Education

Medical education: A case against NEET

Print edition : October 22, 2021

At a call centre offering stress management counselling for students who appeared for NEET, in Chennai on September 15. Photo: Ragu R.

Justice A.K. Rajan. Photo: PICHUMANI K.

At a NEET examination centre in Vellore, Tamil Nadu, on September 12. Photo: PTI

Even as allegations of question paper leak and impersonation mar NEET 2021, a Tamil Nadu government panel report slams the examination for obstructing social justice and calls for its abolition.

A question paper leak ahead of the National Eligibility Cum Entrance Test (NEET), evidence of impersonation of candidates during the examination, and a Tamil Nadu government-appointed committee report that showed the examination did not provide all students with an equal opportunity have raised valid questions on the need for such a national test for admission to medical colleges in India.

As many as 16 lakh students from all over the country appeared for NEET 2021, which was held on September 12. According to media reports, the NEET question paper was leaked from the Rajasthan Institute of Engineering and Technology (RIET) exam centre in Jaipur.

In another shocking incident, a cash-for-proxy-candidate scam was unearthed in Nagpur, where persons running a coaching centre and others were booked for cheating and impersonation (reminiscent of the Hindi movie Munna Bhai M.B.B.S., in which a qualified doctor takes a rogue’s place to help him clear the entrance examination).

On September 12, the Central Bureau of Investigation (CBI) filed a first information report against them, alleging criminal conspiracy, cheating by impersonation, forgery of valuable security, forgery for the purpose of cheating, using forged documents as genuine, tampering with computer source documents, identity theft and cheating by impersonation by using computer resources. The coaching centre reportedly took Rs.50 lakh each from five Delhi-based students, promising them that they would clear the competitive examination.

Students trended #FairNEET on Twitter after this scandal and the case of question paper leak emerged. Earlier, many students had written to the National Testing Agency (NTA) demanding a CBI investigation into the leak. Several petitions have also been filed in this connection.

On September 29, a batch of students approached the Supreme Court seeking relief and cancellation of the examination as neither the NTA nor the Government of India had issued any statement on ensuring a level playing field in the wake of the scandals. In 2015, the Supreme Court, after examining a similar case in the All India Pre-Medical and Pre-Dental Test, said in a 41-page judgment that any attempt to save the exam would “leave merit a casualty and generate frustration among genuine students”, according to a report in The Hindu.

Rajan committee’s findings

It is in this context that the report of the committee headed by former High Court judge A.K. Rajan gains relevance. After thorough analyses of NEET scores, it said that the examination eliminated students from the most oppressed sections.

The committee was formed in fulfilment of the Dravida Munnetra Kazhagam’s (DMK) promise in its election manifesto that it would repeal NEET and restore the old system of class 12 marks as the basis for medical admissions. On assuming office as Chief Minister after winning the Assembly elections, DMK president M.K. Stalin announced that a committee headed by Justice A.K. Rajan would study the impact of NEET.

Its terms of reference were:

(1) To study, whether the NEET-based admission process had adversely affected the social, economic and federal polity and the students of rural and urban poor sections, those who studied in government schools, those who studied in Tamil medium or any other section of students in Tamil Nadu.

(2) If so, to suggest the steps to be taken to remove the impediments and to protect the rights of the State, for advancing the principles of social justice and also to fulfil the mandate of the Constitution to provide equal and equitable “access to health” to all sections of the people of Tamil Nadu.

(3) To study whether NEET was an equitable method of selection of students.

(4) To consider the effect of mushrooming NEET coaching centres on the educational system in Tamil Nadu.

The committee was given a month to submit its report.

On July 14, it presented a 165-page report after taking into consideration suggestions from 86,342 persons across the State. After handing over the report to the Chief Minister, Justice Rajan told mediapersons: “A majority of the people said that there was no need for NEET….The report that we have given the Chief Minister is based on the data generated from the opinion of the people who wrote to us. It is not our opinion.” (“NEET: Rajan Committee submits report, ball in Tamil Nadu government’s court”, Frontline, August 13, 2021.)

The report, which was made public in September, noted: “If medical education is to be affordable to and accessible by all people, it will not be possible without a fair and equitable admission process and criteria and a proper fee regulation. Contrary to this, NEET does not seem to help achieve the much required diversity.”

Even earlier, it was well-known that NEET was skewed in favour of those who could afford coaching. For instance, speaking on the students who had cleared NEET in 2019, Jayaprakash Gandhi, an education consultant, said: “Out of 7,97,042 who qualified in 2019 NEET, 2,02,263 are from the so-called top three NEET coaching institutions. Average fees, to my knowledge, would be around Rs.50,000 per year. Again and again data is proving that NEET is against social justice.”
Also read: Tamil Nadu government passes Bill seeking NEET-exemption

The Rajan Committee, which emphatically concluded that “coaching has replaced learning”, went into this issue and more in detail. It said that 400-plus coaching institutions in Tamil Nadu earned Rs.5,750 crore from this examination alone in a year. It added: “The actual number would be higher than this if a detailed investigation is made.”

It said that students had been converted into “mark scoring machines”, adding that “the culture of coaching and commercialisation caused by the single-criteria admission based on the NEET score would not encourage either the educators to impart a holistic education or the medical aspirants to work towards acquiring it.”

