NIRF rankings fail to influence NEET PG toppers; clinical exposure draws interest

The trend, visible year after year, raises an important question: if NIRF rankings claim to evaluate the “best” institutions, then why are students opting otherwise? And what does this reveal about the effectiveness and limitations of India’s most publicised ranking mechanism for higher education?

What the NEET PG allotment data show

The NEET-PG 2025 round 1 allotment list reinforces the same trend seen every year: top-ranked candidates choose Central and state government medical colleges, not the private institutions ranked higher on the NIRF list. According to the allotment document, All India Rank (AIR) 1, 3, 5, 6 and 7 – all opted for PGIMER at Dr RML Hospital, New Delhi, one of the most sought-after central institutions for MD (General Medicine).

NIRF 2025: Medical category

Rank 2 chose Government Medical College, Kozhikode – a state-run institution with strong clinical exposure.

Rank 4 and Rank 10 chose Vardhman Mahavir Medical College (VMMC), New Delhi, another major government medical college attached to Safdarjung Hospital, known for its massive patient load and intensive training environment.

Even Rank 8 chose Bangalore Medical College and Research Institute, a flagship state government institution in Karnataka with one of the busiest clinical settings in South India.

In fact, none of the top 12 candidates opted for private institutions – including those that routinely rank high in the NIRF list. The pattern continues further down the list, where candidates in the top 50 and top 100 slots overwhelmingly pick PGIMER, AIIMS-affiliated hospitals, MMC Chennai, VMMC, KEM Mumbai, and other long-established public medical colleges.

The allotment data make one thing clear: the colleges that students trust the most are the ones that offer the heaviest clinical exposure, busiest wards, and strongest residency training ecosystems.

“The NIRF might call a college top-ranked, but every PG aspirant knows that real learning happens in hospitals with optimum patient loads, not in fancy auditoriums or smart classrooms,” said a government medical college resident doctor.

“Most private colleges simply can’t offer the same clinical exposure,” he added.

Why toppers prefer government colleges: The real priorities

When the choices of top-ranked NEET-PG candidates are analysed, it becomes clear that their priorities differ sharply from the parameters that NIRF uses to rank institutions. For a postgraduate medical student, the three factors that matter most are:

1. Affordability and accessibility

A postgraduate seat in a private medical college may cost anywhere from Rs 50 lakh to Rs 2 crore, while a government college seat costs a fraction of that – often below Rs 2 lakh for the entire course. Even students who can afford the fees prefer colleges with meaningful clinical training over campus amenities.

2. Clinical exposure and case volume

The central and state government-run hospitals see an overwhelming number of patients daily. This translates to richer hands-on training across specialties – something private hospitals, especially those attached to newer or corporatised colleges, struggle to match.

“In a private college, you may see five cases of a condition in a week; in a government hospital, you see 20 before lunch… This makes all the difference in confidence and skill-building,” said an MD resident at a premier government hospital.

2. Reputation and legacy departments

Institutes like PGIMER, MMC, VMMC, and JIPMER have long-established departments, senior faculty, structured academic programmes, and a culture of medical training that spans decades. This legacy creates trust among students and parents – something private colleges still struggle to cultivate.

NIRF Rankings: What they measure and what they don’t

India’s postgraduate medical admissions run through two parallel systems, and this dual structure significantly shapes student choices. While most candidates appear for NEET-PG, premier institutions such as AIIMS, JIPMER and PGIMER conduct admissions via a separate exam – the INI-CET. The two exams differ in pattern, difficulty level, and timelines, and a large segment of top-performing students explicitly prefer INI-CET over NEET-PG because it grants access to institutions long considered the gold standard for residency training.

This two-track system also exposes the blind spots in the NIRF medical rankings, especially for students using NIRF lists as a guide while selecting NEET-PG colleges. The framework evaluates medical institutes across broad indicators – Teaching, Learning and Resources (TLR), Research and Professional Practice (RP), Graduation Outcomes (GO), Outreach and Inclusivity (OI), and Perception (PR). While comprehensive in theory, the parameters do not assess training quality at the level of medical specialities, which is where students make their most consequential decisions.

For instance, a topper targeting radiology might choose a department in a lower-ranked college because its radiology unit has stronger faculty, better exposure, or a healthier academic culture. Department-level environment – including mentorship, workload distribution, inter-departmental dynamics, and even toxicity – plays a far greater role in student decision-making than institute-wide indicators like patents filed or research grants.

