The Choice Between Medicine and Surgery for PG 2026

Which One Offers a Better Career

You Are At A Crossroads

You are in a hospital. You have to make a decision. On your left, you see the Medicine ICU where doctors are working together to figure out a complicated case. On your right, you see the Surgery OT where doctors are getting ready to operate on a patient.

Both of these options are careers that people can have. Both of these options require a lot of work and sacrifice. When you are deciding between MD General Medicine and MS General Surgery for PG 2026, you are not just picking what you want to study; you are choosing how you want to practice medicine for the next thirty years.

I have been helping students who are taking the PG for twenty-five years, and this is the one thing that people always ask me about. The students who like both options the most are usually the most confused. These are the people who need to know the facts the most.

Let me tell you about the facts and the numbers and the things that people do not usually talk about when they're giving advice about what to study.

Quick Comparison — At a Glance

NEET PG 2026. Counselling Intelligence

Branch Category: Core Clinical. These are the two most famous PG branches in Indian medicine.

The demand for Counselling is really high. Medicine is always the number one or number two most demanded branch. Surgery usually comes in at number three to five. Sometimes it is behind Radiology and Dermatology.

If we look at the cutoff trend from 2020 to 2025, we can see that the cutoff for Medicine has been getting tougher every year. The cutoff for Surgery is a bit different. It depends on how hard the exam is and how the seats are given out.

One important thing to note is that Medicine usually closes 300 to 600 ranks of Surgery in most All India Quota rounds. This gap has gotten a bit bigger since 2023.

What can we expect in 2026? With more colleges being recognized by the National Medical Commission and adding PG seats, there might be a small increase in the number of seats for both the Medicine and Surgery branches.

However, the demand for these branches will still be more than the number of seats at the best institutes. Pg 2026 Counselling Intelligence shows that the demand for NEET PG 2026 will be high.

What is MD General Medicine? The Diagnosticians Domain

MD General Medicine trains doctors to become experts in diagnosing and treating adult conditions. These doctors, also known as internists, manage a range of health issues. When a patient comes in with a fever that is not explained or is in critical condition in the ICU with multiple organ failure, the Medicine specialist is in charge of their care.

In hospitals in India, the Medicine department is usually the unit. A doctor working in a government hospital has to deal with conditions related to the heart, lungs, kidneys, brain, glands, infections and critical care at once. The range of knowledge required is huge, and the ability to diagnose correctly is what draws the best doctors to this field.

As mentioned in Harrison's Principles of Internal Medicine (21st edition), the role of an internist is becoming more important because many patients have health issues at the same time, like diabetes, high blood pressure, kidney disease and heart disease. These patients need a doctor who can manage all their conditions together.

The subject of Medicine is connected to other subjects in the NEET PG exam. It links Pharmacology, which involves choosing the medicine, Pathology, which involves understanding lab test results, PSM, which includes following national health programs and Radiology, which involves understanding images from scans. Medicine is the subject that combines all these areas in the exam.

MS General Surgery- The Operators Arena

MS General Surgery is a three-year postgraduate degree that teaches doctors how to do operations. A general surgeon does a lot of surgeries, like fixing hernias and taking out appendices, and also does more complicated surgeries, like fixing problems in the stomach and intestines and doing breast and thyroid surgeries.

Doing surgery is not about cutting and sewing. A good surgeon knows when to do an operation, when to wait and when not to do one at all. This is what makes a surgeon good at their job. As Bailey & Love's Short Practice of Surgery says, surgeons get better with experience, and in India, surgeons get to do a lot of operations.

In hospitals and government medical colleges in India, a general surgeon is often the only surgeon available. You will have to take care of people who have been in car accidents, people who have stomach problems in the middle of the night, people with hernias and people who have been burned.

You will have to do all of this with equipment and resources. This makes you very good at handling situations, and it is something that you cannot learn from a book.

MS General Surgery is also related to subjects like Anatomy, Pathology, Radiology and Anesthesia. When you are taking the PG test, you will be asked questions about MS General Surgery that involve these other subjects. The test will ask you to make decisions about surgery like a real surgeon would.

Cutoff Analysis — The Numbers That Matter

AIQ Cutoff Trends (General Category, Top Government Colleges)

The big difference is that Medicine usually gets filled up 300 to 600 ranks before Surgery at colleges. At AIIMS, the difference is bigger. Medicine often gets filled up within the top 50 to 100 ranks, while Surgery gets filled up around 100 to 200 ranks.

