Why the side effects of NEET are much more damaging than the disease it claims to cure

The common entrance exam may spell doom for the majority of medical aspirants and state boards.

The Supreme Court of India has revived the spectre of a common entrance examination for all medical colleges. Ostensibly, the National Eligibility Entrance Test is aimed at creating a level playing field. However, many fear that the effect will be exactly the opposite, as demonstrated by widespread protests, rail-rokos and even clashes with police across many non-Hindi states including Assam, Karnataka, Maharashtra, Kerala, West Bengal, Tamil Nadu, Andhra Pradesh, Jammu and Kashmir, among others. There has been vehement opposition from students, doctors (especially rural doctors associations and state units of the Indian Medical Association), parents, non-commercial educationists, political parties and even social justice organisations. The governments of non-Hindi states have also opposed the move.

The overarching fear is that NEET will provide a huge advantage to students of Delhi-headquartered boards such as the Central Board of Secondary Education. Students from these boards also tend to be more urban, upper caste, rich and less likely to be from non-Hindi states, apart from the principal language of non-Hindi states not being their first language.

In short, they will be unrepresentative in a way that will deepen already existing inequities which exist along various axes of class, caste, language, location and rootedness, among others. In addition, many fear that the common medical entrance exam will destroy prestigious state boards as we know them.

Debunking myths

While the NEET judgement was in response to admission-related corruption in private institutions, other reasons have also been offered in its support. There is a belief in some quarters that a common exam will provide relief to students appearing for multiple entrance tests and that supervision by the Medical Council of India and CBSE will curtail corruption in admission tests. And then there is the purported desirability of a common syllabus, which will ensure that physicians of similar pedigree are produced all around (this a ridiculous idea, since medical entrance exams do not make doctors, rather it's the MBBS exams after admission that do).

However, these arguments, do not hold water.

Firstly, most major states were already conducting their own medical entrance exam. Private medical colleges are not located in the air, but on the soil of these states. A simple solution would have been to admit students on the basis of the already-existing state medical entrance exam. States such as West Bengal, among others, have been conducting transparent medical entrance exams for nearly four decades. It is beyond comprehension why corruption in some places was used as an excuse to change admission policies everywhere.

Capitation fee corruption involving the management quota of private institutions is a headache only for people who can pay in tens of lakhs and even crores – in short, not even 5% of the students who take medical entrance exams. It is a problem of the upper middle class and the super-rich, which obscenely fancies itself as the “common man”.

Numbers tell a story

As for relief to students who take multiple exams, a reality check is in order. Who exactly are these students and what percentage do they comprise of all medical entrance test takers across all states? It is astonishing that no such data has ever been presented – likely because anecdotal experiences suggest that this is a very small proportion of students.

Let us take some statistics into consideration. Across multiple All India Institutes of Medical Science, the common entrance test attracted about one lakh students last year. This figure is under 10% of the medical college admission seekers across all states. In Maharashtra alone, about four lakh students took the Common Entrance Test exam this year. And when we compare the number of all Class 12 science students across all states, irrespective of entrance-takers, the percentage becomes negligible.

Even among that small minority, CBSE-like central board students are hugely over-represented in this multiple entrance test-taking class. The fact that the NEET judgement might imply science syllabus changes across many boards tells us how the stupendous majority is being victimised and marginalised for the convenience of a tiny minority.

Quality queries

Among the major characteristics of this minority mentioned earlier, what stands out is the board – CBSE.

It is the CBSE syllabus that will be followed for NEET. Is this the largest board in the Indian Union? No. The Maharashtra state board alone has more Class 12 students than the all-India strength of the CBSE. If that statistic comes as a surprise, we need to seriously question our sense of standard and get out of our metro-centric, Anglo-Hindi bubbles.

Is CBSE the “best” board in some academic sense? Hardly so. Are Class 12 students studying science in the CBSE syllabus uniquely equipped with an understanding that is unparalleled by the state boards? Or in other words, if the state boards are being forced to emulate the CBSE (in the name of aligning syllabi), is it something worth emulating?

Following rigorous research (published in Current Science, 2009) that reviewed the comparative performance of students from different boards, Anil Kumar and Dibakar Chatterjee of the Indian Institute of Science showed that when it comes to science proficiency, CBSE is not numero uno.

West Bengal board students did better than CBSE students in all four science subjects – physics, chemistry, biology and mathematics. Andhra Pradesh does better than CBSE in mathematics and physics. By the same metric, Maharashtra is hardly the worst performing state, as it was in the NEET that was held in 2013 before it was scrapped.

