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The Government of India conducts NEET examination through the National Testing Agency for the admission into nationwide medical colleges. The supreme court had earlier ruled the decision regarding medical college admission based on the following three principles.

1. The current practice of having two qualifying criteria at the state level and individual college level for admissions could be eliminated by having one standard examination.

2. Private medical colleges may allow unqualified students to enroll in their colleges which will dilute the quality of the doctors.

3. A common standard exam across the country will ensure a quality standard for medical education and in turn into medical personnel.

Educational policies

Our country has seen many changes in education policies in the last seventy years. Foremost among them was the introduction of the Right to Education Act in 2009. It applies to people between the ages of 6 and 14. But we can also say that the challenges start from here. There are about 1.25 crore government schools in the country. The number of private schools is about 1.60 crore. About 90 percent of private schools offer tuition. Only those who are economically weaker are enrolled in government schools. The idea that private schools are of the better standard comes to mind when parents enroll their children in private schools for a higher fee. With this background, the Supreme Court ruled in 2012 to amend the Compulsory Education and Free Education Act to provide free education to 25 percent of underprivileged, backward and economically disadvantaged students in private schools. The government spends large sums of money on teacher salaries and administrative expenses to run low-enrollment public schools. Private education, on the other hand, has prospered with higher student numbers and lower teacher salaries and administrative costs. The same is true for higher education. The government spends a huge amount of money on administrative expenses of institutions of higher education in Engineering, Medical and Management. Private education, on the other hand, has prospered with higher student numbers and lower teacher salaries and administrative costs. 

Vocational exams

Qualifying entrance exams in India are conducted in many disciplines. Particularly in Engineering, Joint Entrance Test is conducted for engineering admission. The score of the entrance examination is a common standard to all engineering colleges in India. However, the score is not required by all colleges but is mandatory for admission to the top educational institutions. Engineering college entrance exams mostly are not affected as there are more engineering colleges than required in our country.

Examinations in Professional Courses give students the opportunity to prove the competency for study in the field. But it is the duty of the government to ensure that appropriate slots are provided for the students who qualify through this examination. But the scope of such entrance examinations is diluted when the students who have passed and qualified in the examinations do not get the relevant educational opportunities. Total seats should ideally be allocated top-down based on the scores of eligible students. However, it is not only the score but also the marks of other examinations that determine the allocation of a seat for a student. The government cut-off mark is based on the total number of students who wrote the exam that year, the number of seats and also depending on the difficulty of the questionnaire. It is also necessary to have Minimum Eligibility to pass the Caste and General category. The current system does not pose much challenges in engineering admissions, as there are more engineering colleges in the country than required. This is not the case with medical colleges.

How are medical study seats filled on an entrance basis?

The NEET examination is made mandatory for all the admission requirement of medical colleges. Around 15% of the seats in the total number of medical study seats in a state will be filled on the basis of the score of NEET examinations at the All India level. The remaining 85 percent will be filled at the state level based on NEET selection. Private medical colleges can fill in students who have passed the NEET exams. This allows qualified students to enroll in the private self-funded fee system. This will prevent unqualified students from entering private medical colleges through the back door. 

State Reservation

The reservation that states adhere to can be allocated based on the NEET exam score. This allows states to determine their own rights. Tamil Nadu has the largest reservation based admission system in India. Tamil Nadu follows the 65 percent reservation system. With more medical seats being filled by state students, the All India quota is set to snatch up 15 per cent of opportunities for Tamil Nadu students. But on the other hand, NEET selection helps other state students who do not have medical colleges to get the opportunity to study in medical colleges in Tamilnadu.

School Education Issues

Due to the fact that education is on the state list, it is not possible to have the same education standard and options in India as there are different linguistic states. Not only that but many education systems like state board, ICSE, CBSE, matriculation are also taught. But NEET exam questions are asked only from the Central Board of Secondary Education (CBSE) syllabus. It is true that students studying under the state education curriculum find it difficult to face the NEET exam.

The second biggest drawback is that the marks obtained in the Class XII examination are not considered as eligible for admission in the NEET examination or medical course. The marks scores based on hard work and schooling are going to be worthless, so the effort of school education is seen as wasted.

Features of NEET Exam

Introduction of NEET for medical admission had disrupted many of the prevailing systems of admission. Earlier, both the students with money affordability as well as students with good grades were able to get admissions easily in medical school. Currently even with money, you need to qualify for the NEET exam. Students with the lowest marks are barred from enrolling in medical studies through the Overseas Section (NRI Quota).

Talented students from the most backward states in development can benefit by joining other state medical colleges through All India Reservation.

Private medical colleges can be indirectly brought within a limit by the NEET qualifying examination.

Students from forward communities who do not get into medical colleges due to state reservations despite having the required qualifications will have the opportunity to join medical colleges under the All India quota.

Disadvantages of NEET selection

NEET does not give importance to the state education system, and it will greatly affect the socially backward and poor students who excel in state board. Because these students have no choice but to go to government schools.

So far, the 12th-grade exam is a huge burden for state students, causing stress. The marks are required to join every college departments by merit, so students are compelled to work hard for higher marks. However, now the marks obtained in the state board way do not help the medical admissions through NEET exam. In addition, NEET can be passed only if you work harder than that. This is the biggest flaw in the education system. This will place a huge burden on students.

