Passages or barriers?

More than a hundred aspirants of NEET-UG are reported to have committed suicide between 2014 and 2023, including six in the last month, in Kota, the coaching hub of India. Many more such heart-rending incidents have frequently been in the news across the country. The tragic phenomena are ascribed to factors like cut-throat competition, pressure to excel one-self, lack of emotional support, parents' pressure, uncertainty of future, etc. The entrance tests such as NEET, JEE, and GATE are so hyper-competitive that it takes a grueling 10-12 hours of study a day, apart from laborious test series, and continuous drilling and skilling in coaching institutes. The narrative is one of Herbert Spencer’s, ‘survival of the fittest', replacing the joy of learning with the fear of failure. Today, the coaching industry in the country is striking pay dirt with an estimated net worth of Rs 1.25 lakh crore.

Though India has the highest number of medical colleges in the world (around 900), the number of seats offered are less than 92,000, whereas China, with less than 500 colleges, offers more than 2.8 lakh seats. The demand-supply gap is the obvious reason for the tough entrance exam which, in spirit, is more of elimination than selection. In NEET-UG 2023, 20,38,596 students appeared for a total of 91,927 MBBS seats in 612 colleges, and 26,773 BDS seats in 313 colleges; the final success rate was only about 7-8 per cent. Similarly, while 5-10 lakh candidates sit for GATE every year, only about 15 per cent of them qualify. In professional courses, unlike in humanities, failure to crack the entrance exam means the end of the road. It leads to frustration and emotional distress in young aspirants who are not conditioned to cope up at such a tender age. The spate of suicides in last few years, perhaps points to a much deeper malaise in the schema of admissions.

In all fairness, NEET-UG happened to be the best system of screening because it saved the trouble of a multitude of entrance exams conducted by states and other independent institutions before 2012. It also plugged the loopholes of corruption and fraudulent practices that were rampant earlier. Most importantly, NEET paved the way for national integration, as opposed to narrow regionalism. However, some pertinent issues pose challenges to equality, equity, and inclusiveness, which are the main pillars of the education system. Firstly, the entrance test is largely biased in favour of CBSE schools and NCERT's pedagogic content, whereas the vast majority of aspirants hail from state boards with vernacular mediums of instruction. Secondly, the rigors of exams necessitate expensive coaching facilities, putting aspirants from low-income groups at a disadvantage. The coaching fee is between Rs 1-2 lakh per aspirant, and according to a survey (https://www.careers360.com), over 80 per cent of successful candidates receive coaching. This issue of affordability makes the test classist in spirit and sharpens the existing inequalities in society. Thirdly, unlike in Europe and the West, academic performance up to class 12 is practically of no consequence in the selection process. Only the NEET ranking is ultimate and decisive, ignoring the possibility that a bright student throughout their academic journey may fail in the entrance test, while conversely, an average student with the best coaching may succeed.

The criteria in the Western world are more inclusive, focusing on selection rather than elimination. There is neither a roaring coaching industry nor a string of suicides out there. The University Clinical Aptitude Test (UCAT) followed by a consortium of universities in the United Kingdom, Singapore, Australia, and New Zealand for medical and dental degree programmes is only a test of aptitude and attitude, not of academic achievement, which candidates already acquire through the A-Level, the school leaving qualification in the entire UK. UCAT assesses behavioural attributes and mental abilities such as critical thinking, logical reasoning, and inference. Besides, UCAT is only a part of a well-rounded admission policy designed to probe innate skills in an aspirant. The UCAT consortium also provides free study materials to aspirants for preparation. The International Medical Admission Test (IMAT) in Italy is also a test of aptitude. It has 20 questions on logical reasoning and general knowledge and 40 on the candidate's ability to apply scientific knowledge from school science. Most importantly, if two candidates score equally, then their respective scores in logical reasoning and general knowledge will serve as the tiebreaker.

The Medical College Admission Test (MCAT) in the US, Australia, and Canada is a medical ability test offered by the Association of American Medical Colleges (AAMC), with a reported chance of success at around 50 per cent, compared to 5-7 per cent for NEET. According to Geoffrey Young, Senior Director at AAMC, the admission policy has helped increase historically underrepresented groups because it believes that greater diversity among physicians builds trust and enhances the physician-patient relationship. Enrolment of Black or African Americans increased by 14 per cent, Hispanic, Latino, or individuals of Spanish origin increased by 7.3 per cent, and Asian applicants by 13.3 per cent. Interestingly, the majority in all groups were women candidates, accounting for 56 per cent.

Admission criteria need to be inclusive in nature, providing equitable opportunities to all. It should resemble a marathon more than a hundred-meter race, allowing aspirants from diverse backgrounds enough space to perform at their best in an atmosphere of fairness and freedom. As long as 'win-lose' entrance tests continue to be the sole decisive factor for admissions, increasing the number of seats or regulating the coaching business will provide limited benefits. A philosophical question arises: is it really necessary for innocent adolescent aspirants to endure years of self-mortifying, emotionally destabilizing cramming and rote learning in coaching centres to become dedicated doctors like Kotnis, visionary engineers like Visvesvaraya, or cosmologists like Stephen Hawking? I believe not, for there are less painful ways (we are not talking about management quotas).

Merit is nothing but an opportunity which, again, is a combination of access, equality and inclusion. Selection of candidates solely on the basis of one grand but nightmarish entrance test is only to disregard years of hard-earned academic achievements in school, and to ignore the natural mental abilities and critical thinking in the aspirants. The system needs to be more scientific and rational. A holistic approach to admissions with a system of comprehensive evaluation according equal importance to school performance, aptitude, reasoning skills, and behavioural attitudes will create a level playing field whereby the candidates feel emotionally secure and mentally confident. In other words, the entrance tests should be only a part and not the whole. That said, the present NEET or similar other national entrance tests should continue, since they have more merits than demerits. Nevertheless a revisiting of the admission criteria and remodelling of NEET may be necessary.

The writer is a former Addl. Chief Secretary of Chhattisgarh. Views expressed are personal