How India’s cadaver crunch is failing future doctors

Come July and it will be a full year since the Union Health Ministry issued an appeal to state governments to increase awareness about cadaver donation. Not much has, however, changed on the ground as several medical colleges across India are faced with a severe shortage of cadavers.

According to the Medical Council of India recommended ratio, one cadaver is needed for every ten students to study anatomy during their undergraduate years. But various research studies related to cadaver shortage and whole body donation point out that in the worst cases close to 50 students in India are using a single body for dissection classes.

Dr Sandeep Deshmukh, dean of the anatomy department at Bidar Institute of Medical Sciences (BRIMS) in Karnataka, is among the few experts who have spoken out about the shortage of cadavers and how it is a nationwide issue affecting medical colleges in the country. He told the media that merely 15% of medical institutions have sufficient cadavers, while the remaining 85% are struggling with inadequate numbers.

India has close to 800 medical colleges and 1.50 lakh new students join to pursue MBBS and postgraduate courses every year. Due to cadaver shortage, students’ practical skills and anatomical knowledge are getting compromised. It also weakens the ability of medical students to effectively handle surgeries and other medical procedures in future. Experts say this could potentially impact the capability of future doctors.

Simulator bodies

Students of the Government Medical College in Kumuram Bheem Asifabad, Telangana, gathered on roads for a protest citing a severe shortage of faculty and cadavers. Students said that they couldn’t learn only from notes given to them and appear for exams without even seeing the specimen.

In the case of Karnataka, the state government is opening medical colleges in several districts with the aim of establishing one medical college in each district. But these newly established colleges are experiencing cadaver shortages. Colleges in Gadag, Haveri, Kodagu, Vijayanagara, and others started recently, are among those with the highest cadaver shortages, affecting student learning.

According to sources in the Department of Medical Education, the medical college in Kodagu tops the list for cadaver shortages, followed by Vijayanagar Institute of Medical Sciences. Recently, the shortage has become more acute. Kodagu, Vijayanagara, and Gadag medical science institutes are facing shortages of more than 10 cadavers.

In private medical colleges in Tamil Nadu, there are instances of bodies being cut into three parts and distributed to three batches studying different lessons.

A private college professor in Tamil Nadu, speaking on the condition that he remain anonymous, told The Federal that his students could not study anatomy lessons properly because the institution couldn’t receive a sufficient number of cadavers and had to wait for almost eight months of the academic year.

“We have to procure bodies from the state government at a cost of Rs 1.25 lakh per cadaver. The second option would be to source it from medical institutions and mortuaries in other states that charge Rs 25,000 to Rs 50,000. Even then we have to pay charges and get approval before getting cadavers from other states. After meeting all these struggles, sometimes, a cadaver is given to a private institution which is ready to pay more than us. We have to handle this issue almost every year,” said the professor.

In a couple of colleges in Kerala, virtual dissection methods have been introduced to reduce repeated dissection of the same body and to manage the shortage.

Health department officials in Kerala shared that in 2024 the government medical colleges in Kalamassery and Alappuzha in Kerala received only 18 and 20 cadavers — significantly short of the Medical Council of India's recommended ratio. Sources said unclaimed bodies routed through the state’s Anatomy Act are simply not enough to meet this demand. Government medical colleges in Kerala receive an average of 15 cadavers annually. However, there is no available data for private medical institutions.

Alappuzha Medical College admits 175 students annually, and Kalamassery Medical College in Kochi takes in 110. So, excluding resident doctors and postgraduate students, the total number of undergraduate students at any given time would be roughly 875 in Alappuzha and 550 in Kalamassery, assuming a five-year course duration.

As far as cadaveric dissection is concerned, it is undertaken by first-year students, so the number of students involved in this lab work will be 175 at Alappuzha and 110 at Kochi.

Medical college authorities in Rajasthan sought permission from the state government to claim bodies of the destitute and those abandoned in shelter homes amid a crippling shortage of cadavers for students. Not just private colleges, even government colleges faced severe cadaver shortages and were forced to manage practical studies by grouping students together. For instance, at Government Medical College in Kota 250 students had to learn with just 10 cadavers, and Government Medical College in Jhalawar, on the other hand, had only six cadavers for its 200 students.

Delhi paints a different picture

Unlike most medical colleges across the country, the All India Institute of Medical Sciences (AIIMS), which started body donation in 1986, does not have a cadaver crunch. However, the dire situation elsewhere affects the institute, as it has to donate cadavers from its stock.

“There is no shortage in AIIMS, but there is a lot of shortage in medical colleges all over the country which is impacting the teaching and clinical skills of medical students,” Dr SB Ray, Professor of Body Donation Programme at AIIMS, said.

“We have a huge register of potential donors. We get roughly 30 to 50 bodies annually. There are 140 UG students and 40 PhD students. So around 180 students are working almost daily on these cadavers. What is happening is that other medical colleges in Delhi and outside Delhi are not receiving donations. So they request us. So, breaking that understanding with the donors, we have to share three to four cadavers with each medical college. We are doing that because we consider that it is for the larger good. If we don't give it, then probably we will not have good doctors in the future,” he added.