BE CAREFUL WHILE COUNSELLING: Students with ranks around 1,200 to 2,000 often have a choice to make. Should they choose Medicine at a not-so-good college or Surgery at a good college? In my opinion, the quality of training depends a lot on the institution. Doing Surgery at a hospital with experienced teachers will help you learn a lot more than just the name of the branch. Do not give up training just for the name.

What About Marks?

Looking at the 2024-2025 trends to get into Medicine at a government college, you need around 535 to 540+ marks out of 800. For Surgery at a college, you need around 500 to 520 marks. For colleges, you can get into both branches with marks in the range of 450 to 500.

Career Scope. The 10-Year Trajectory

MD General Medicine. Where the Career Goes

Hospital demand: Every hospital needs doctors who're physicians. The rising burden of diseases like diabetes, hypertension and other non-communicable diseases means the demand for internist doctors is growing every year. The National Programme for Prevention and Control of Cancer, Diabetes and other diseases is helping district hospitals expand their Medicine departments.

Private practice: A doctor who is a physician can start their clinic with very little money. Just a stethoscope, a table to examine patients and a pad to write prescriptions. They do not need to set up an operating theatre. In cities, a well-established physician can earn between ₹15–30 LPA within 5 years. Big hospitals pay intern doctors between ₹20–40 LPA.

Career: The Medicine departments in medical colleges are really big and have a lot of teaching jobs available. The path to becoming a professor is clear and possible. A doctor can start as an Assistant Professor. Work their way up to become a Professor and Head of Department.

Pathway: For Indian Medical Graduates, doing a residency in Internal Medicine is a great way to get into the US medical system. Another option is to get an MRCP from the UK after completing an MD in Medicine. MD General Medicine offers opportunities to work in other countries compared to other clinical branches.

MS General Surgery—Where the Career Goes

People need surgeons in hospitals. In India, there are about 1.5 to 6.8 surgeons for every 100,000 people, which is really low. The World Health Organization says we need surgeons. So there are jobs for surgeons in hospitals all over the country, from big cities to small towns.

Private practice is also an option for surgeons. Surgeons can earn a lot of money by doing operations like removing gallbladders, fixing hernias and taking out appendices. In a hospital, a surgeon can earn around ₹15 to ₹30 lakh per year after just 5 years. If a surgeon specializes in something like laparoscopic surgery or breast cancer surgery, they can charge more money.

The operating room is a part of being a surgeon. Unlike doctors who just give advice, surgeons make a lot of money by doing operations. They get paid for each surgery they do, which can be a lot of money. This is one of the things about being a surgeon.

Some surgeons also like to teach. There are jobs for surgeons in colleges, but there are not as many as there are for doctors. Surgeons who teach get to do three things: teach students, do operations, and do research. It is a lot of work. It can be very rewarding.

If a surgeon wants to work in another country, they can. They can take a test in the UK. Then work in a hospital there, or they can take a test in the US and work in a hospital there. It is not easy to get a job in another country as a surgeon.

It takes time, and there is a lot of competition. MS General Surgery is a career, and surgeons have many options for where they want to work and what they want to do.

Super-Specialty Pathways—DM versus MCh: 

This is the point where long-term career planning takes routes. The two paths lead to special specialty training, but the available choices and market conditions are quite different.

• Post MD Medicine, you can pursue DM. Doctorate of. After MD Medicine, you can do DM
• DM Cardiology is highly competitive and one of the most sought-after super-specialities in India.
• DM Gastroenterology has procedure training, such as endoscopy and ERCP.
• DM Nephrology has demand due to dialysis and transplant needs.
• DM End has the work-life balance among all DMs with a growing demand for diabetes diabetes due to diabetes.
• DM Pulmonary Medicine saw a COVID surge in recognition.
• DMDM Rheumatology is seeing growth in the biologics era.

There are over 10 DM specializations. This variety gives Medicine an edge in long-term career planning.

• Post MS Surgery, can pursue MCh. MCh is a Chirurgiae.
• MCh Neurosurgery is a highly respected super-speciality that commands premium fees.
• MCh Cardiothoracic & Vascular Surgery has stakes and is lucrative.
• MCh Plastic Surgery is both cosmetic and reconstructive. Is highly paid in metros.
• MMCh Surgical Oncology is seeing expansion due to the growing cancer burden.

