Tamil Nadu’s MBBS graduates caught between scarce jobs and low pay

As our series enters its seventh part, the struggle for government jobs continues in Tamil Nadu, with scarce vacancies, fierce competition, and contractual work leaving aspirants and young professionals increasingly frustrated. Catch up on Parts 1, 2, 3, 4, 5 and 6 of the series here.

It was a proud moment for M Senthil Kumar when he finally completed his MBBS degree in 2020, donned the white coat, and took the oath to serve people. After years of blood, sweat, and hard work, he believed he would be able to help his family repay a Rs 10-lakh loan and build a new house in Tiruchirappalli district. But when the reality of poor pay in private hospitals and the scarcity of government jobs hit him, it was not just Senthil who struggled to accept the situation; his family did too.

After completing his MBBS, many of Senthil’s friends landed private-sector jobs with salaries of less than ₹35,000 a month. Since Senthil did not want to work in a private hospital and wanted to serve marginalised communities, he joined a contractual position under the National Health Mission in 2023, a public health programme jointly run by the Union and state governments. He earns ₹60,000 a month now, but a major share of his salary goes towards paying interest on loans his family took to fund the marriages of his two sisters and meet other household needs.

MBBS graduates face bleak prospects

“Since 2020, I have written exams, but I missed the cut-off by a small margin thrice. The Tamil Nadu government has stopped creating new posts in government medical institutions since 2012. Only when a doctor retires or goes on leave for three years does the post become vacant. Fresh graduates like me are forced to seek jobs in the private sector or start a clinic on our own. We can’t even dream of a government job,” Senthil told The Federal.

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Senthil’s classmate Ramachandran (name changed) works at a prominent private hospital in Chennai. He joined the hospital five years ago, and his current salary remains ₹50,000 a month.

“I slog for 12 hours every day. Getting a salary hike in a private hospital is unthinkable. I continue to work because I want to repay my loans. The salary is unbelievably low. My marriage is getting delayed because of the poor pay,” says Ramachandran. He cannot invest in setting up a private clinic because of his current financial constraints.

Despite clearing the gruelling NEET examination and undergoing a rigorous four-and-a-half-year course, nearly 11,000 new MBBS doctors graduating from government and private medical colleges in Tamil Nadu face a fate similar to that of Senthil and Ramachandran.

Govt jobs fiercely competitive

Speaking to the media about vacancies in government hospitals, Tamil Nadu Health Minister KG Arunraj said the state had filled 99 per cent of sanctioned posts and that only a very small number of vacancies remained. However, various doctors’ associations point out that Tamil Nadu continues to have around 22,000 sanctioned doctors' posts since 2011 across its institutions, while roughly twice that number is required to meet the demand.

Sources say the Tamil Nadu Medical Recruitment Board (TN MRB) did not conduct examinations to recruit doctors from 2018 to 2021. When recruitment resumed, not only general practitioners but also specialist doctors joined the race, since the MRB Special Qualifying Examination had not been conducted from 2013 to 2025. As a result, fresh graduates and doctors who had completed specialised courses such as MD and MCH were also competing in the MRB recruitment process, which was usually dominated by junior doctors and fresh graduates.

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Official statistics show that 25,000 candidates took the MRB examination in 2023 for 1,021 vacancies. Similarly, in 2024, 26,000 doctors competed for 2,500 posts, while 30,000 doctors competed for just 1,000 posts in 2025.

Medical boom, doctors’ meagre pay

Many MBBS graduates who spoke to The Federal say that while government jobs are scarce, private hospitals often function like sweatshops. Several studies have shown that Tamil Nadu remains a leading medical tourism hub in India, attracting about 45 per cent of international health tourists and 30–40 per cent of domestic patients. The state reportedly serves roughly 15 lakh (1.5 million) foreign patients annually from more than 70 countries. Yet medical professionals, including both general practitioners and specialists, say they continue to suffer in silence.

“Various hospital chains that report big jumps every quarter fail to pay even decent salaries to doctors like us. Medical tourism is booming in Tamil Nadu, but our salaries are very meagre. Under the name of multi-speciality and super-speciality hospitals, several departments function under one roof, but general practitioners are taken for granted and forced to slog across different departments with minimal support,” said Dr Sheethal (name changed), who works at a prominent hospital chain in Chennai.

In 2025, the Tamil Nadu Labour Welfare and Skill Development Department fixed revised minimum basic wages for duty medical officers in private hospitals and nursing homes at ₹14,000 to ₹16,000 per month, categorised by bed strength and regional zones.

Docs seek end to contractual hiring

Dr G Ravindranath, general secretary of the Doctors' Association for Social Equality, a forum that fights for the rights of doctors, criticised the fixed minimum rates. He argued that the mandated minimum wage floor is disproportionately low relative to a doctor’s extensive education, workload and market realities.

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“The state government is keen on contractual appointments and not to increase postings through MRB. Instead of recruiting doctors, nurses, lab technicians, pharmacists, health inspectors, dental assistants, urban health nurses and other workers on contracts through the District Health Societies, they should be appointed permanently through the MRB after holding examinations,” he said.

He also pointed out that no permanent jobs were provided for dentists in Tamil Nadu. “Instead, dentists continue to be appointed on contracts and on daily wages. A consolidated pay of ₹35,000 a month has been announced for them. Recently, the state government has decided to abolish the post of Deputy Director of Tuberculosis. The state government is aggressively promoting contractual jobs and not increasing permanent posts. Scores of students who clear NEET and pass graduation and post-graduation should be treated with dignity,” Ravindranath said.

You can read Part 1 here: Legal twists, endless wait: How Bengal failed a generation of job seekers

Part 2: Scandal after scandal: Is this the end for Karnataka PSC?

Part 3: Kerala PSC faces credibility test over recruitment, exam lapses

Part 4: Telangana's police aspirants fume: Age is catching up, jobs aren't

Part 5: Karnataka's age relaxation for govt jobs: A lifeline too little, too late?

Part 6: Why Karnataka's 2-4-6 recruitment formula is running into multiple hurdles