Editor,
An 80:20 female-to-male ratio in nursing recruitment means that 80% of the nursing posts are allocated to female candidates and 20% to male candidates. This approach has been adopted by major healthcare institutions, including AIIMS and JIPMER, and has been cited in relation to ESIC hospitals and the Chittaranjan National Cancer Institute (CNCI), Kolkata. Its stated rationale is to ensure adequate availability of female nursing personnel in departments and specialized wards where patient comfort, privacy, dignity and gender-sensitive care are particularly important.
As per the CIB AIIMS minutes of meeting (No. F. 5-2/2019-Genl.{CIB-4} dated 28/10/2019) point no. 16 it states due to appropriateness and requirement of female nursing staff in a number of departments/specialized wards vis-a-vis patient comfort and care 80% of the posts are reserved for female nursing staff while the remaining 20% posts may be filled by male nursing staff.
Similarly, JIPMER governing body minutes of meeting (JIPMER/PRESIDENT/1531 dated 19/05/2021) under agenda 17, it had agreed that the work requirements at several locations necessitate that a female nursing officer be available instead of a male nursing officer. It also mentions that the matter had been challenged in court, but the court accepted the idea of fixing 80% of posts for women.
Further, ESIC in its annual report 2024-2025 mentioned that during the two meetings of ESI Corporation held on 08.10.2024 and 19.12.2024, a proposal for an 80:20 female-to-male reservation be made for nursing recruitment for which the Corporation approved the proposal in line with AIIMS recruitment policy.
And, Chittaranjan National Cancer Institute, Kolkata 15th governing body meeting held on 11th April 2022 decided that 80% seats are reserved for females and 20% are reserved for males in its institute.
It is important to note that the demand for an 80:20 ratio is not gender discrimination but based on clinical necessities and workplace requirement. Courts have upheld special provisions for women and children under Article 15(3) of the Constitution, recognizing the need for gender-sensitive caregiving in healthcare institutions. Courts have also rejected pleas from several plaintiffs, affirming that such measures are constitutionally permissible when tied to patient-care requirements.
A distorted recruitment history
In the last two major Nursing Officer recruitments at NEIGRIHMS:
- Letter no. NEIGR-E.III/15/2014 Pt. VII dated 1st June 2023, out of 180 selected candidates approximately 55% were males; and
- Letter No. NEIGR-E.III/15/2014/Pt. VII, 194 posts were advertised, of which 174 selected candidates were male—nearly 90% of the intake.
This has resulted in a significant staffing imbalance in an institute that serves a mixed patient population, including women, children and other vulnerable groups who often require gender-sensitive care. If this is the trend that continues in the subsequent recruitments then it will pose a great risk on the nursing manpower leaving inadequate female nursing coverage across sensitive wards and other areas. The 2023 recruitment outcomes have created an acute and avoidable gender imbalance. This is particularly concerning because female nurses are indispensable in maternity, paediatric, female wards, ICU and other sensitive care settings.
The Governing Council should therefore examine the recruitment outcomes not merely as historical statistics, but as indicators requiring a forward-looking assessment of workforce adequacy and patient-care requirements.
Current nursing manpower in NEIGRIHMS
Presently, NEIGRIHMS has approximately 549 Nursing Officers: about 317 female (57.7%) and 232 male (42.3%). While women remain the majority in absolute terms, the recent recruitment pattern has materially worsened the balance.
While male nurses play a vital role, the current composition does not reflect the clinical reality that most wards 33 departments in all cater to both genders, and only two departments exclusively house male patients (viz. Male medicine ward and Male surgery ward). The Institute must therefore move beyond aggregate headcounts and adopt a needs-based approach to staffing, deployment and future recruitment.
Clinical necessity, not discrimination
Critical areas such as Obstetrics & Gynaecology, Labour room, Female medicine and surgery wards, Paediatric wards, Paediatric ICU and Neonatal ICU, ICUs, OTs, Cardiology ward, ICCU, Urology ward, Private wards predominantly require female nursing manpower for reasons of patient privacy, dignity, cultural comfort and effective communication. The need for female nursing personnel is not based on an assumption that one gender is inherently more capable or compassionate than another. Rather, it arises from the practical requirement to ensure that patients have appropriate care options and that the Institute can respond sensitively to individual preferences without compromising patient safety or delaying treatment.
