What does the National Eligibility cum Entrance Test (NEET) mean to the 23.8 lakh students aspiring to become doctors? “Blood, sweat, tears, repeat” — this is how a second year MBBS student described her years of preparation for the NEET, while studying in classes 11th and 12th. At least a year before that is consumed by anxiety, decision-making, determination and planning for the preparation. And, all this does not include the financial aspect, which amounts to lakhs and sometimes even crores.
Shalmali (name changed) is a second-year MBBS student in the Government Medical College in Dhule. She recounts the long nights and days spent either studying for NEET, thinking about NEET or recovering from the stress of NEET. “For two years our social life came to a naught. I studied for 12 to 13 hours every day for two years. I did not attend any festivities or go for outings. We put our heart and soul into it. For two years, it is just blood, sweat and tears. Again and again. And this is what everyone does. This is what our future depends on. Doesn’t the NTA understand that?”
She is referring to recent developments after the NEET results were hastily declared on June 4th, the same day as results of Lok Sabha Elections. Since then, every other day a new facet of mismanagement of the exams and results has been making news. As if the incredibly unlikely event of 67 students getting a perfect score of 720/720 was not suspicious enough, what has unravelled is even more disturbing.
NEET 2024: Mismanagement at many levels
This year’s NEET exam has been mired in controversies spanning various issues. Initially, allegations arose that students were not given the stipulated time to complete their exams, prompting some to approach the courts. Subsequently, the National Testing Agency granted these students grace marks.
This was challenged in the Supreme Court and the decision was withdrawn. Now, the 1,563 students have the option of a re-exam on June 23rd or moving on with retracted (without grace) marks. Among other things, when grace marks were reduced, the number of toppers fell from 67 to 61. One of the vocal opponents of the grace marks move is Alakh Pandey, who runs the popular ed-tech platform, Physicswallah.
Second, students have been protesting inflation in ranks. Once the marks are declared, NTA releases rankings that decide whether a student will get into a government medical college. This year, there is considerable inflation in ranking.
For instance, if a student scores 650 and secures a rank of 5000, the following year, the same score might only fetch a rank of around 7000. The significant increase in the number of students scoring well this time has led to thousands more students achieving similar marks — this is being called suspicious inflation. This may have happened because of lapses in correction or setting an easier paper.
Third, and perhaps most damning of all, is the allegation of paper leak in various cities. The Supreme Court is hearing several petitions, many of them urging for a re-exam. The matter is posted for July 8th. However, the court has not stayed the process of admissions and counselling for the same will start on July 6th.
Last week, the Supreme Court remarked that the sanctity of the exam had been affected. On June 19th, the apex court asked for an explanation from the government and the NTA, saying that even a 0.1 chance of lapse must be addressed.
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Impact of inflated NEET results on students and parents
Priya, a single mother, has been busy trying to find counsellors to help their son figure out applications for colleges. Her son got a score of 609, which would have been sufficient for a medical seat until last year. But not this time. “It is not easy to plan for admissions. With these marks my son would have secured admission in a government medical college in Bengaluru or Mysore but now we don’t know. He also appeared for other entrance exams and may end up studying engineering instead of medicine,” she says.
Despite best efforts to provide the atmosphere, coaching and support, parents like Priya are feeling helpless and are worried about the impact on children’s mental health.
Shalmali empathises with students who appear for NEET more than once; it gets challenging for their mental health. “It is not easy to prepare for and attempt this exam several times. Imagine the condition of a student now, who has tried in the past and has got the marks this time but the rank is poor. Not everyone can afford private medical colleges, as the course fee runs runs into lakhs. Having this kind of inflated results is playing with the future of the students.”
Another parent was distraught over getting 607 marks as the ranking had fallen beyond available seats in government colleges. “Who can tell if a drop year is a wise thing to do? There is no guarantee. It is not easy to see your peers move ahead as you wait and prepare one more time,” she said.
Shalmali also brought up the issue of getting less time when she appeared for NEET. “When we had appeared, we faced the same problem. We lost almost 15 minutes, which is a big thing. But we didn’t get extra marks nor did we approach the courts. This must be happening in many places. What bothers me is having to fill out several sheets during exam time. It is distracting but we have to do it.”
