The critique offered by Mr Fayaz Khan in Ziraat Times on January 20, 2026, in response to my article “The Case for a Medical University in Kashmir: Why SKIMS Must Lead the Way,” is serious, articulate and unsettling—largely because much of it rings uncomfortably true. His diagnosis of the academic culture in Jammu and Kashmir is familiar to anyone who has lived or worked within it: rote learning eclipsing inquiry, compliance replacing curiosity, optics trumping outcomes, and survival overshadowing scholarship. These are not imagined shortcomings; they are real, deep-rooted and long-standing.
Where I respectfully but firmly part ways with Mr Khan is in the conclusion he draws from this diagnosis—that under such conditions, the creation of a medical university would merely centralise mediocrity, magnify existing flaws and quietly fail. This conclusion, in my view, inverts the causal relationship between structure and culture. It assumes that academic freedom, research ethics, protected dissent and meritocratic governance must pre-exist before institutional reform can occur. History, and the global experience of higher education, suggest precisely the opposite.
The question is not whether a medical university automatically produces excellence. It does not. The more pertinent question is whether excellence is structurally possible without one. In deeply centralised and bureaucratic systems, culture does not reform itself organically. It is shaped, constrained and often suffocated by statutory frameworks and governance models. Expecting a hospital-centric, deemed-university structure—burdened by limited autonomy, fragmented authority and heavy regulatory oversight—to generate academic freedom and intellectual courage is unrealistic. Universities are not rewards bestowed upon virtuous systems; they are instruments designed to enforce standards, accountability and reform.
Much of the public debate also rests on a misunderstanding of what is actually being proposed. Declaring SKIMS a full-fledged medical university is often portrayed as a symbolic or cosmetic change. It is neither. SKIMS already enjoys deemed-to-be university status under the UGC Act, but that designation comes with inherent limitations in governance, affiliation, expansion and regulatory reach. The real policy question is not whether Kashmir needs a medical university, but what additional powers and responsibilities such a university would possess that SKIMS, in its current form, cannot effectively exercise.
Despite its strong clinical legacy, SKIMS remains structurally constrained in ways that directly contribute to the deficits Mr Khan rightly identifies. As a deemed university, it cannot function as a true affiliating hub for multiple medical, nursing, paramedical and allied health institutions across the Valley. The absence of such a hub has resulted in fragmented curricula, uneven assessments and widely varying academic standards. Centralisation with enforceable standards is not the problem; decentralisation without standards is.
Academic expansion is another casualty of the existing framework. Establishing new disciplines such as public health, biomedical sciences, health economics, digital health, medical law, ethics and health policy requires navigating multiple layers of approval, often from distant central bodies. This severely limits responsiveness to Kashmir’s unique health priorities, including environmental health, conflict-related trauma, mental health challenges, disaster medicine and high-altitude physiology. A university created through legislation can establish interdisciplinary schools and departments with far greater agility and relevance.
Governance bottlenecks further compound these challenges. Deemed universities operate under tight UGC supervision with limited statutory autonomy, leaving recruitment rules, promotion pathways and faculty evaluation mechanisms bureaucratically frozen. A full-fledged university framework, by contrast, enables independent academic councils, functioning senates, transparent finance committees and clearly defined statutes governing appointments, promotions and accountability. Without such structures, calls for rigorous peer review and transparent evaluation remain rhetorical rather than operational.
Research is another area where structural limits translate into cultural stagnation. SKIMS has immense clinical volume, but limited freedom to create dedicated research institutes, biobanks, innovation parks, translational research centres and robust doctoral programmes. Negotiating international grants, endowments and public–private partnerships remains cumbersome. A medical university structure enables multicentric clinical trials, public health surveillance, climate-and-health research and structured doctoral and postdoctoral pathways. These are not luxuries; they are prerequisites for any serious research ecosystem.
Context also matters. No national medical university currently prioritises the specific health realities of Kashmir—high-altitude medicine, environmental and air-pollution-related illnesses, mental health in conflict settings, non-communicable diseases in resource-constrained systems, and emergency medicine in fragile terrains. A regional medical university is not an exercise in parochialism; it is an assertion of relevance. Curriculum, training and research must be anchored in lived realities, not generic templates imported wholesale from elsewhere.
Equally neglected in the current system are ethics, patient communication, professionalism and the so-called hidden curriculum of medicine. Overburdened general universities, stretched across multiple disciplines, are ill-equipped to nurture these domains with the depth they require. Independent medical universities worldwide have demonstrated that dedicated schools of medical humanities, ethics and communication can be institutionalised as longitudinal, assessed components of training rather than token lectures. This depth is not achievable through affiliation alone.
Human resource retention is another critical concern. Kashmir does not lack medical talent; it loses it. The absence of clear academic career pathways drives clinicians and researchers elsewhere. A medical university can offer in-house fellowships, research-linked promotions, mentorship-driven faculty development and academic mobility without geographic exile. Without such pathways, mediocrity becomes self-perpetuating.
It must be said plainly that declaring SKIMS a medical university guarantees nothing. If governance remains politicised, leadership appointments non-merit-based and accountability weak, the exercise will amount to little more than a change of nameboard. But that is not an argument against a medical university; it is an argument against doing it badly.
Mr Khan’s critique accurately identifies the pathologies of our academic ecosystem but then draws the wrong conclusion. A medical university is not intended to crown excellence already achieved; it is meant to create the conditions in which excellence becomes possible and enforceable. As a deemed or hospital-centric institute, SKIMS lacks the statutory tools to mandate research output, enforce ethical compliance, protect academic autonomy, tie promotions to scholarship and attract clinician-scientists of global standing. A medical university does not automatically generate excellence, but without one, excellence remains structurally improbable.
Trust, as Mr Khan rightly notes, is not built by titles alone. Yet trust does not emerge in a vacuum. It is earned through autonomy, accountability, transparency and performance—all of which require empowered institutions. Kashmir’s deficit of trust is not the result of institutional expansion, but of institutions never being truly enabled to earn that trust.
The choice before policymakers is therefore stark. Is university status meant to empower academic reform or merely to rebrand administratively? If accompanied by transparent statutes, independent leadership, merit-based governance and protected academic freedom, a medical university in Kashmir can be a solution rather than a liability. Without these safeguards, it will undoubtedly disappoint. The debate should not end in resignation but begin with resolve, grounded in governance safeguards, phased reforms and serious engagement with the very risks that critics rightly highlight.
The author is a national-level certified professional in healthcare policy analysis, planning and reforms, and can be reached at [email protected].
