The Disappeared Doctors: Kashmir Trains Them, Then Loses Them

Credit By: RK Health and Investigative Desk

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• 20 Apr 2026

Government Medical College (GMC) Srinagar trains Kashmir's finest medical minds at public expense. Then it watches them leave. The valley's sick are paying the price of that departure in waiting rooms, in referral slips, and in deaths that should not have happened.

Dr Aadil Mir graduated from Government Medical College (GMC) Srinagar in 2019 with a gold medal in surgery. He completed his postgraduate residency at SKIMS. He is, by every measurable standard, precisely the kind of specialist a valley with Kashmir's healthcare burden needs trained, talented, and forged inside the public medical system that the state finances with considerable public expenditure. He now practices at a private hospital in Pune. He has not returned. He does not plan to.

In a primary health centre in frontier Kupwara district, a government medical officer named Dr Rubeena Shah sees between sixty and eighty patients daily. There is no specialist within forty kilometres. The ECG machine has been non-functional for seven months. The nearest cardiologist, should a patient require one, is in Srinagar, four hours away on a good road, longer when it is not. Dr Shah stays. She has stayed for six years. She cannot fully explain why, except to say that someone has to.

These two doctors are the complete story of Kashmir's healthcare crisis told from both ends of the decision that is quietly hollowing the valley's medical system from the inside.

The numbers behind the departure: Government Medical College Srinagar and its affiliated institutions produce hundreds of MBBS graduates and postgraduate specialists annually. The public investment in each student subsidised tuition, residential facilities, and clinical training infrastructure runs into lakhs of rupees across the duration of their education. The state's expectation, formalised through bond agreements signed at admission, is that this investment will be returned through service within Jammu and Kashmir's public health system.

The bond, in practice, has become a formality that the system processes and then fails to enforce. Medical graduates who leave Kashmir for postgraduate seats in other states, for private practice in metropolitan cities, or for emigration to the United Kingdom, Canada, and the Gulf routinely cite bond obligations they were aware of and unconcerned by because enforcement has been so inconsistent as to function as no enforcement at all.

The Health and Medical Education Department does not publish, in any accessible consolidated format, the attrition rate of GMC graduates from the public health system. That opacity is itself a policy choice — and a revealing one. Governments that are proud of their retention numbers publish them. Governments that are not, do not.

Why they leave and why the answer is uncomfortable: The reasons Kashmir's doctors leave are not mysterious. They are documented, consistent, and entirely preventable, which makes the government's failure to address them not a resource problem but a political one.

Specialist salaries in J&K's public health system lag significantly behind both private sector equivalents within the valley and government health service salaries in several other Indian states. A postgraduate specialist returning to a government posting in Kashmir faces a starting salary that their peers in corporate hospitals in Delhi or Mumbai exceed within the first year of practice. The financial mathematics is not complicated.

Infrastructure compounds the insult. Doctors trained to international standards in tertiary care settings are posted to district hospitals where basic diagnostic equipment is absent, broken, or awaiting procurement processes that move at a pace incompatible with clinical urgency. Paul Farmer, in his foundational work Pathologies of Power: Health, Human Rights, and the New War on the Poor, identifies the systematic under-resourcing of public health infrastructure not as administrative negligence but as a structural choice that communicates, with precision, which populations a state has decided matter. Kashmir's rural and semi-urban populations are receiving that communication daily.

Career progression within J&K's public health bureaucracy is opaque, seniority-dominated, and resistant to merit-based advancement. A talented young specialist who stays faces years of administrative subordination to a system that rewards tenure over competence. The ones who leave are, by definition, the ones with options, which means the ones who leave are disproportionately the best.

The rural catastrophe: The consequences of this departure are not evenly distributed. They concentrate, with brutal precision, on the populations least equipped to absorb them, rural Kashmir, the border districts, the semi-urban communities where the public health centre is not a supplement to private care but the only care that exists.

Atul Gawande, in ‘Being Mortal: Medicine and What Matters in the End’, writes that the quality of healthcare a person receives is determined less by the sophistication of available medicine than by the proximity and consistency of the clinician who delivers it. In Kupwara, Bandipora, Gurez, Poonch, and Rajouri, that proximity and consistency are fragmenting. Specialist posts sanctioned on paper sit vacant in practice. Patients with cardiac symptoms, oncological concerns, neurological episodes, and high-risk pregnancies are being referred upward to Srinagar, to Jammu, to facilities three to five hours distant, not because their conditions require tertiary intervention, but because the secondary care that should have caught them earlier does not functionally exist.

The referral slip has become Kashmir's most honest healthcare document. It is an admission, issued daily in hundreds of health facilities across the valley, that the system has not held.

The bond that binds nobody: The J&K government's bond policy, requiring medical graduates to serve in the public system for a defined period, exists in regulation and evaporates in practice. Enforcement actions against bond defaulters are rare, inconsistently applied, and frequently resolved through financial penalties that graduates with metropolitan salaries absorb without difficulty.

A bond that costs less to break than to honour is not a bond. It is a suggestion.

What genuine retention requires is not punitive enforcement of a broken system but structural reform that makes staying the rational choice, competitive salaries benchmarked to national standards, functional infrastructure, transparent merit-based career progression, and rural service incentives substantial enough to shift the financial calculus that currently points every talented graduate toward the exit.

The doctor who stayed

Dr Rubeena Shah finishes her clinic at seven in the evening. She drives herself home on a road that the PWD has been promising to resurface for three years. She will return tomorrow at eight. Her ECG machine is still broken. Her requisition for its repair has been pending since September.

She was offered a position at a private hospital in Srinagar eighteen months ago. The salary was three times her current government pay. She declined; in terms she describes simply: her patients have nobody else.

Kashmir's public health system is surviving, where it survives at all, on the conscience of doctors like her. Conscience is not a healthcare policy. It is not scalable. It is not sustainable.

The valley's disappeared doctors did not abandon Kashmir. Kashmir's institutions gave them no convincing reason to stay.

This report is the second in a series on Kashmir's public health crisis. Doctors, medical officers, and health workers with information are invited to contact this newsroom in confidence.