NEET’s increasing competition and mounting pressure
In the past three years the number of applicants has gone from 18,72,343 in 2022 to 20,87,449 in 2023 and 23,81,833 in 2024. Last year, a total of 11.45 lakh students qualified.
Compare that to the availability of seats. Despite the seats getting doubled in the past few years, the total number stands at 1,07,950 including private and government medical colleges. The government has added as many as 157 colleges since 2014 and the seats have more than doubled. This indicates that barely 10 to 12% of the successful candidates get a medical seat.
Not only do we need more seats, but we also need more doctors. Although India has a national ratio of 0.9 doctors per 1000, which is comparable to the ratio suggested by the World Health Organisation of 1:1000, it is far from being evenly distributed.
An Indiaspend article on the state of medical colleges based on a study by Center for Social Economic Progress (CSEP), a Delhi-based think-tank, says, “At 0.92 doctors per 1,000 population, the number of MBBS doctor supply is close to the World Health Organization guideline of 1 doctor per 1,000 people, as per the National Health Profile 2021. This ratio varies significantly across states. Goa has the highest doctor-population ratio at 2.53 doctors per 1,000 people, followed by Sikkim at 2.13. Karnataka and Tamil Nadu had ratios of 1.92 and 1.91, respectively. In contrast, states such as Bihar and Uttar Pradesh had lower ratios of 0.38 and 0.37, respectively.”
The numbers of seats reduce further for PG courses. Therefore, availability of PG doctors shrinks too. However, it is not easy to set up medical colleges. The same study also talks about lack of infrastructure, inadequate number of faculty and so on at private medical colleges.
While more seats are needed and perhaps being planned for, in reality barely 5 to 7% of the applicants are likely to get a medical seat.
This basic maths of ratio of seats and candidates, which is drilled by coaching institutes, as they get the applicants to practise for the ultimate competition, plays on a student’s mind on a daily basis. So, when a single mark has the potential to make or break your career, students and parents are asking how the NTA could be so lax as to allow so many lapses.
Systemic issues in NEET exams
Dr. Medhinee Kulkarni, who teaches at a medical college, is livid with the way things have unfolded. She says by allotting grace marks, the NTA has messed up. “NEET is an entrance exam. Unlike a certification exam such as the 10th or 12th, the principle behind an entrance test is exclusion. You want to select students for the course, which is highly competitive. The quality of the paper and marking is such that only a fraction would get through. I wonder if those sitting in the ivory towers are aware of what is happening on the ground because of the way this has been managed.”
A principal of a PU college spoke about the practice of integrated coaching and how coaching classes have made cracking this exam into a money-making business. “They make the students write this paper several times. More students are qualifying but what are they learning and how are they learning? Now, a student feels compelled to join that system.”
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When Citizen Matters spoke to a few parents, they said that the coaching fees runs into a few lakhs and if a student decides to repeat they get a small discount. Overall, the coaching for NEET could easily cost anywhere between Rs 1 to 5 lakh per year for two years.
Balaji Sampath, educationist, also pointed to two trends that are particularly affecting students and adding to the cut-throat competition. He says, “This is the only entrance exam that allows as many repeat attempts as you like, without any age bar. This adds more and more applicants every year and competition increases. Secondly, students who just qualify with 100 odd marks get through management quotas. This further reduces the seats that are available for other applicants.”
In addition, counsellors and teachers have flagged the way NTA has conducted itself, which has created mistrust in the integrity of testing agencies. Alakh Pandey has urged the NTA officials to come forward and have an open dialogue with students to pacify and help them.
Future of NEET and that of students
The chances of a re-exam, given the fact that the Supreme Court has not stayed the admissions, are slim. So in the next few weeks, more than 10 to 12 lakh successful candidates will be trying for around 50,000 government college seats and approximately the same number of seats in private colleges.
Teachers say that many of these students might take a drop year and attempt next year, thinking that other issues of paper leak, grace marks, insufficient time and so on, won’t happen next time and they will be able to secure better rank. If the past numbers are anything to go by, the number of applications for NEET could easily cross 25 lakh next year.
Psychologists and educationists have flagged this repeatedly, as it might add immense pressure on students next year as well.
But for now, parents and students are glued to the news alerts and watching the Supreme Court developments and admission notices. The journey of blood, sweat, tears and repeat is far from over.