India's medical education expanded rapidly, tripling seats, largely via the private sector which now hosts over half. While commendable for addressing student competition and doctor shortages, critical issues abound. Exorbitant private fees concentrate talent in urban areas, worsening rural shortages. Uneven quality, persistent capitation fees, and graduates preferring private practice or abroad due to poor incentives are concerns. The author urges the government to increase affordable seats, enforce NMC fee regulations, enhance inspections, and incentivize rural service.