Biased in many ways

According to the report, one of the many flaws of NEET was that it ended up “duplicating Board examinations”. It said that NEET assessed students “using the same standardised criteria-referenced test as used by the Board exams, unlike the tests used in some progressive countries, like UCAT (University Clinical Aptitude Test) and MCAT (Medical College Admission Test), which assess both the students’ achievements and/or aptitude and whose scope is completely different from [that of] the Board/school exams.” Besides, NEET is biased in favour of the Central Board of Secondary Education (CBSE).

The committee analysed the NEET results from 2011 and found that there was a “huge rise in the admission of CBSE students to 22.66 per cent in government seats in the post-NEET period from a meagre 0.1 per cent pre-NEET, while the rate of admission of TNSBSE [Tamil Nadu State Board of Secondary Education] students to government colleges fell from 70.11 per cent pre-NEET to 46.77 per cent post-NEET. The share of the other Board candidates has also slightly increased, from 0.243 per cent pre-NEET to 1.763 per cent post-NEET.”
Also read: Rajan Committee submits report

Using statistics from the past decade, the Committee found that urban students were admitted in much larger numbers; a disproportionately high number of English-medium students were admitted as compared to Tamil-medium students; the number of students who were the first graduates in their families was much lower than students whose parents were graduates; children from high-income families formed an overwhelming majority of those who cleared NEET; and between ‘repeaters’ and first-timers, repeaters cornered more seats.

Besides this, the report said, the “validity and reliability” of NEET has not been evaluated so far and this raises concerns over the genuineness of the test.

Impact on TN health infrastructure

The Committee said that the continuation of NEET would also have a devastating effect on Tamil Nadu’s public health infrastructure.

It pointed out that the State-run medical colleges depend on admission of local government doctors to postgraduate superspeciality medical courses for their teaching faculty. (Those who complete superspeciality courses at State-run colleges have to sign a two-year government service bond.) With more and more of these seats going to candidates from outside the State, the State’s existing medical colleges will find it difficult to maintain the student-teacher ratio, especially since many candidates violate bond conditions or pay the bond amount to leave the State.

The report said: “From what has been stated above, it can be seen that if NEET continues for a few more years, the health care system of Tamil Nadu will be very badly affected.” The government may not be able to post enough doctors at the primary health centres or employ enough specialist doctors in government hospitals, it added.

“Further, the rural and urban poor may not be able to join the medical courses. Ultimately, Tamil Nadu may go back to pre-Independence days, where in small towns and in villages only ‘barefoot’ doctors were available. Tamil Nadu would go down in the rank among States in the medical and health care system,” the report said.

The committee recommended abolition of NEET using provisions under the Constitution to enact a law, and also bringing all private medical educational institutions (deemed universities) under the purview of the Act. It underscored the need for a comprehensive reform of school education where the emphasis will be more on learning than coaching and wanted the government to use an “adversity score” to ensure affirmative action for the disadvantaged sections of the population.

NEET Bill

On September 13, the Tamil Nadu government passed a Bill against NEET. The Tamil Nadu Admission to Undergraduate Medical Degree Courses Bill, 2020, sought to dispense with NEET and provide admission on the basis of class 12 marks. ( “Tamil Nadu Assembly passes Bill seeking exemption from NEET in the State”, Frontline Dispatches, September 13, 2021.)

Similar Bills (one for undergraduate education and another for postgraduate education) passed by the previous All-India Anna Dravida Munnetra Kazhagam (AIADMK) government in 2017 did not receive the President’s assent.

Worried about the possibility of students taking their lives owing to the stress caused by NEET, the State government stepped up counselling measures and asked teachers to stay engaged with students. However, this was not enough. The State reported multiple suicides over the week in which NEET was held.

A report in The New Indian Express quoting counsellors in Tamil Nadu said that at least 60-70 per cent of the students who write NEET for the second or third time are at an increased risk of depression and anxiety. The report also said that the State government had collected the contact details of 1.1 lakh candidates for NEET-UG and gave them stress management counselling.

Writing in The Hindu on September 29, Faizan Mustafa, Vice Chancellor of NALSAR University of Law, Hyderabad, and constitutional law expert said: “Merit requires fair competition and equality of opportunity….When NEET does not satisfactorily meet this fundamental criterion, competition cannot be termed as fair and just, and the equality of opportunity becomes illusory….There in an element of class in NEET and the Justice Rajan Committee has found hard evidence of such elitism. If similar committees are appointed in other States, there are sure to be identical findings.”
Also read: Tamil Nadu's political parties continue to resist NEET

Questions on NEET are being asked in Maharashtra too after Tamil Nadu subjected it to intense scrutiny. On September 21, Maharashtra Congress president Nana Patole demanded that the State government exempt its students from NEET. In a letter to Chief Minister Uddhav Thackeray, he said that students should be admitted on the basis of their State board examination marks because NEET tends to favour CBSE students.

On September 15, Stalin said that Tamil Nadu would reach out to other States to put forth its views on NEET. Accusing the Union government of being cold-hearted despite the several student suicides in the State, he said: “You don’t need to qualify to study. Once you study, the qualification will come automatically.”

Former High Court judge K. Chandru said that the “battle for and against NEET” will continue in the courts.

Writing in The Hindu on September 16, he said: “Hopefully, the courts will determine the legality and have a definite solution to the question of medical admissions within the next year.”

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