NEET – National Eligibility cum Entrance Test for admissions into medical colleges. That’s what the chaos is all about. To understand the issues we need to go back in time. Entrance examinations started with the AIIMS. Gradually some government colleges as well as private colleges introduced admission tests of their own. Many states continued to admit students on the basis of the XII standard marks.
In 1984, attempting to introduce some semblance of uniformity, the SC decreed that all government colleges set aside 30% seats (later reduced to 15%) for an all India quota based on ranking in an All India Pre-Medical Test (AIPMT). In 2009 a petition was filed in the SC to do away with the multitude of tests (around 38) and introduce a single national level examination for medical admissions. In Dec. 2010 the MCI notified NEET as the entrance test for all medical admissions including the reserved seats. This was implemented in May 2013; but when over 80 cases were filed opposing NEET the matter reached the SC and which set aside NEET in July 2013 (largely because of botched arguments by the government).
However NEET continued for the all India quota as well as those colleges (both state and private) who chose to use the NEET rankings for admission. On 11 April 2016 the SC recalled its previous verdict and decreed that NEET would indeed be the national qualifying examination. However the on-going NEET examinations for the all India quota were already scheduled for 1st May. To circumvent this problem the SC decided to label this as NEET-1 and have a second examination on 24th July termed NEET-2.
Total chaos ensued. NEET is based on CBSE course studies. Many schools followed non-CBSE curriculum and conducted entrance tests in local languages. Parliamentarians argued 11 weeks did not allow sufficient time for the NEET preparations. NEET they said differed from the state tests by 30% in content. What was left unsaid was that the 80 parliamentarians across party lines who led the charge against NEET had significant direct or indirect stakes in private medical colleges. The SC directive was set aside by an ordinance. NEET-1 (or the AIPMT) would continue and an all India NEET-2 deferred for one year.
Whilst some apprehensions over NEET do have some justification, the basic concept is, in my opinion, a sound one for various reasons. Various sources estimate that there are nearly 40 different entrance tests. (Unofficial figures are put at 100). With overlapping dates and varying curricula a mad scramble ensues for the students and provides a gold mine for coaching classes whose fees have doubled from Rs7500 to Rs 15,000 even as directors of some coaching centers admit that the NEET and state entrance tests are similar, but the former requires a deeper knowledge and therefore more practice. Another concern is that whilst states conduct school examinations in local languages, NEET is predominantly in English.
This objection is not sustainable on various grounds. First many states like Karnataka conduct CET examinations in English; the MCI rules require English as a subject in the school leaving examination; all MBBS courses are conducted in English; and at the end of the day most of the professional text books and journals are published in English. Local languages are certainly important to communicate with patients, but not exclusively so. My undergraduate studies were in Calcutta and I had to be familiar with Bengali, Hindi and English in clinical practice. Emotional attachment aside (or should I say political attachment) one cannot get away from the fact that medical education at any level is impossible without a thorough knowledge of English.
It is the 80 politicians with stakes in private colleges that is the core issue; and in my opinion it is here that the rot starts. There are 49990 medical seats in the country. Of these 24660 are in the private colleges. Of these officially around 40% are linked to NEET, another 30% to other tests like MCET or COMEDK, around 20% in management quota and another 15% NRI seats. It is a well-known fact authenticated by media reports that even with good entrance test rankings, candidates have to part with capitation fees. Indeed the outright sale in the NRI and management quota creates an estimated Rs 10, 000 crore industry. From the point of entry to exiting with an MBBS degree from a private medical college, an expenditure of Rs 1 crore is par for the course. The doctor emerges from a college with dubious standards and a hefty debt to recover. Now enters every form of malpractice that plagues the profession today, including cut practice, unnecessary tests and surgeries, defiance of the PNDT Act etc. to recover this debt. In my opinion not only would NEET in one fell stroke sweep away this curse, but the establishment of uniform standards could be complemented by a national level Exit test for all candidates at the end of the MBBS course. This would truly ensure that all doctors are equally qualified to practice.
The SC dismissed a petition challenging the government ordinance saying that “it was not an earth shattering matter”. The chaos and uncertainty is indeed an “earth shattering matter” that threatens to become a political football. Ask any candidate or their parents.
(Dr Gladstone D’Costa is the Chairman, Accreditation Committee and member, Executive Committee, Goa Medical Council.)
