“A hero is someone who has given his or her life to something bigger than oneself.”
– JOSEPH CAMPBELL
Medicine is a profession that needs such ‘heroes’ without capes, who can dedicate their life to the service of patients; sometimes at the cost of their own physical and mental health, family time and personal desires. But how does a nation best enable the aspirants to enter the coveted medical training, with a fair, equitable evaluation?
In the last few years, a student’s score in the nationwide NEET entrance exam has been used as the admission criteria to all government and private institutions in all states of the country. Earlier along with a pan India entrance exam; every state used to also conduct separate entrance exams for admission into the government institutes that fell within their borders. Additionally, private institutions too, would have their own separate exams. The previous system caused immense stress to students, as they had to both prepare and sit for multiple exams within a span of 2 months. Often the format of these exams differed from each other with respect to parameters such as negative marking, syllabus included etc. adding to the difficulty of students. This system also caused a large financial burden on students and parents; as they not only paid separate application fees for every exam but also travelled to far off locations to appear for them.
Financial burden on medical students
Thus, the concept of having a pan India exam like NEET has helped students immensely in respect to the aspects mentioned above.
On the other hand, NEET demands a CBSE format syllabus. Majority of the students taking up ‘10+2’ high school training (prerequisite for entrance) does so in different ‘state’ board formats—formats that are accessible to majority of Indian students and differ from CBSE in syllabi.
Medical students giving exams
For these students, the preparation and resources required for understanding, assimilating and applying the concepts to crack the NEET prove to be costly. Majority of these ‘state-board’ students come from an economic stratum that does not pay income tax. This non income tax paying stratum constitutes 93.6% (Jan 2022 stats) of Indian population. Students belonging to this stratum are from villages and small towns, where training and access to resources required for CBSE based NEET are scarce. Those in cities may not afford the costly coaching classes and resources required. Thus, even before the entrance exam an economic and logistic gap gets created. A fair entrance evaluation should also focus on equitable and fair access to resources required to prepare for the entrance, apart from performance in the entrance itself.
A centralized pan India entrance exam means that students only have a single opportunity in a space of a few hours to prove their mettle. Even the most intelligent, sincere and well-prepared student can falter on a particular day.
More importantly, can marks in a multiple-choice exam be the single most important criteria for admitting doctors to the MBBS course? Is the ability to read and retain large volumes of information, the only quality needed in our future doctors? I think not!
The capability and social temperament of a student evolves from practical training received during the medical study and not necessarily with an entrance test. An entrance exam like NEET at best evaluates basic concepts and analytical reasoning required to pursue the technical knowledge in any medicine study.
It does not identify qualities such as:
- Passion for the profession
- Establish clear communication with colleagues and his patients
- Work in a team
- Empathy for patients and ability to advocate for them
Can these characteristics be tested in a simple knowledge-based exam? No, they can’t!
A survey conducted in India in 2020 suggested that nearly 43 percent of MBBS students in India wanted to opt out of the course mid-way. While there can be multiple reasons for the same, from my personal experience and those of my peers, most aspiring medical aspirants who come from a non-medico family background are unaware of the ground realities of the profession. They often lack prior knowledge of the time, work and financial commitments needed to succeed in this profession and often experience anxiety, when they realize the long journey that lies ahead.
Looking Ahead…
In 2021, 14,10,755 students appeared in NEET UG 2021 exam and among these 7,97,042 candidates have qualified. Considering the large number of students interested in applying for medical courses, is it really possible to abandon the system of a pan India entrance exam like NEET? Well in the United States of America in 2020-2021, 896,819 applications were filed by 53,371 prospective students, each applying to an average of 17 medical schools.
In India, if every student applied individually to different medical schools across the country, the applications would be exponentially more than those mentioned in the USA. But perhaps we could take pointers from their system.
- Starting, with ensuring a single board and syllabus for all students across the country at the secondary and higher secondary level.
- Instead of conducting the entrance exam only on a yearly basis, bi-annual entrance examinations can be conducted so that students need not drop an entire year, in case they fail.
Along with that, the admission process to medical colleges can be centralized yet multi-tiered. While the student’s scores in the pan India entrance exam NEET can act as one of the admission criteria, other qualifying criteria could include:
- Assessment of student’s participation in extracurricular activities
- Student’s performance in orientation courses that equip students to make an informed choice about choosing the medical profession
While these steps may need additional manpower, if they are incorporated into the admission process, it will allow both examiners and students to gauge their preparedness to enter the medical stream.
Ultimately, an admission process like NEET is simply concentrated on weeding out students; while a more holistic process may actually help them identify their passion!
For your career shouldn’t be just your profession, it must be your vocation!
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