There are 6 MCh. specializations. Though fewer in number, they command fees and institutional prestige.

The reality is that if you want a range of options after PG Medicine, Medicine has more DM pathways. If Medicine wins in the number of DM pathways. However, if you are looking for a procedure-high-earning super-speciality like neurosurgery or CTVS, only MS Surgery gives you that gateway. Your choice of PG will lock you into super-speciality ecosystems.

Salary & Earnings — The Real Numbers

The financial reality: At the base level (without super-speciality), starting salaries are comparable. The divergence occurs in two areas: Medicine physicians earn more through consultation volume (high OPD throughput), while surgeons earn more through procedure fees (operating charges per case).

Over 10+ years, surgeons who develop niche operative skills and build referral networks can match or exceed physician earnings — but the income curve is steeper and more variable.

After super-speciality, both DM Cardiologists and MCh Neurosurgeons/CTVS surgeons are among the highest-earning medical professionals in India, with top consultants exceeding ₹1 Crore annually.

Work-Life. Lifestyle. The Unfiltered Truth

This part can really make people think when they are talking to a counselor. So you should read it carefully.

MD General Medicine. What It Is Really Like

• The hours you spend in the ward are very long. The medicine ward in a government hospital is always full of patients. When you are a resident, it is normal to take care of 30 to 50 patients at a time. After a night with no sleep, you have to do rounds. This is something you have to do.
• You will also spend a lot of time in the ICU. As a medicine resident, you will take care of patients in the ICU who're on ventilators, have septic shock or other serious problems. This can be very stressful because you have to make decisions that can affect whether someone lives or dies. You have to use your brain a lot to make these decisions.
• The job is not physically demanding. You do not have to stand for hours in an operating room. You will walk a lot in the hospital, sit for long periods of time and spend a lot of time looking at reports. This can be hard on your mind more than your body.
• What happens after you finish your training? When you are a consultant physician, you will see a lot of patients, do rounds and take care of people in the ICU.
• You will work a lot. It can be a little more predictable than being a surgeon. You will not usually get called to an emergency at 2 AM unless you are on call.
• People who work in medicine can get burned out slowly over time. Taking care of many patients and having to diagnose their problems can be overwhelming.
• When doctors in medicine get burned out, they often feel emotionally exhausted, rather than just physically tired. MD General Medicine can be very demanding. The workload of an MD in General Medicine can be heavy.

MS General Surgery - Daily reality.

• The hours I spend in the operating theatre are what define my life as a resident. I am in the operating theatre for 4 to 8 hours every day during my training.
• I have to do emergency surgeries at night, like when someone has an injury or a hole in their intestine, and these things happen all the time.
• It is physically demanding. I have to stand for hours in the operating theatre, help with surgeries, and take care of patients after their operations at night. Then I have to get up the next day and go to rounds.
• Surgery residency is the training in all of medicine. My schedule is also very tough. I have to be ready to go to the hospital at any time, at 2 AM if someone is hurt badly in an accident.
• I still have to be ready to go to the hospital at any time for emergencies. The good thing is that when I am an established surgeon with a lot of patients, I have control over my schedule.
• I get very tired. Burned out sometimes. When something goes wrong with a surgery, a patient dies, or I have to deal with a problem, it affects me a lot.
• I always tell my students that if they cannot work well when they are very tired and if they get angry or make mistakes when they do not get enough sleep, then being a surgeon will be very hard for them.

Both surgery and medicine require a lot of sacrifice. Surgery is harder on your body.

HONEST MOMENT: I tell my students this. If you cannot function well on 4 hours of sleep, if sleep deprivation makes you irritable and error-prone, MS General Surgery will test you harder than Medicine. Both demand sacrifice, but MS General Surgery demands it physically in ways Medicine does not.