Ray said it was a “fundamental necessity” for students to work on cadavers. “It is imperative that students dissect the cadaver. Suppose a person comes with pancreatic carcinoma, which is increasing in prevalence nowadays, a doctor needs to know about the different parts of the pancreas, where it is located, what the shape of the pancreas is, what are the adjacent structures, to be able to do surgical oncology,” he said.

“Like a magician takes out birds, handkerchiefs, and all kinds of stuff from the hat. We call our inner body space a ‘magic box’. There are so many structures which are packed so tightly that a person who has not dissected the human body will never know how to extricate a specific organ which is diseased without damaging the surrounding organs,” he said.

Attachment and emotions affect body donation

According to experts, not just lack of awareness but also attachment to cultural last rites practices prevent cadaver donation in many cases. Kerala witnessed a peculiar case of objection to cadaver donation by a daughter while the father had opted for whole body donation after his death.

When veteran CPI(M) leader MM Lawrence passed away in October 2024, he had left behind a clearly documented final wish — to donate his body to medical science. But what should have been a smooth handover turned into a legal and ideological battle, one that climbed all the way to the Supreme Court of India.

One of his daughters, who had been estranged from the family for years and joined the BJP, petitioned for a religious burial, arguing that the donation violated cultural and spiritual traditions. Meanwhile, Lawrence’s other children, along with the CPI(M), upheld his decision as a deeply personal and rational choice.

The Supreme Court dismissed the plea, affirming the individual’s right to decide what happens to their body after death. But by then, the body had laid at Kalamassery Government Medical College for weeks, awaiting resolution — a chilling symbol of the complex tangle of belief, family, and bureaucracy.

MM Lawrence’s case is not an isolated one, but it shines a light on Kerala’s growing crisis around body donation. Despite being a state known for high health literacy, medical colleges continue to struggle with a cadaver shortage.

W.S. Johnson, professor of Anatomy and member of the Anatomical Society of India, told The Federal that though Tamil Nadu is a forerunner in organ donation, whole body donation remains a non-starter.

“Apart from lack of awareness, many individuals who register to donate have queries about final disposal of bodies after the cadaver is used for education and research purposes. Every medical college has a burial ground on the campus to bury the used cadavers. A decent burial is given after the usage. But many couldn’t come to terms with this burial. We have to improve awareness on this,” said Johnson.

Private hospitals buying big

As per an RTI reply given in 2024, unclaimed and unidentified bodies have emerged as an unusual yet steady source of revenue for the Kerala government. Since 2008, government hospitals have sold 1,122 cadavers to private medical colleges in Kerala. Ernakulam Government Medical College alone has sold 599 such bodies. Each cadaver, once embalmed, is sold for around ₹40,000.

“In the early 2000s, private medical colleges faced a severe shortage of cadavers, with management organisations complaining that they were forced to spend over ₹3 lakh for each body. When they raised the issue in a press conference around 2006, it triggered public outcry, and someone approached the High Court seeking a CBI investigation. Following this, the court intervened and directed that unclaimed bodies be distributed to medical colleges for a fee — reportedly ₹40,000 for embalmed cadavers and ₹20,000 for those not embalmed,” a health department official said.

In the case of Delhi, all Delhi hospitals The Federal spoke to said they got donations from NGOs – primarily the Dadhichi Deh Dan Samiti (DDDS), an NGO working at dispelling religious myths about donation by citing religious texts like the Bhagavad Gita. Mahesh Pant, DDDS president, said that the NGO had donated 519 bodies to various government medical colleges and hospitals since its inception in 1997.

“We publicise through camps, social gatherings and religious activities. We also talk to RWAs and try to dispel myths around body donation; like no religion says not to go for body or organ donation. Cadaver is the first Guru of any medical student,” said Pant.

“We also organise a ‘Dehdaniyon ka Utsav’. We honour those who have pledged, those who have donated and we call the public also. Apart from medical professionals, we call Dharam Gurus also who explain the importance of donation from the religious point of view, citing the (Bhagwad) Gita etc,” he said.

Researchers who had published papers on the usage of cadavers in medical education and ethical use of cadavers point out that there are discrepancies between different state Acts, which make national guidelines necessary to ensure uniformity across states and improve cadaver donation.

Srividya Sreenivasan and V. Sreenivasan, who had published an article titled ‘Ethics of the use of dead human bodies in anatomy teaching in India’ in the Indian Journal of Medical Ethics, say that the major flaw is the absence of uniformity in the Anatomy Act in India.

“We have separate Anatomy Acts in every state in India. A law governing the transport and transfer of cadavers and body parts is missing from all these Acts. Medical colleges without an existing body donation programme are dependent on the transfer of cadavers from institutes with such programmes or from government institutes that receive unclaimed bodies. The absence of a law covering transfer and transport allows for loopholes in the system and the possibility of profiteering by unscrupulous officials,” said the authors.