Is NEET designed for exclusion?

NEET’s low cut-offs let in less qualified candidates. High costs for coaching and fees create economic barriers, making the exam exclusionary.

Students protest over the NEET-UG and UGC-NET examinations issue outside the Ministry of Education in New Delhi on June 20, 2024. | Photo Credit: SHASHI SHEKHAR KASHYAP

Central examinations are a way of measuring performance, usually against certain predefined standards, and are intended to provide information on how individual students perform relative to the national or regional student population. Given that education itself is fraught with agency problems in developing economies, the role performed by central examinations may be pivotal to how the education system works. The information they generate is used by many stakeholders in, and even beyond, the education system.

Central examinations are considered an important element of meritocratic educational systems. There are two ways, broadly speaking, that one might conceive of meritocratic education. The standard narrow conception distributes certain educational goods and opportunities on merit. This conception is based on the premise that scarce educational goods such as admissions into universities are allocated in such a way that students with greater merit are prioritised. This version of meritocracy is typically invoked when demands for affirmative action or other non-merit-based policies arise.

The other is the broader view, where “meritocracy” refers to the practice of distributive justice, according to which certain economic goods (such as jobs and income) must be distributed in accordance with merit, and in order to do so one’s merit must satisfy certain other constraints. Merit is developed against a background of equality of opportunity. Given that education is one of the primary vehicles through which we develop merit, an education system rooted in meritocracy would need to adhere to a principle of equality of opportunity as well. This requires a commitment to embrace decidedly unmeritocratic, egalitarian approaches to allocate educational goods that would permit certain forms of “levelling down”.

A commitment to a meritocratic view involving distributive justice requires rejecting the narrow meritocratic conception of education. An understanding of the connections between meritocracy and equality of opportunity is vital to shed light on disagreements about the role and value of equality of opportunity in education. Central examinations in India, and the National Eligibility cum Entrance Test (NEET) in particular, are designed with the narrow conception of meritocracy and therefore manufacture exclusion.

In India’s federal system, centralised examinations such as NEET, conducted in order to admit students into undergraduate medical courses, generate both horizontal and vertical imbalances. The health of its citizens is the de facto responsibility of States. Article 21 of the Constitution protects the “right to life”, which presupposes a right to access reasonable healthcare. Public health is a subject on which State governments can legislate almost exclusively. State public health departments offer preventive and curative services to elevate the quality of life of their citizens. The majority of medical colleges are run by State governments; they play a critical role in producing healthcare professionals, who form the backbone of States’ health infrastructure for timely delivery of public health.

Medical education thus needs to be conceptualised from a broader perspective than just institutions of higher education as it generates and maintains an important public service, namely, the healthcare system. This highlights the need for a “systems thinking” approach to deliver quality public healthcare, which has faced challenges, especially after the COVID pandemic.

As State governments run the public health system, they require greater autonomy in deciding inputs to ensure better outcomes, and entry into medical colleges is a critical input on which States require freedom to sustain their health systems. A centralised process would curb the autonomy of States and result in arbitrary allocation of inputs, skewing their healthcare systems and leading to inter-State and intra-State imbalances in terms of both inputs and outcomes. Further, a unilateral change in the selection of healthcare professionals through NEET without a consultative mechanism to assess its impact on a State’s healthcare system, while also ignoring the social and economic implications of such a process, leads to the exacerbation of inequalities, which gets perpetuated owing to the lack of autonomy.

Multiple levels of exclusion

The exclusionary aspects of NEET surface at multiple levels. First, an examination rooted in meritocracy dilutes the entry standards to open the floodgates of medical education to non-meritorious candidates, which is evident in the low cut-off scores for qualifying. The cut-off score this year is 164 out of 720, which is 22.78 per cent. In 2022, it was 16.36 and in 2023 19.03 per cent. The qualifying percentile of NEET-PG (postgraduate) and NEET-SS (super speciality) courses was slashed to zero percentile in 2023 under instructions from the Ministry of Health and Family Welfare.

Reducing the qualifying percentile only allows private medical colleges to make money and facilitates large-scale corruption by the blocking of seats. As a result, students with high merit are not able to get admission, while those with low scores and more money secure admission. So much for meritocracy that a test with questions in physics, chemistry, botany and zoology makes it possible for students who score in single digits in any one subject to qualify and become medical professionals by virtue of marks in other subjects.

