The time has come for the central government to unshackle the medical education system from the avaricious clutches of the vested interests whose only interest is pocketing billions at the cost of the poor people of our country , writes former IAS officer V.S.Pandey
The Tamil Nadu state government has been opposing NEET i.e. National Eligibility cum Entrance Test (Undergraduate) or NEET exam by passing a bill that bans the medical entrance exam in the state. It demands admission of students based on marks obtained in Class 12 instead of NEET. The TN NEET Bill, which banned the entrance test, was passed on the basis of an Expert Committee Report led by Retired Justice AK Rajan.
The key finding of the AK Rajan Expert committee report on the NEET Medical Exam is that the national level medical entrance exam ignores the ‘diverse societal representation in MBBS and higher medical studies’. It further states that the NEET exam only favours the rich and affluent segments of society while adversely impacting the students from underprivileged and poor sections of the society and denies them the opportunity to receive medical education.
The AK Rajan Expert Committee report very succinctly pointed out that a massive NEET exam coaching industry has emerged due to the centralized entrance exam system. The report noted that in Tamil Nadu itself , more than 400 coaching institutions have come up -only for NEET preparation. This amounts to Rs 5,750 crore of additional burden on students and their parents . The report explicitly stated that more than 95% of students in the state just cannot pay the exorbitant cost of private coaching. Some other major findings of this committee reveal how this exam has created a series of distortions in the system like aspirants who take coaching or are repeaters have a higher success ratio in NEET Exam and in 2020, 99% of aspirants who appeared for NEET took private coaching. The Report also highlighted that of the total appeared candidates, 71% were repeater candidates. The students from State Boards saw a sharp downfall in MBBS Admission post NEET i.e. from 65% to 43.13% while there was a 30% increase of MBBS aspirants from CBSE Board . Further, the participation of English Medium Students in NEET increased from 56.02% to 69.53% and a sharp decrease of 12% was noted in participation of students from Rural Backgrounds. Another significant finding, noted in this report, states that in post NEET scenario 70% of students on finishing their PG course chose to work with private corporate hospitals. Before NEET, over 70% of students passing out of medical colleges chose to work for govt hospitals! The Expert committee also noted that if NEET continues , the health care system of Tamil Nadu will be very badly affected, and may even go back to the pre-Independence era.
All the findings of the expert committee are an eye opener ,to say the least .But the basic problem lies elsewhere . Leaving aside the NEET exam controversy , we need to look at the pathetic condition of our public health care system , which due to decades of neglect, is in complete shambles and the corona crisis a few months back gave ample proof of that . In India, there is one government doctor for every 10,189 people (the World Health Organization (WHO) recommends a ratio of 1:1,000), or a deficit of 600,000 doctors, and the nurse: patient ratio is 1:483, implying a shortage of two million nurses.
Despite these glaring shortages, governments -past and present , have done nothing to ameliorate the situation, for decades. In 2021 , for serving a population of more than 135 crore people , we have less than 85000 MBBS seats on offer . This shortage in medical seats has allowed crores of rupees through donation system to continue . Is it not shocking to know that a medical seat costs a crore of rupees and a post graduate seat nearly two crores in private medical colleges? Why was no action taken to increase the number of medical colleges and MBBS seats for all these decades? Will any one own up the responsibility for the mess that we are in currently?
A similar situation used to prevail in engineering education till the year 2000. The intake in Engineering institutions stood at 1,35,000 in 1998 and the practice of donation, worth several lakhs, was prevalent in admission to engineering colleges also . I had the occasion to serve as Joint Secretary in the then Human Resource Development Ministry and was in charge of engineering education. It was easy to understand that shortages of engineering seats had led to this situation. A series of policy decisions were rapidly taken in the year 2000 to increase the intake and open new engineering colleges, as per requirement . Despite massive resistance from the vested interests and those arguing that increase in seats will lead to lowering of standards, the policy was implemented with all remedial measures to ensure good quality of education .The intake in engineering colleges was increased to 3,80,000 by the year 2003.
In the field of Information technology , where we had started tasting success in 1998 and 1999, there was a heavy demand to provide additional technically trained manpower. We responded by adding nearly seventy thousand seats in the year 2000 itself. Today our country has more than 15 lakh seats available for our children, who aspire to acquire a B.Tech or B.E degree. Due to that policy decision ,taken nearly twenty years ago, today every child born in our country can aspire to become an engineer without being extorted through donation, a uniform examination system , abundant free , top quality web based course material generated by proficient teachers from our best institutions through the National Programme for Technology Enhanced Learning , NPTEL , established and fully funded by the HRD Ministry in the year 2002 . Consequently , there is no shortage of engineering seats. Consequently, there is almost no quota war in engineering education.
Can’t we learn from our own experience? The time has come for the central government to unshackle the medical education system from the avaricious clutches of the vested interests whose only interest is pocketing billions at the cost of the poor people of our country .The foremost criticality required to improve our public health care system is to first remove the massive shortage of MBBS and PG seats. It can be done with one stroke of the pen. Is anybody listening?
(Vijay Shankar Pandey is former Secretary Government of India)