Students studying in the state education system are required to train separately for NEET examination. There is an additional expense for this. This causes education to become an unattainable fruit for the poor. The Government of Tamil Nadu is taking steps to refine the state education curriculum in parallel with the Central School Education (CBSE) program, which is a good initiative but it will only help the poorer students to pass the NEET examination if the government's role is more and more expeditious.

Whether qualifying entrance examination necessary?

What is the purpose of entrance examination? Is it for selecting a few hundred deserving students out of several thousand students? Unfortunately, there are a very limited number of medical seats available in the country, and the exam is used only for filling the limited seats by ranking. The rest of the students will not be admitted even if qualified. In what way is this fair? This calls into question the objectives of the entrance examination and the qualifying examination.

For the reason that education is on the states list, those states should create adequate medical colleges considering the number of students. The states with the highest number of medical colleges are Karnataka, Maharashtra, Tamil Nadu, Kerala and Uttar Pradesh respectively. The southern states account for 44 per cent of the total medical college seats in India. There are more private medical colleges than government medical colleges in the country where education is a fundamental right. The central government has announced that it has received applications to start 85 new medical colleges this year, most of which are private medical colleges.

The government should have created medical colleges on a wartime basis before bringing in entrance exams like NEET but failed. Students across India would have benefited from state reservation if the required number of medical colleges had been established in all the states.

We need to change our education policies. On the one hand, there are more engineering colleges in which there is no competition for vacant engineering courses and on the other hand fewer medical seats with huge competition. The answer is to have a flexible education system. Opportunities to study medicine should be available to all students who pass the medical course in one year.

Engineering colleges which are currently in excess of the requirement should be allowed to conduct other courses. Adequate facilities may be upgraded to allow colleges to conduct specific medical related courses.

Under the current system students joining under the self-funded category on the basis of NEET examination score will be charged only the fees fixed in Government Colleges and the remaining amount will be paid jointly by the State and Central Governments. This should continue until adequate medical colleges are established. The recent announcement by the Government of Karnataka is welcome.

What it is important in medical education?

Keeping aside NEET selection, eligibility, reservation etc., what is the purpose of medical education? Not only sound education but the alertness and dedication of doctors too are most required. India, the world's second most populous country, has about 7.5 lakh registered physicians. According to the World Health Organization, there should be one doctor for every 1000 people. The total population of our country is 135 crores. Accordingly, India needs 13.5 lakh doctors, but there are only 7.5 lakh. With an immediate need for 5.5 lakh doctors, the total number of doctors appearing in our country every year is only 52000. We have to wait at least 7 to 9 years to meet the current urgent need.

The government should make efforts to start enough medical colleges on a wartime basis that we need. Qatar has the largest number of doctors in the world, at about 7 per 1000 people. Countries like Cuba, Belgium, Spain and Greece have more medical care than they need. In our most populous country, there is only a 1 doctor ratio per 1800 people. This rate is even worse in rural areas. That means there are more doctors in less populous cities and less doctors in more populated rural areas.

Due to the shortage of doctors, people are flocking to public and private hospitals. It changes the status of medicine as a service; Medicine has become fee-based.

India is the country with the highest youth population. The youth population in our country is about 60%. Only by producing the necessary doctors for our country will we be able to provide appropriate medical care in the future.

Human resources are our strength

The total number of students who wrote the NEET exam in 2017 was about 11 lakh out of which the number of eligible students was about 6.75 lakh. Of these, only about 52000 had been offered. The number of students who were eligible but not admitted is 6.25 lakh. Thus the human resources required for our country and the world were wasted. If all students had been given the opportunity, we would have had the adequate doctors we needed in five years. With fewer doctors coming out each year, medical services are having difficulty reaching people from all walks of life. Only basic treatments are provided in government hospitals due to the shortage of doctors. Thus; People have become dependent on private medical care for high-quality treatments. This pushes the medical service to transform into a medical market.

With adequate medical colleges, each state can become self-sufficient and create enough doctors for our country if it can provide admission for all those who pass the NEET exam. You can get employment by serving other countries.

Cuba spends 44 percent of its GDP on medicine. Our country can too achieve self-sufficiency in the medical field by creating the basic infrastructure for medicine.

The nation is for the people, and the welfare of the people must be paramount in everything. India is allocating more funds to the military to protect its borders and the more important requirement to protect the people from diseases is being missed. Medical service should be considered as the next step to our fundamental rights. A few thousand medical seats available for millions of deserving students is forcing everyone to take the private route at additional cost. Although the government is unable to establish the required medical colleges at present, it has hastened to create the necessary medical colleges with private assistance.

Every deserving student should be given the opportunity. If we look at this only from the narrow perspective of the NEET entrance exam problem, we tend to miss the bigger picture. The division among the states, the division of power between the central and state governments, the caste and economic inequalities and many other factors are ignored in the medical admission through NEET. We need to postpone the NEET at least for few more years until an acceptable standard ecosystem is established in the country for medical education. Until then, states should be allowed to function to roll out medical education for all their qualified students in large numbers. Tamilnadu example of rolling out doctors from rural places in large numbers without any compromise in quality is an excellent role model of a state.

Written by Santhosh Kumar Sundar

Translated by Ganapathy Nallasivan

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