Decision Framework. Choose With Clarity

• If you want to go for MD General Medicine, here are some things to think about. You should choose MD General Medicine if you really like figuring out what is wrong with patients and solving mysteries across different parts of the body.
• This is more exciting to you than performing surgeries. You should also choose MD General Medicine if you want to keep your options open for fields. There are specialized fields you can go into more than ten.
• If you want to work outside of your country, like in the US, MD General Medicine is a choice. It is also a choice if you want to earn money by seeing a lot of patients rather than by performing surgeries.
• You might also like MD General Medicine if you want a schedule that's a little more predictable after you finish your training.
• If you like teaching and doing research, MD General Medicine is a choice. This field has the teachers and the biggest departments.
• If you want to go for MS General Surgery, here are some things to think about. You should choose MS General Surgery if you like working with your hands and doing procedures. You like operating and working with instruments.
• You should also choose MS General Surgery if you want to be a specialist, like a Neurosurgeon or a Urologist. These careers are only available if you go into Surgery.
• You should choose MS General Surgery if you can handle the mental demands of the job. You should be able to work under pressure and not get too stressed.
• You might also like MS General Surgery if you want to earn money by performing surgeries. The more skilled you are, the more money you can earn.

THE DECIDING QUESTION: When you are very tired at 3 AM during your training, and you get a call from the hospital, what do you feel? Do you feel a little better if it is a call from the Intensive Care Unit, which is more related to the MD General Medicine?. Do you feel a little better if it is a call from the Operating Theatre, which is more related to MS General Surgery? Your instinctive reaction will tell you which career path is right for you.

Master Comparison Table — The Complete Picture

Frequently Asked Questions

Which one is better for PG? Medicine or Surgery?

Medicine is better for people who like to figure out what is wrong with patients and want to have options for their career. Surgery is better for people who like to perform operations and want to have a career that involves doing procedures. You should choose Medicine or Surgery based on what you're good at and what you want to do in the long run. Do not just look at how hard it is to get into these programs.

What is the difference in the PG cutoff for Medicine and Surgery?

At government colleges, Medicine usually requires a rank that is 300 to 600 higher than Surgery. For the 2025 cycle, students needed around 535 to 540 marks to get into Medicine at institutes, while they needed around 500 to 520 marks to get into Surgery. This makes Medicine a bit harder to get into.

Which one pays MD Medicine or MS Surgery?

When you start working, the pay is the same for both Medicine and Surgery. Around 10 to 20 lakhs per year. Over time, surgeons can earn money by performing operations, while doctors who specialize in Medicine can earn more money by seeing many patients. After super-specialization doctors who specialize in Cardiology and surgeons who specialize in Neurosurgery can earn a lot of money. Around 50 lakhs to over 1 crore per year.

Which one has options for super-specialization. Medicine or Surgery?

Medicine has options. Over 10 different fields like Cardiology, Gastroenterology and Neurology. Surgery has options, but they are all related to operations. Like Neurosurgery and Surgical Oncology. The right choice is not about which one has options but about which one is right for your career goals.

Is Surgery harder than Medicine as a postgraduate residency?

Surgery is physically harder. It requires working hours, being on call at night and standing for long periods. Medicine is mentally harder. It requires seeing patients, figuring out what is wrong with them and managing their care over time. Both are very challenging. Surgeons often feel very tired, while doctors who specialize in Medicine often feel mentally drained.

Can I do Medicine after MS Surgery or Surgery after MD Medicine?

It is very rare for someone to switch from one field to another after they have completed their postgraduate studies. However, some super-specialization programs accept students from various fields. For people, choosing a postgraduate program is a one-time decision.

Which branch is better for going into Medicine or Surgery?

Medicine is easier for people who want to work in other countries. It is easier for international students to get a residency in Internal Medicine in the US, and there are established programs for doctors who specialize in Medicine to work in the UK. Surgery is harder. It requires training, and there are fewer spots available.

Clinical Pearl

I have learned something from watching students make this choice for 25 years. The doctor who chooses Medicine because they love figuring out what is wrong with people, and the doctor who chooses Surgery because they love performing operations. Both of these doctors do well.

The doctor who chooses Medicine just because it is easier to get into, or chooses Surgery just because surgeons make money. That is when they start to regret their choice. Your choice of what kind of doctor you want to be should match what you are good at, what you are skilled at with your hands, and what you really care about.

I have seen some great doctors who would have been very unhappy as surgeons, and some amazing surgeons who would have hated working in the Medicine department. One type of doctor is not better than the other.

If you choose the wrong type of doctor for yourself, it can feel like you are stuck in a job you do not like for 30 years. So choose your type of doctor carefully. Then give it your all.