Reports from the ground also point to possible gender imbalances during particular shifts. In certain ICU shifts, eight out of 11 nurses on duty are reportedly male, while in the Paediatric Intensive Care Unit, four out of six nurses on duty are reportedly male. These figures raise legitimate questions about the availability of female nursing personnel when sensitive care is required.
Cultural relevance
NEIGRIHMS serves people from Meghalaya and across the northeastern region, which is home to diverse communities, traditions and cultural expectations. Some patients may feel uncomfortable receiving intimate nursing care from a person of the opposite gender, particularly in matters involving sensitive procedures. The concerns of patients who seek gender-sensitive care should never be disregarded.
As a regional tertiary-care institution, NEIGRIHMS has a responsibility to deliver healthcare that is not only technically sound but also respectful of individual dignity, privacy and reasonable personal preferences. Adequate female nursing coverage can contribute meaningfully to patient confidence and culturally sensitive service delivery.
Retirement-related risk
A further concern is the impending retirement of a substantial number of experienced female nurses who joined during the 2006–2008 recruitment cycles. If future recruitment continues to produce male-majority intakes, the Institute may face a severe and possibly irreversible shortage of experienced female nursing staff within the years to come.
This would disproportionately affect female wards and maternity services, paediatric ward, NICU and PICU services, female patients requiring chaperoned intimate care, ICUs and critical-care units requiring gender-balanced shift deployment, and patient and family confidence in nursing care.
The issue is therefore not merely representational. It has a direct bearing on continuity of care, patient dignity, cultural sensitivity and the Institute’s ability to deliver safe nursing services.
The question is clinical need, not merely institutional status
During press briefings on 17 October 2026, the Director reportedly stated that the 80:20 female-to-male recruitment arrangement is followed only by institutions of national importance. With due respect, as per the earlier mentioned citations, the ratio is adopted to ensure that the patients’ rights for privacy, dignity and comfort are respected and met. Also, other central autonomous bodies who have not been accorded institutes of national importance such as ESIC and CNCI, Kolkata have adopted the ratio in their nursing recruitment to ensure that gender sensitive issues are taken care of.
RIIMS, through Advertisement No. NORCET-09 268/2025, dated 22 July 2025, advertised 33 posts with a proposed bifurcation based on the 80:20 female-to-male ratio. A corrigendum, No. GEN/MISC/50/2025-EST Sec, was subsequently issued withdrawing that bifurcation. The information available to the proponents of this representation indicates that RIIMS has an adequate number of female nursing officers and that its existing workforce composition enables it to address gender-sensitive requirements in critical and sensitive departments.
Conclusion and requests
The present situation, if left uncorrected, risks compromising patient dignity, cultural sensitivity and the quality of nursing care at NEIGRIHMS. The 80:20 female-to-male recruitment ratio is a patient-centred and clinically grounded workforce policy, not discrimination against male nurses. Given NEIGRIHMS’s role as the region’s premier Central tertiary-care institution, its existing workforce imbalance, the 90 per cent male intake in the 2023 recruitment cycle, and the approaching retirement of experienced female nurses, the Institute should urgently seek and implement a legally sound, Ministry-approved gender-balanced recruitment framework through its Governing council meeting scheduled to be held on the 27th October 2026. Its nursing workforce must be planned with the same seriousness as its clinical infrastructure, specialized services and future manpower requirements.
In view of the foregoing, the esteemed members of the Governing Council are earnestly requested to intervene and address this pressing concern in the larger interest of patient dignity, gender-sensitive healthcare and sustainable nursing workforce planning at NEIGRIHMS. The Council is urged to recommend the adoption of the 80:20 female-to-male ratio in Nursing Officer recruitment, subject to applicable legal provisions and approval by the competent authority, and to initiate the necessary steps for its timely implementation. A proactive decision at this critical juncture will help ensure adequate female nursing staff, protect patients’ privacy and dignity, and safeguard the quality of healthcare services for the people of the Northeast.
(Name withheld on request)
