own admission test. We included a paper on Gandhian thought. We wanted students who were not only academically capable, but also temperamentally aligned with the idea of rural service. We insisted on proximity to villages. We sent our postgraduates to village health centres for two years, not as punishment, but as training in reality. We offered our undergraduates a near-assured path to postgraduation within the institute, creating a closed and nurturing ecosystem that produced a certain kind of doctor—clinically sound, socially aware, and less dazzled by the glamour of urban medicine.

That ecosystem cracked in 2013.

The institute fought hard to retain its autonomy, even taking the matter to the Supreme Court, but we lost. The judgement was final. The old rules dissolved overnight, and the new ones arrived with the confidence of a policy that believes uniformity is the same as justice.

I often wondered what Dr Sushila Nayar would have felt if she had lived to see this. She had built MGIMS with a moral blueprint, not merely an administrative one. The new “merit-only” system—devoid of values, aptitude, or rural commitment—felt antithetical to the code she had woven into the institution’s DNA. There were days when I thought she might have preferred to close the gates rather than watch MGIMS become just another medical college on a long national list.

The casualties of the change were not abstract. They were immediate, personal, and painfully visible.

First, we lost families.
For years, a ward quota gave faculty members a sense of stability. If their children were qualified, they had a place at MGIMS. It was not charity; it was an anchor. It kept good surgeons and physicians in Sevagram when they could easily have moved to bigger cities with bigger pay and brighter lights. They stayed because their children’s education mattered, and because MGIMS, in return, offered them belonging. When NEET stripped that away, the glue that held many faculty members to Sevagram weakened. Recruitment became harder. Retention became harder still. The institution did not collapse, but the slow drift began.

Second, we lost the loyalty of our own students.
Earlier, our undergraduates knew that if they worked well and served the system, the system would nurture them through postgraduate training. It was not an entitlement; it was a relationship. NEET broke that relationship. Suddenly, our students were thrown into a national pool with nearly two million competitors, uncertain not only about branch and college, but sometimes even about which state they might land in. Anxiety became the new normal. Gratitude became a luxury.

The students adapted quickly. Young people always do.

Their focus shifted from the patient to the paper. Why spend hours at the bedside learning the nuance of a murmur when the exam would not ask for nuance? Why attend long lectures on compassion when compassion carried no marks? Why go to villages when villages did not improve rank? Slowly, without any villain in sight, the art of medicine began to get traded for the mechanics of multiple-choice questions.

Coaching centres mushroomed. Online apps became the new teachers. The professor, once a mentor and model, became an optional extra. The clinical ward—once the beating heart of medical education—began to feel like a place students visited out of obligation, not curiosity. They still worked hard, but their hard work was aimed at cracking an exam, not understanding a patient.

What unsettled me most was the quiet breakdown of the teacher–student relationship.

For years, I had been an unofficial custodian of the MGIMS family tree. I knew thirty-five batches—nearly two thousand students—by their first names. I knew their backgrounds, their quirks, their ambitions, their parents’ illnesses, their marriages, their children. I had built a database with the stubbornness of a man who feared that memory, left unattended, would decay. Alumni often called me for a classmate’s number, a job reference, a word of advice, or sometimes simply a voice that reminded them of Sevagram.

I still remember June 2014. Dr Manoj Singh, a critical care specialist in Australia, landed in Nagpur. I had sent him a simple invitation for my daughter Amrita’s wedding. He had no conference to attend, no professional agenda, no work excuse. He flew across the ocean simply to be there. That kind of loyalty does not come from institutional branding. It comes from relationships built slowly, over years, in classrooms, wards, and shared meals.

That era, I realised, had passed.

With the MD Medicine intake increasing to twelve postgraduates a year, the department was busier than ever. The corridors were crowded. The ICU was full. The academic calendar was packed. And yet, oddly, I began to feel a kind of anonymity. I no longer knew the new residents well—where they came from, what shaped them, what frightened them, what they secretly dreamed of becoming. They were polite, competent, and efficient, but distant. The old warmth had cooled. The days of students coming home for a meal, asking for Bhavana’s cooking, lingering in conversation, and sharing their lives without a deadline—those days had quietly slipped away.

Perhaps this is what happens when systems scale up. Intimacy becomes the first casualty.

Tennyson wrote, “The old order changeth, yielding place to new.” I had quoted it often in speeches, but now I felt it in my bones. The river had changed its course, and standing on the bank with nostalgia would only make me bitter. I had to accept that the world my teachers gave me could not be recreated exactly for my students, and that the new generation would build its own version of medicine—different, faster, more digital, perhaps less human in the old ways, but not necessarily less sincere.

So I stopped looking back as often as I used to. I began to look inward instead, searching for small anchors—habits, friendships, hobbies—that could keep me steady in a changing world.

That, however, belonged to another page of my life.

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