The declaration of the results of the National Eligibility cum Entrance Test (NEET) for medical colleges in June this year has been followed by massive protests by students and people of Tamilnadu. Before NEET was made compulsory this year for all states (exemption provided to TN in 2016 from NEET was withdrawn this year), the entrance to government medical colleges in Tamilnadu was based on the marks obtained by the students in the final school examination conducted by the Tamilnadu Board.
What is NEET?
The National Eligibility cum Entrance Test – UG (NEET- UG) is a common all-India Entrance Examination conducted by the CBSE (Central Board for Secondary Education) for admission to MBBS/BDS Courses in India in Medical/Dental Colleges. It is conducted with the approval of the Medical Council of India/Dental Council of India under the Union Ministry of Health and Family Welfare, Government of India. This year, 11,38,000 students appeared for the NEET-UG examination. Nearly 6,11,000 students qualified. Of all these students who qualified in the entrance examination, only about 25,000 will get into government medical colleges, while another 30,000 will get into private medical colleges. According to the Medical Council of India, there are 477 colleges in India offering MBBS courses, which have about 60,000 seats.
The withdrawal of exemption from NEET in 2017 and the protests following the same in Tamilnadu has brought to the fore, yet again, many severe problems concerning medical and other professional education in the country. These include problems concerning the method of admission, shortage of job opportunities and the enormous mental and financial stress it places on youth and their parents, and the complete disharmony between society’s need for doctors, engineers, nurses, teachers, etc., and the availability of such qualified resources. These are problems that concern youth in particular and society at large.
No justification for a common medical entrance exam
It has been argued by the government that a common all India Entrance Examination will ensure that the standard of students entering medical colleges will be uniform, and will provide equal opportunity to students from every state, especially states where there are very few medical colleges or none, as in the North East.
This claim is totally baseless, in a situation where there is no uniform standard in school education. All over India, there are two systems of schooling. One set of schools are run by the Central or state governments. Another set of schools are run by private bodies. There are different Boards of Education running the schools and widely varying curriculum.
A common All India Entrance Exam imposed by the central state on all students from different parts of the country will actually serve to deepen this difference and to ensure that those sections that have had a disadvantage in basic school education (the vast majority in every part of the country), will continue to suffer the same and greater disadvantage in higher education, including medical education.
Imposition of a common exam ignores the wide diversity in language and culture of the peoples of various nations and nationalities within the Indian Union. While the Constitution does not recognise the multi-national character of our country, it has placed education in the concurrent list, to enable state governments to have a say in curriculum, examinations and other matters. The imposition of NEET across all states has violated this right.
Devastation of youth
The number of medical college seats available and the number writing the exam are a telling reflection of the acute shortage of job opportunities for the youth and as well as the shortage of doctors. Of over 11,00,000 students who appeared for NEET in 2017, about 6,00,000 passed the test, of which only about 60,000 will be able to get into a medical college.
Youth spend precious years of their lives preparing for such examinations. Those whose parents can afford it spend large amount of money on coaching classes. Such exams create fierce competition among the youth, who are compelled to pursue one exam after another in the hope of getting admission somewhere. Many repeat this process for 2-3 years in a row. At the end of it, if they do not succeed, they are totally disheartened and at times, even driven to suicide.
Among the 60,000 who do get admitted, more than 50 percent have to pay exorbitant fees to private colleges before they qualify as doctors. Today, medical education is largely privatized and the fees in private colleges are 30-40 times more than in government colleges.
Many of the private medical colleges owned and controlled by big capitalists and ruling class politicians are known to have substandard facilities for education. They have limited faculty and no attached hospitals, in violation of the standards set by the Medical Council of India. All this has gone on with the full connivance of the Central and state governments, as well as the Medical Council of India which is supposed to monitor the quality of medical education in the country.
On the Tamilnadu case
The results of NEET-2017 show that this exam has led to a decline in the number of students admitted to Medical colleges from smaller towns and rural regions of Tamilnadu, while those from Chennai and other big centers has shown a sharp increase. This shows that the NEET examination has discriminated against students from smaller towns and rural areas.
This is only to be expected. NEET exam is based on the CBSE syllabus. Those students who study in CBSE schools, or have the opportunity to go to coaching centers which train them for this examination, will have an advantage over students who study in the government schools and who do not have opportunity to go to coaching centers. In Tamilnadu this year, over 8,93,000 students studied 12th standard in State board education, whereas only 13,000 students have studied the 12th standard under CBSE. Nearly all schools in rural districts are based on the state board syllabus. This examination is particularly discriminatory to the meritorious children of the poor, who have studied hard in difficult conditions to do well in the school leaving examination.
Moreover, doctors who had graduated from government medical colleges in Tamilnadu in previous years (admitted on the basis of their Class 12 state board examination results) have proven themselves to be no less capable than other doctors.
Thus, given the fact that the cost of medical education is much less in government colleges and quality of education in most government medical colleges is far superior to that provided in most private medical colleges, aspiring medical students and their families are naturally desperate to get admission into the government medical colleges. The vast majority of aspiring medical students simply cannot afford the cost of private medical colleges and have to abandon their dreams of becoming doctors.
India’s health system urgently needs more doctors
While lakhs of students are being deprived the chance to become doctors, the availability of doctors is less than half of what the country needs. A parliamentary committee report has pointed out, "The total number of doctors in India is much smaller than the official figure and we may have one doctor per 2,000 population, if not more." (Mail Today, April 29, 2016). The World Health Organisation has put forth a standard of 1 doctor for every 1000 patients. Given that the distribution of doctors in India is extremely skewed in favour of the big cities, the shortage of doctors in semi urban and rural areas, and in the less developed states of the Union, is extremely acute. The shortage is further accentuated by the fact that large numbers of trained doctors immigrate to foreign countries.
The policy of the Indian state towards medical education is not geared towards providing our youth adequate and equal opportunities to fulfill their aspirations of becoming doctors and serving society. It is not geared towards fulfilling the health service needs of our people. It is aimed at creating a health system in which the state progressively abandons its responsibility of ensuring health care to the people through adequate number of public hospitals and primary health institutions, while encouraging growth of private hospitals as a profit making industry. Correspondingly, it is creating a medical education system geared to the needs of this profit making health industry. The Medical Council of India is the institution through which this anti-social and anti-national policy is being implemented.
If medical education has to serve society, then the government must ensure there are enough hospitals in each state, staffed with doctors who are capable of and willing to deal with the problems of the people in the language they understand. There must be more government medical colleges established in each state, to meet the health needs of the people. All medical colleges must be of the highest standard. The doctors who graduate from these institutions must be educated and motivated to serve society. Private medical colleges which are being run for profit must be taken over by the state. The anti-social program of privatization of health care and education, including medical education, must be stopped and reversed.
The agitation against imposition of NEET in Tamilnadu deserves the support of all people who are fighting to establish an education system which provides opportunities to all and a health care system which is in the service of society. It is part of the struggle of our people to ensure that the meritorious sons and daughters of the working class and toiling peasantry are not deprived of the possibility of training to become doctors to serve society.