The math doesn’t work. It never did.

In the high-stakes theater of Indian healthcare, the All India Institute of Medical Sciences (AIIMS) is supposed to be the lead actor. It’s the gold standard. The place where the country’s best minds fix its worst problems. But if you walk through the halls of these sprawling campuses today, you’re increasingly likely to be met by a ghost.

Recent data reveals that one in three faculty positions across the AIIMS network is currently vacant. That’s 33% of the brains trust missing in action. But wait, it gets grittier. There are over 17,000 non-faculty posts—the nurses, the lab techs, the people who actually keep the lights on and the blood moving—sitting empty.

It’s healthcare vaporware.

We see this in tech all the time. A company announces a "revolutionary" new platform, skips the boring infrastructure part, and then wonders why the whole thing crashes on launch day. The Indian government has spent the last decade aggressively expanding the AIIMS brand, planting new institutes in nearly every state like they’re franchise coffee shops. It looks great on a campaign poster. It looks even better during a ribbon-cutting ceremony. But a hospital isn't a building. It's the people inside it.

When you hollow out the staff to this degree, you aren't running a premier medical institute; you’re running a very expensive real estate project.

Let’s talk about the friction. You can’t just "disrupt" medical education by doubling the number of campuses while the talent pool remains the same size. The trade-off is obvious and painful. To fill the new spots, you drain the old ones. Or, more commonly, you just leave the desks empty and hope nobody notices the wait times or the plummeting research output.

In AIIMS Delhi—the mothership—the pressure is becoming unsustainable. When the satellite campuses can’t find a head of neurosurgery or enough senior residents to run a night shift, the patients don't just disappear. They get on a train. They head to Delhi. They clog the corridors of an already suffocating system because the "local" AIIMS they were promised is effectively a shell company.

The 17,000 unfilled non-faculty roles are perhaps more damning. You can have the most brilliant surgeon in the world, but if there isn't a technician to calibrate the imaging software or a nurse to manage the post-op recovery, that surgeon is just an expensive ornament. These 17,000 holes in the ship represent a massive failure of basic logistics. It’s a clerical nightmare that results in actual bodies in the morgue.

Why is this happening? It’s not just a lack of applicants. It’s the bureaucracy. The hiring process for these institutions is a labyrinth of red tape, outdated prerequisites, and a pay structure that can’t compete with the private sector’s siren song. A top-tier specialist can make five times their AIIMS salary at a corporate hospital in Gurugram or Bengaluru without having to deal with the soul-crushing paperwork of a government gig.

The government’s response is usually a shrug and a promise that recruitment is "ongoing." It’s always ongoing. It’s a permanent state of becoming. Meanwhile, the burn-out rate for the faculty who actually showed up is skyrocketing. They’re doing the work of three people, teaching students they don’t have time for, and performing surgeries with a skeleton crew.

It’s a classic scaling problem. If you try to scale a high-touch, high-expertise service without a plan to actually hire experts, you don't get growth. You get dilution. You turn a prestigious brand into a generic label.

We’re told we’re entering a new era of digital health, where AI will bridge the gap and remote diagnostics will save the rural poor. It’s a nice fairy tale. But you can’t automate a lumbar puncture. You can’t "algorithm" your way out of a 17,000-person staffing deficit.

The strategy seems to be: build the boxes first, find the souls later. But as the vacancies mount and the "Gold Standard" begins to look more like brass, you have to wonder what we’re actually building. Are these institutes meant to heal people, or are they just meant to be counted during an election cycle?

If the current trend holds, the "1 in 3" vacancy rate won't be a temporary glitch. It'll be the feature. We’ll have the most impressive collection of empty medical buildings in the world.

How many empty rooms does it take before we stop calling it a hospital?