The second striking form of exclusion emanating from NEET is economic exclusion. This manifests at two levels. At the first level, there is the exorbitant cost of coaching, which students have to undergo in order to prepare for the examination. The annual revenue of coaching institutes was a whopping Rs.24,000 crore, according to a 2015 estimate by an expert committee set up by the Education Ministry. In 2022, the market revenue of the coaching industry in India was Rs.58,088 crore, according to the Pune-based consultancy firm Infinium Global Research. The coaching industry’s growth is projected to reach Rs.1,33,995 crore by 2028. The size of the industry reveals the expenditure borne by households and the heavy financial burden they face so that their children can prepare for the examination. Households that cannot afford the expense of coaching classes are left out of the system.

After this initial heavy expenditure comes the next big expense: the fees charged by institutions. The cost of education varies according to the institution. There are four categories of institutions, based on the type of management: Central universities, government colleges in the public sector, private colleges, and deemed universities in the private sector. Out of the total number of seats, 51.67 per cent are in public institutions and the rest in the private sector. The fees charged for the entire course ranges from Rs.3.64 lakh to Rs.6.2 lakh in public institutions and Rs.78.2 lakh to Rs.1.22 crore in private institutions. Government institutions are affordable for a large section of the population, while private institutions can be afforded only by a small fraction of high-income households. The distribution of seats and low cut-off marks clearly reveal the exclusionary design of NEET in an economy characterised by rising inequalities.

Members of the Indian Youth Congress during their protest over the alleged rigging of the NEET exam at Jantar Mantar in New Delhi on June 27, 2024. | Photo Credit: SHASHI SHEKHAR KASHYAP

The third form of exclusion is based on gender. Unlike other competitive examinations, such as the Joint Entrance Examination (JEE) for engineering courses, a higher number of female candidates appear for NEET. Out of the total number of candidates who appeared for NEET in 2024, 57 per cent were female and 43 per cent male; for JEE, it was 67 per cent male and 33 per cent female. The system of lowering the cut-off marks is to be interpreted as an intention to erect barriers for the entry of women into the medical profession. To elaborate, the household expenditure towards education is skewed in favour of boys in patriarchal societies; hence, households would be willing to fund the educational expenses of a male student with a low NEET score than that of a female student with relatively higher score.

The logic of meritocracy would assume it to be the other way, but social realities tell us the opposite. Female students face a double disadvantage in this scenario. First, they face difficulties in convincing parents to fund the expensive coaching programmes, which often do not match the convenient timings of parents and students and lead to anxieties about the safety of girl students. Second, if the scores are not high in NEET, they fail to get family funding for fees of medical colleges. This generates a scenario where girl students after much toil end up as losers due to a peculiar system of low cut-off marks in the qualifying exams.

The recent NEET fiasco raises doubts about the capacity of the state to create robust institutions that deliver consistently good outcomes. The fragilities associated with state capacity in India fall largely into three categories: planning, process, and personnel. A closer look reveals that the state is actually understaffed in several key areas. The National Testing Agency (NTA), a registered society, is an example of this. Understaffing has been a feature of India’s public administration for many years now as successive governments have been going slow on recruitments in the name of efficiency. Further, “state capacity”, or the ability of the state to effectively design and implement public policies, varies greatly across India.

Multiple issues require attention in this context while focussing on the manifold shortcomings of agencies such as the NTA. First, there needs to be focussed attention on the levels of corruption and venality these agencies generate. Second, the lack of competence is a severe limitation both at the policy design and at the policy formulation levels. The third and most crucial challenge is the effective implementation of policies.

The NEET fiasco shows that instead of expanding the coverage of “pockets of efficiency”, hastily planned transformations through weak institutions are spreading incompetence in India’s governance institutions. Unfortunately, the core of India’s public educational apparatus has not enjoyed the same kind of rejuvenation that has embraced some other domains. If this is left unaddressed, it will undermine human welfare in the long run.

M. Suresh Babu is Director, Madras Institute of Development Studies. The views expressed are personal.