Tellingly, neither West Bengal nor Andhra Pradesh were top performing states in NEET. Independent, non-CBSE excellence has thus become an albatross around their neck. The CBSE syllabus “pattern” has become the standard, even though research shows it isn’t the best.

Clear hierarchy

On corruption and the Medical Council of India, the less said the better. Its former chief Ketan Desai was charged with accepting a bribe for granting affiliation to a private medical college. Last year, the CBSE-organised All India Pre-Medical Test was cancelled because of widespread cheating.

When a body such as the Ketan Desai-tainted MCI approaches the Supreme Court to fight corruption, and the Supreme Court employs the cheating scam-tainted CBSE to ensure a fair and free examination, we have to understand the deeper games being played.

CBSE schools are naturally very excited about NEET as it hands their students a huge and undeserved competitive advantage over the stupendous majority. After the NEET judgement, we are sure to see a mushrooming of CBSE schools everywhere and an exodus from state boards of the class who can pay for such private CBSE schools.

There is already a surge in the business of CBSE syllabus-based coaching institutes – all of this is big and often corrupt business, but that doesn’t seem to matter.

Therein lies the danger, where the Supreme Court ruling is already creating a caste system between boards and forcing everyone else to align with the Centre, which isn’t necessarily the best as described earlier.

Reducing importance

Framed from Delhi, after “consultation”, the CBSE-based NEET syllabus favours those who have undergone their schooling and training in the CBSE/Indian School Certificate framework, the syllabus being a vital component of that framework.

State boards with syllabi that differ considerably from the CBSE are at an unfair disadvantage – they have to change or perish, for absolutely no fault of their own.

The viability or “worth” of a board of education’s science syllabus then is not in how well it teaches the subject to the students but incredibly, by how well it has adapted (or not) the basic framework of a Delhi-based board's syllabus. This will reduce the importance of the Class 12 exam, and we will increasingly see coaching institutes operating under the legal shell of a school.

The schools affiliated to the state boards will rapidly become low-grade holding pens for the rural and the poor, while the urban middle class will detach itself from them – taking educational apartheid to another level. By completely disregarding the percentile obtained in Class 12 board exams, multiple choice question-solving is privileged over detailed concept development, something boards such as the ones in West Bengal and Tamil Nadu have been historically proud of and is evident in the over-representation of these boards among faculty members of science institutions, where the CBSE “advantage” evaporates. We cannot even fathom the damage that this development will do to science education.

Explicit bias

This Delhi-headquartered board and Anglo-Hindi bias in so-called “all India” medical entrances is not new. Central board students (comprising less than 10% of Class 12 students) have till now enjoyed a de-facto 15% reservation in all medical colleges, as the syllabus of the AIPMT exam (held in Hindi and English only, though no MBBS courses are taught in Hindi) through which these seats were filled, was modeled on the CBSE syllabus and conducted by the CBSE.

So much so, that in West Bengal, students coming through this “all-India” were from Hindi belt central board schools almost to the last man and in West Bengal were referred to simply as "CBSEs" or "Delhi boards".

Such a naked violation of the principle of natural justice and fairness went unchallenged as the positive beneficiaries of this provision constituted the unofficial first-class citizens of the Indian Union – typically well-to-do, urban, largely upper-caste Hindu males from Hindi-speaking areas studying in Delhi-headquartered school boards.

Since Hindi areas have much fewer medical colleges per capita, the AIPMT is a system to lodge North Indian students in South and East India in disproportionately high numbers, under the innocuous dissent-stopping fig leaf of "all-India".

The NEET seeks to create a hugely expanded version of this unjust dominance over all seats of all medical colleges in the Indian Union. Given the explicit bias, it is pertinent to ask to which board do the grandsons and granddaughters of the Supreme Court judges belong?

To which board do the sons and daughters of the lawyers defending the NEET, the functionaries of CBSE and the MCI head office, belong? Does this class more closely match the social profile of people studying in central boards or state boards? What is the definition of conflict of interest in such cases?

The Supreme Court ruling of holding a test under CBSE syllabus thus violates the fundamental legal principle of fairness. A state board student in a non-Hindi state will have to compete against a CBSE student who has studied for 12 years of incremental science syllabus learning. For example, in Tamil Nadu, the biology syllabus is about 70% different from that of the CBSE. Can a state be forced to change its board syllabus to align with central syllabus or otherwise risk playing in an unfair non-level playing field? It makes a mockery of the federal structure of the Constitution of India.

This is the first in a two-part series on NEET. The second part can be read here.

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