The National Eligibility Entrance Test as a common medical entrance exam is biased against students who have studied in mediums where the mother tongue is not Hindi, students who have studied in state boards, and students who are poor and from a rural background.

This bias in favour of urban, rich, Anglo-Hindi students in the form of the Central Board of Secondary Education syllabus affects not only aspiring doctors, but also the healthcare system. In addition, this centralisation of power and influence in the hands of Delhi in matters of education is an ominous sign for our pluralist democracy as a whole.

Let’s remind ourselves about the purpose of medical entrance exams, and by extension, medical colleges. They are not for providing successful Class 12 science students with a prize in the form of a lucrative career. They are also not for nourishing holy cows such as “national integration”, filling medical college seats with the most “meritorious” (with all the dubious assumptions associated with that term) or worsen the already skewed urban-rural divide in the density of doctors.

At a very basic level, the purpose is to produce trained health workers who would provide healthcare to the masses and/or advance the understanding of human biology and diseases by research. The particular biases of NEET pose a grave challenge to these objectives.

Rural fallout

Doctor density is very low in India, and abysmally lower in rural areas. By handing an entrance exam advantage and hence medical college seats to students of a board who tend to be more urban with an ethno-linguistic bias, the health of millions is being jeopardised.

Experience from non-Hindi states show that students who hail from rural areas and studied in their mother tongue are over-represented in the rural public health system. Moreover, in the communicative art that is medical practice at the grassroots, those who are separated by language, culture, and class from the masses are less likely to get to the heart of the complex social context of disease in South Asia, and therefore would be sub-standard caregivers for the grassroots.

NEET plans to not only destroy the dream of poor, rural, non-Hindi mother tongue medium students (that is, a plurality of all students) of becoming a doctor , but also wants to create a cadre of doctors who want urban and foreign careers, with lesser ties to soil and the realities of rural areas, which is where the majority live.

Most states already find it hard to get qualified doctors for rural postings. An urban rich bias will destroy the system irreparably. The only beneficiaries of this regressive move will be private nursing homes, big healthcare chains and of course, the US. Medical colleges of the Indian Union will serve as supply factories for these entities, to an even greater extent than at present.

Cutting the cord

The anxiety of many parents and students about the imposition of NEET is apparent, as is the planned solution. Many say that had they known earlier, they would have put their children in CBSE schools. This is exactly what the central governments have always wanted – an opportunity to catch more students whose lives can be affected by their periodic ideology-driven syllabus changing fiats via the National Council of Educational Research and Training and the CBSE.

The central government has always believed that deracination and diversity – destruction of the various ethno-linguistic nationalities of the Indian Union through top-down manipulation and usage of various carrots and sticks – is a path to a homogeneous Indian-ness.

It is not accidental that Bollywood, cricket and other aspects of the Anglo-Hindi culture sphere created by post-liberalisation corporate interests (including urban corporate healthcare giants) have exactly this deracinated “ideal Indian” consumer in mind.

State board students have no clue about the immensity of the forces stacked up against them. NEET paves the way for that great unstated New Delhi dream – the effective destruction of state boards and hence the destruction of all the possible wellsprings of autonomous ideological streams that give precedence to sentiments, realisations and consciousnesses, which tie an individual to one’s own society and homeland.

This makes NEET a criminal project of epic proportions, something that has already been partially achieved by the introduction of a common engineering entrance examination throughout the Indian Union.

Early, unstructured observations reveal a huge surge in the proportion of central board students in engineering colleges everywhere. A side effect of that is in the form of Hindi-Hindu-Hindustan type of political disturbances in hallowed institutions such as West Bengal’s Jadavpur University for the first time, where some are finding the academic and ideological culture of Bengal alien and in opposition to what their own academic and socio-economic and ideological rearing taught them as ideal.

Autonomy is crucial

The political clout of the rootless, migrant, urban, middle and upper-middle classes steeped in Anglo-Hindi national consciousness is at its peak. They are the first citizens of the Union. It is not surprising that NEET finds huge support among this group. This support for schemes that ensure legal over-representation in the name of uniformity or merit overlaps hugely with opposition to reservation. This demographic overlap is probably not accidental.

What may be effective and efficient in homogeneous and unitary nations is a formula for selective cultural genocide in a nation-of-nations formation like the Indian Union.

This is why the autonomy of state boards need to be protected. At this point, it is important to remember that in BR Ambedkar’s constitution, education was squarely in the State List and Delhi had no business in poking its nose through CBSE and other agencies.

During the Emergency, Indira Gandhi’s government transferred it to the Concurrent List, which is all but an euphemism for the Union List. Now, NEET might help CBSE cannibalise prestigious state boards and reduce them to the status of school leaving certificate printers for the rural vernacular poor, as is currently the case with Madrassa boards.

That’s how much Delhi’s power has grown since 1950. And that’s how much we have fallen. NEET is a medicine whose side effects are much more damaging than the disease it claims to cure. It is time for the non-Hindi states to get together, curb the powers of the Medical Council of India and make concurrence of state medical councils obligatory, and put education back into the State List where it originally belonged in Babasaheb Ambedkar’s Constitution.

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