The chances of securing a clinical seat with a rank of 149,000 in the general category are slim, especially considering the high competition for medical seats in India. However, the exact chances can vary depending on several factors, including:

• State-specific cutoffs: Cutoffs for medical seats can vary significantly from state to state. Some states may have lower cutoffs compared to others.
• Category-specific reservations: There are reservations for various categories, including SC, ST, OBC, and EWS. This can affect the overall competition for general category candidates.
• Number of seats available: The number of seats available for clinical courses can also influence the chances of admission.

Given your PMHS job, you might consider the following options:

1. In-service quota: Some medical colleges offer seats through the in-service quota for candidates who are already employed in the healthcare sector. If your PMHS job qualifies you for this quota, it could increase your chances of admission.
2. Management quota: Some private medical colleges offer seats through the management quota. However, these seats can be expensive and may require additional fees.
3. State-specific counseling: Participate in the counseling process for medical colleges in different states to explore all available options.

It's important to note that the situation can change from year to year. The best way to assess your chances is to:

• Research state-specific cutoffs for previous years.
• Contact medical colleges directly to inquire about admission requirements and quotas.
• Consult with a career counselor who can provide personalized guidance based on your specific circumstances.
  
  I hope this information helps you.