Medical education in India remains one of the most demanding career paths, yet doctors often face the heaviest burdens in return. Despite years of training, relentless workloads, and the emotional toll of patient care, medical graduates must still comply with compulsory rural service bonds, some reaching ₹1 crore in certain states.[1,9]
What feels unfair to many is that this rule applies almost exclusively to doctors. Engineering graduates from premier institutes, who also benefit from government subsidies, face no such obligations. This double standard reveals a deeper imbalance in how different professions are treated in India.
A recent post by Dr. Rahul Chawla, a well-known neurologist on Instagram, brought renewed attention to this issue. In his post, he questioned why young doctors continue to face compulsory bonds while other government-funded graduates pursue private-sector careers without any comparable obligations. His message resonated widely because it reflects concerns shared across the medical community.
Both medical colleges and Indian Institutes of Technology receive substantial public funding. Despite this, only one group is required to serve in government-appointed rural postings.
IITs receive regular grants through central funding mechanisms and research collaborations. For example, IIT Indore recently received a large collaborative research grant under the PAIR program.[2]
If subsidised education were the basis of mandatory service, similar expectations would apply to engineering graduates. This inconsistency shows a gap in how public service obligations are assigned in India.
Mandatory service bonds remain widely enforced for medical graduates across several states. Court proceedings have repeatedly addressed disputes regarding these bond requirements, showing the continued tension between students and state authorities.[3]
Various policy discussions suggest that governments use these bonds to address shortages in rural healthcare. However, the selective imposition of mandatory service only on medical graduates raises questions about consistency, especially since professionals in other essential fields are not required to serve.[4]
Medical residents play a critical role in the day-to-day functioning of public hospitals. Several reports describe heavy workloads, long hours, and inadequate rest during residency training. Many residents work between 80 and 100 hours per week, often without adequate compensation or proper working conditions.[5]
For these doctors, the compulsory bond becomes another hurdle that delays career progression and increases stress after years of demanding work.
Engineering graduates follow a very different path. IIT placement reports show high recruitment rates from multinational companies with competitive packages. IIT Bombay’s 2023–24 placement report documents both domestic and international packages in high salary ranges across various sectors.[6]
IIT Bhubaneswar also reports strong placement outcomes with no government service conditions.[7]
Engineering students benefit from public funding but do not face compulsory rural service or penalties for not joining government sectors.
Rural health facilities often lack proper equipment, diagnostic tools, and specialist support. This makes it difficult for newly trained doctors to deliver safe and effective care in these settings.
Studies have pointed out that inadequate infrastructure, safety issues, and limited growth opportunities are major reasons why rural postings remain unattractive.[4]
National development requires participation from all professional groups. Restricting compulsory service to doctors does not address the larger structural issues in rural public systems.
Mandatory bonds can delay postgraduate training, fellowships, and international opportunities. Young doctors experience uncertainty and burnout while navigating these requirements.
Some reports highlight how prolonged working hours and delayed career transitions affect mental health and family life, especially for women in medicine.[8]
These challenges add to the cumulative stress already experienced during medical training.
A recent discussion on MedBound Hub, on the same topic, highlights how young doctors perceive the compulsory rural service bonds.
Participants shared their views on the disproportionate expectations placed on medical graduates compared to engineering peers, emphasizing long working hours, career delays, and systemic inequities. The thread reflects a broader sentiment in the medical community, showing that these policies are not only a regulatory issue but also a source of professional and emotional concern for doctors across India.
The contrast between crores of rupees packages in engineering and mandatory bonds for medical graduates highlights a harsh reality: years of study often lead to bonded obligations rather than freedom. Reforming these bonds and improving career anatomy is essential for valuing young doctors.
Harsh Meshram
It’s a sad reality that doctors are not always respected as they should be. They are instead treated as commodities in this economy. Though the demand is high, they think doctors are dispensable and are replaceable.
Allsun Sweetline, BDS student
I think India will continue this until it has sufficient doctor density to support its population. With far more years of study as compared to other fields and an even higher workload, the medical field is already very demanding. With the government spending lakhs on training doctors and looking at the condition of medical facilities in rural areas, where there is an actual need for trained specialists, 1-2 years of this essential service in rural areas seems valid, but it should be as a bond is highly debatable.
Dr. Prabhdeep Kour, MDS
Improving rural healthcare requires investment in infrastructure, staffing, diagnostics, and safety systems. Voluntary service becomes more feasible when working conditions are predictable and adequately supported.
Evidence suggests that incentives such as housing, rural allowances, and academic benefits work better than penalties in attracting medical professionals to underserved regions.[4]
Sustainable reform must focus on strengthening health systems rather than enforcing mandatory service.
The difference between how doctors and engineers are treated reflects a broader pattern in professional expectations. Doctors are held to stricter service obligations while other publicly funded graduates are free to pursue high-paying private-sector roles. This creates a structural imbalance that requires policy attention. A fair system would apply consistent rules across fields or develop incentive-based models rather than profession-specific penalties.
India needs a balanced and transparent approach to public service obligations. Young doctors already contribute significantly through long and demanding training. A reform-focused strategy that strengthens infrastructure, improves incentives, and ensures fairness across professions can create a more equitable system. Revising the bond policy is an important step toward building a health workforce that serves the nation without compromising individual career growth.
References:
Uttar Pradesh Government Introduces 2 Years Compulsory Rural Service Bond In Medical Courses. [ Aug; 2023 ]. 2018. https://www.ndtv.com/education/uttar-pradesh-government-introduces-2-years-compulsory-rural-service-bond-in-medical-courses-1829629
Times of India. “PAIR Grant for IIT Indore to Lead Collaborative Research Network.” Times of India, 2024.
https://timesofindia.indiatimes.com/city/indore/pair-grant-for-iit-i-to-lead-collaborative-research-network/articleshow/121504818.cms
The Week. “Supreme Court Hears Case on Doctors' Bond Requirements.” The Week, April 2025.
https://www.theweek.in/wire-updates/national/2025/04/02/lgd32-sc-doctors-bond.html
Indian Council of Medical Research. “Why We Do Not Get Doctors for Rural Medical Service in India.” National Medical Journal of India (2018).
https://nmji.in/why-we-dont-get-doctors-for-rural-medical-service-in-india/
South-East Asian Journal of Medical Education. “Resident Work Hours and Training Challenges in India.” 2019.
https://seajme.sljol.info/articles/104/files/submission/proof/104-1-254-1-10-20191017.pdf
Campus and Placement Office, IIT Bombay. Placement Report 2023–24. 2024.
https://campus.placements.iitb.ac.in/static/docs/placement_report_2023_24.pdf
IIT Bhubaneswar. Placement Highlights 2024. 2024.
https://www.iitbbs.ac.in/index.php/home/placement-2024/
ResearchGate. Mandatory Service Bonds in India: A Draconian Policy Hindering MBBS Doctors' Leadership and Growth. 2024.
https://www.researchgate.net/publication/390520764
National Library of Medicine. “Mandatory Service Bond for Medical Students in India.” Journal Article. 2023.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10550849/