As one resident doctor put it, “the gaps are visible on the ground.”

“NIRF rankings don’t reflect speciality-wise training at all,” said Dr Shubham Anand, Junior Resident at AIIMS Deoghar. “A department like radiology or dermatology might be excellent in a college that appears low in the NIRF list. Students rely on seniors, not rankings, because department-level experiences differ widely,” he added.

According to him, toppers overwhelmingly prefer government colleges because of the very things NIRF fails to measure.

“The patient inflow in government hospitals is unmatched, and that directly boosts clinical skills. Fees are minimal, so students can learn without financial stress. Above all, colleges like AIIMS, JIPMER, PGI and VMMC have reputations built over decades. Their alumni networks help immensely with mentoring, references and opportunities – and that matters far more than a ranking score,” he said.

Key blind spots in NIRF’s methodology

1. Patient load and clinical exposure are not measured

Perhaps the most important determinant of postgraduate medical training – patient volume – is not an NIRF parameter at all. This means a college with world-class infrastructure but a low patient footfall may rank higher than a hospital where students see hundreds of patients a day.

“If clinical parameters like patient load, bed occupancy, range of specialities, faculty strength, critical care exposure, emergency department capacity, surgical volume, and teaching hospital accreditation are not included in deciding ranking, it can be misleading to young medical students and also colleges will not take serious efforts to improve these parameters since ranking is not decided by these essential parameters,” Dr Nitin Bagri of Ram Manohar Lohia (RML) Hospital-Delhi said.

This single omission, experts argue, makes the NIRF ranking fundamentally incompatible with the lived reality of medical training.

2. Overemphasis on research output and publications

Many private deemed universities invest heavily in research publications, patents, and corporate-funded projects – categories that boost NIRF scores. But medical PG students rarely prioritise these metrics.

“Most students are not looking to publish papers; they want solid clinical skills and confidence,” said a NEET PG mentor from Hyderabad. “The NIRF system rewards metrics that matter to administrators, not to students,” he added.

3. Infrastructure scores do not reflect educational quality

Newer private medical colleges often have gleaming infrastructure, multi-storey buildings, laboratories, and simulation centres that impress in rankings but do not guarantee better clinical training. Students repeatedly mention that shiny buildings don’t replace real patients.

4. Perception scores favour marketing-heavy private institutions

Institutions that invest heavily in branding and outreach often gain perception points – even when their academic and clinical strengths remain questionable.

What toppers’ choices tell us

The dissonance between NIRF rankings and NEET-PG preferences sends a clear signal. Students do not trust the NIRF medical rankings as a guide to choosing PG colleges.

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These are precisely the areas where older government institutions excel. “Every topper knows there are only about 15-20 truly great PG training institutes in India – and most are publicly funded,” said a first-year radiology resident at a central institute. “NIRF rankings don’t reflect that reality at all,” he added.

A system misaligned with ground realities

The trend raises a deeper policy question: Should medical colleges be ranked the same way as engineering and management institutes are ranked?

Engineering and medical college ranking systems and parameters cannot be compared, Dr Bagri said, adding that treating machines and humans cannot be the same. “Apart from this, the possibility of paid inclusions in ranking by private institutions cannot be ruled out,” he further said.

Many experts argue that medical education needs a specialised ranking mechanism that includes:

– Patient load

– Bed occupancy

– Range of specialities

– Faculty availability

– Critical care exposure

– Emergency department size

– Surgical volume

– Teaching hospital accreditation

Dr V Vignesh Rajendran, Co-Chairman, Federation of All India Medical Associations (FAIMA), said: “Students become capable, lifesaving doctors only when they are exposed to a high patient load and real clinical situations. It’s the day-to-day experience of seeing diverse cases – the many permutations and combinations of how diseases present – that prepares them to handle both simple and complex medical problems in the future.”

“Studying in air-conditioned halls with smart boards and touchscreens, or publishing countless research papers, can only take you so far. Without strong clinical exposure, none of it truly translates into medical competence,” he added.

The NEET-PG 2025 allotment list underscores a long-standing truth: the best medical education in India is still delivered by government institutions, not by the private colleges that dominate NIRF rankings.