Why Is NEET So Hard To Tidy Up?

The National Eligibility cum Entrance Test (NEET) for admission to under-graduate (UG) medical education has become national headlines for wrong reasons.

The arrest of  NTA agency partners in Gujarat has once again exposed the dark underbelly of medical admissions. This is not the first time when such malpractices have been reported.

Previously in 2019 and 2020, Tamil Nadu reported unravelling of a major scam where ghost candidates were hired to impersonate aspiring doctors.

Roughly 23.33 lakh aspirants take the NEET exam to compete for 109,000 medical seats spread across 706 medical colleges.

The exam is not conducted by Central Board of Secondary Education (CBSE) or some government body, but by a designated quasi-governmental agency called the National Testing Agency (NTA) which relies on several outsourced partners and players.

What Is The Core Issue?

Many social activists and politicians complain about excess dependence on coaching classes and/or malpractices in the NEET-based admission process. What they fail to grapple with is that these are not a feature of the NEET exam, but are a characteristic of medical admissions in India.

When the competition intensity is so high (ratio of 23:1) and medical degree is being viewed as a ticket to high socio-economic standing, wouldn’t candidates do everything possible to claim every bit of fair and unfair competitive advantage? 

Hence, whether the states use Class XII marks (like Tamil Nadu did), or conduct their own CET/EAMCET (like Karnataka and Andhra did), or have a single national exam such as NEET, coaching and malpractices are here to stay.

The core reason is the huge mismatch between supply and demand of medical seats. The only way to curb this menace (complete elimination is impossible) is to increase the capacity multiple times. And that is exactly what the Narendra Modi government has done over the past 10 years by doubling the UG medical education seats from 51,000 to 109,000.

This is still not enough and we perhaps have a long way to go. The map of engineering education in this country has shown how capacity augmentation (especially with private sector involvement) can significantly reduce this problem by bridging the supply-demand mismatch.

Why Do Students Resort To Unfair Competition/Malpractices? 

NTA has put several rules and regulations in place to prevent malpractices such as copying and seeking outside help during the exam. However, the kind of malpractices discovered in recent times reveal a sophistication no less than organised crimes.

Clearly only the ultra-rich candidates can afford to spend so much to indulge in these sophisticated malpractices. These ultra-rich kids (typically children of doctors or hospital owners) are not so much interested in bagging the coveted merit seats (which have subsidised fees in government colleges), but are primarily behind the management quota/NRI quota seats.

Even though these seats cost a bomb in terms of tuition and hostel fees, there is sufficient demand for the same. But the problem is Medical Council of India (MCI) has imposed a bizarre rule that one has to have a NEET rank (colloquially referred as cleared NEET) to seek admissions under management or NRI quota.

NEET rank is awarded typically to only the top 50 percentile of the test takers. So even the ultra-rich kids find it very hard to get a NEET rank. Do you see where the problem lies now? All the media noise about NEET, especially in states with huge private medical education capacity such as Tamil Nadu, comes from this vocal lobby which is handicapped by this rule.

To be in the top 50 percentile is a rat-race and the ultra-rich candidates would do anything possible to get there; including adoption of malpractices. But the problem gets compounded.

Given they have to risk everything to qualify NEET exam, would they just settle for that? The answer is ‘no’. When they can go for the stars, why would they settle for the moon?

They typically go all out to bag the coveted merit college seats also. And that is when they start to get noticed and complaints from their classmates start to flow in social media.

Some people who ask how can we not have a minimum eligibility criterion for entry to medical education, especially when it involves dealing with lives of people?

That is correct, but that criteria can be some cut-off on the Class XII board marks or an absolute marker (such as 30 per cent marks in NEET). By deliberately setting a relative marker (50 percentile score) that keeps going up and up every year, we have invited this problem into our boardroom by design.

Some people ask why should management/NRI quotas be there in the first place?

Harvard gave a beautiful explanation that the biggest votaries for management seats are the merit students in their classrooms.

This is because merit students (many coming from humble backgrounds) seek access to wealthy networks and angel investors to realise their dreams. Who better than their fellow classmates, who know their strengths and weaknesses, be willing to place a bet on their innovative technical/business ideas?

Hence it is very important to carefully seed a healthy mix of meritorious students and management/NRI quota students in a classroom to create a symbiotic economic ecosystem and a vibrant society.

Way Forward — What Can We Do?

Given that management/NRI quota seats are here to stay and their demand is unlikely to vanish, it makes sense to remove the existing rule of NEET rank being mandatory to seek admissions under these quotas.

This can be replaced with some other minimum threshold rule such as Class XII board marks or absolute marks within NEET. Once this is done, NEET will essentially become a competition for the merit seats and much of the sophisticated malpractices we today see will simply go away.

Furthermore, all the noise you hear from the most vocal lobby of private medical colleges in states such as Tamil Nadu will also fade away too. 

How should we go about conducting NEET for merit students then? Let us not forget that all we seek is a fair sorting order for allocating students to seats. NEET was conceived as a single national level exam to reduce the workload for students from taking multiple entrance exams.

Although the intent is puritan, it actually hurts students more than helping them. This is the same leftist philosophy that treats students as snowflakes. The problem is any student can have a bad day on the day of NEET.

Now a single exam model can risk wastage of one whole year for the student. Contrast this with the scenario in engineering admissions. There is a national level entrance exam (JEE Mains) and there are other options such as state level exams (CET, EAMCET, etc), and some deemed universities conduct their own exams (VIT, SRM, Amrita, etc).

This diversifies the risk for the student as he/she can prove his/her capability in one or more of these exams, without losing a whole year.

Furthermore, for a country that is as diverse as ours where all education (both at school level and UG level) is not in the same standard, having such a federated model allows both students and colleges to find a match for their capabilities and interests. 

World over whether it is SAT score (for US UG admissions), or CAT score (for Indian MBA admissions), these are not the sole criteria for admissions, but are usually blended with several other selection criterion by individual educational institutions (who enjoy autonomy) to select from their applicant pool.

Providing such a flexibility for both colleges and students to find their match is something the architects of NEP would love to see as the way forward.

Even if abolishing the sole and mandatory nature of NEET is not on the table for the government, there are more pressing reforms they can immediately pursue. They should move away from the current pen and paper model which is prone to paper leaks and malpractices, and replace it with a computer-aided adaptive testing process followed by exams such as GRE and GMAT.

NTA should set-up permanent infrastructure (with less reliance on outsourced players) in every district for taking these exams.

Students should be able to take the computer NEET exam, any time during the year, and any number of times during the year by prior appointment, just like the way it is done for GRE and GMAT exams. This will not only reduce stress for students and also de-risk them from the perils of a single exam.

Furthermore, running a fixed number of slots in a centre and conducting it right through the year is easier for NTA to manage, than the nightmare logistics of conducting a national level exam on a single day for 23 lakh students. Tidying up NEET is not that hard and hope the powers to be are listening.