NEET exam 0 Percentile Ruling

 For the lay readers a small primer on the word NEET. National Eligibility cum Entrance Test. Well admission to medical colleges in India say in 1979 when I got admission were based on the results and marks one obtained in the Higher Secondary Certificate (HSC) science stream exam. Within the exam the core science subjects were considered to be Physics, Chemistry, Biology and Mathematics. A combination of marks in Physics, Chemistry and Biology determined the merit for admission in MBBS, Dentistry, Physiotherapy, Pharmacology streams of education. A combination of marks in Physics, Chemistry and Mathematics determined the merit for admission in the Engineering and allied streams of education. In case of a tie the total marks were the tie breaker. Besides this state and local domicile certificate as a proof of local residency were a criterion to determine eligibility. This was a departure from Inter Science college marks, which were old school long form essay type of answers. The marks were not very high and getting first division over 60% marks was not commonplace and getting a Distinction was rare indeed. Even then in the name of modern education the 12th standard exams became objective with short answers and Multiple Choice Questions becoming the order of the day. This led to high marks and even then getting more than 80% marks became common place. Later as students parents and coaching classes learnt the exam patterns the sole purpose of the 12th standard exam shifted decisively from pursuit of knowledge to cracking the code and getting ridiculously high marks. Scoring almost 100% marks was possible and achieved on a regular basis. Such was the glut of marks that anything less than 90% in PCB (Physics, Chemistry and Biology) meant not standing a chance to become a doctor. However, reservation of 33% for the backward classes, scheduled castes and tribes and others led to significant number of persons getting less than half of the marks obtained by merit students could get into medical college. 

I do not recollect the history but I think a PIL in the court led to an attempt at State and later National level create common entrance tests with seats distributed based on formulae which accounted for state and national and reserved seats. The exam was a total MCQ exam with negative making and with cut throat competition. While the attempt was to give equal opportunities to students all over the country to make their choices of colleges, it also paved the way for privatization of medical colleges, with management quotas and minority quotas. This enabled and abetted corruption and some seats were sold at exorbitant prices, while many meritorious students could not get admissions. Besides some autonomous universities conducted their own entrance examinations. This made it a logistic nightmare for students a led to one common test named National Eligibility cum Entrance Test. 

NEET brought all colleges private, government and deemed universities under one banner in terms the admission test. However, to curb this menace of corruption and arbitrary fees, a Fee fixing commission was established. At state and national level it allowed private institutions to charge fees based on the expenses projected to cover the costs of running the college and have surplus for future development and expansion. In a vast and diverse country like India with very great differences in development across geographical boundaries, it is very difficult to have a common playing field providing equal opportunity to get medical education. 

In the old system merely relying on marks obtained in a qualifying exam where jugaad or an ability to crack the exam without any real attempt to learn was at best a sorting system to determine who among the candidates obtaining over 90-100% marks was ahead to qualify for the seats available. At least in this system which predated the era of private medical colleges, geographical and cultural adaptability and ability to pay fees was not of great importance. Once capitation fees based private medical colleges came in politicians became education barons and seats were bought and sold without any criterion of merit. Reservation was available for  different categories without any qualification bench mark except for highest marks in the category applied for. 

National Eligibility cum Entrance Test sought to address these issues. While it still remained a sorting system an attempt was made to reduce the differences in opportunity to seek medical education based on geographical location. However, the ability to afford medical education based on private vs state run medical colleges remained. Only difference was the fees were regulated and there was transparency in the financial dealing. On top of that the NEET entrance mandated that candidates below 50th percentile for merit students, 45th percentile for Persons with Disabilities and 40th percentile were not eligible for entrance into medical colleges. This resulted in some seats going wasted in a situation where in some categories meritorious students could not get seats. The problem was not a big one but got magnified when it came to postgraduation seats as these criteria resulted in non clinical subject seats remaining unclaimed. The solution for such a situation could be fee reduction or making future prospects for such jobs monetarily more attractive. 

An easy solution for this problem was sought. Without application of mind the regulatory authorities dropped eligibility criterion completely. So the logic of NEET named National Eligibility cum Entrance test was overturned and for vacant seats Eligibility was forgotten. So MBBS doctors who came through the system of NEET for undergraduate training merely had to appear for the PG NEET and get assured seats for subjects where there were no takers. So doctors selected for nonclinical subjects where they became typically medical college teachers could be of the lowest quality and they were the ones who in turn taught the students foundational subjects, thus undermining the quality of medical education significantly.

All these rote examinations with no interviews, group discussions or general knowledge evaluation has created an atmosphere where exams and marks instead of becoming a means to achieve an end became an end itself. This has led to creation of doctors who spend more time in studying to qualify for the admission than in honing their practical skill sets. Besides this the modern trend of prescribing and depending on too many investigations without clinically examining patients has created "hyposkiliac" doctors. The saving grace of having some minimal marks upwards of 40th percentile is also now being set aside for the purpose of ensuring no seat remains unfilled. It is indeed one more sad day in the chapter marking the decline of medical education in India. 

I have no solutions to offer at present except to at least retain the present structure, make NEET less objective and to add national interviews and General Knowledge along with group discussions to evaluate skill sets needed to create a good humane compassionate doctor who has the requisite skills to give great clinical outcomes. 

Vispi Jokhi