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Two types of medical colleges graduate students: one is run by the different state governments; and there are a few private medical schools.
To get into the former you need to take their entrance exams and students are accepted based on the test results alone or in some cases entrance test results+(physics, chemistry, and biology marks from the 12th standard final exams). Indian citizenship is also a requirement as far as I know. Tuition is extremely cheap because it is heavily subsidized by the government.
Private schools are run for profit. Most, not all, private schools take students based on how much they are willing to pay. (Some do take students based on marks, but the fee structure is not pocket friendly.) Most of them are filled up with kids that did not make it to the state schools. Or they are filled up with NRI (Non Resident Indian) students who choose to come to India to get their medical degree for a variety of reasons.
Hope it helps.