NEET-ly divided

CHENNAI: There are very few topics in Tamil Nadu today that can set off passionate debates and arguments like the National Eligibility cum Entrance Test (NEET). With the State government fighting for NEET exemption, medical aspirants are reeling from the uncertainty of it, as they’re not sure of the outcome and what it means for their future.

Add to that was the heated exchange between Chief Minister MK Stalin, Governor RN Ravi and Health Minister Ma Subramanian over NEET exemption recently, which has had everyone on edge. But it’s also a fact that despite having some of the best facilities and infrastructural developments in medical education, students in Tamil Nadu continue to struggle to ace the NEET exam.

This is also one of the reasons why doctors are demanding exemption of NEET, NeXT (National Exit Test) and the removal of all-India quota.

MBBS seats

In India, there are around 704 medical colleges, of which 74 are in the State. There are over 1.07 lakh MBBS and 67,802 PG medical seats in India.

Tamil Nadu has the second highest number of 11,600 MBBS seats and third highest 5,082 PG medical seats. This shows the strength of the medical infrastructure in the State.

Karnataka tops the list with 11,695 MBBS seats, and the maximum number of 6,402 PG seats. Third place in the list goes to Maharashtra with 10,745 MBBS seats and 6,043 PG seats.

Tamil Nadu had 49 medical colleges in 2017 with 6,850 MBBS seats, which increased to 71 colleges in 2022 with 10,825 seats. For PG medical, the State had 2,960 seats in 2017, which increased to 4,830 by 2022.

Tamil Nadu also has the highest number of 8 medical colleges in the National Institutional Ranking Framework (medical category), with Christian Medical College Vellore being third in the country, after All India Institute of Medical Sciences, New Delhi, and Post Graduate Institute of Medical Education and Research, Chandigarh.

Before, After

NEET was introduced in the country in 2013. At the time, there were 387 medical colleges with 51,348 MBBS seats and 31,185 PG medical seats.

When NEET was made compulsory in 2017, the number of medical colleges increased by 82%. It also led to an increase in NEET coaching centres across the country and the craze towards the medical profession grew over time.

Over 317 medical colleges were approved across the country. Currently, there are 704 medical colleges in India. There has been a 110% and 117% hike in MBBS and PG medical seats respectively.

Until 2022, India had 96,077 MBBS and 63,842 PG medical seats at the 648 medical colleges. This ultimately led to an increase in the number of MBBS and the PG medical seats.

Between 2018-2020 (3 years), 101 medical colleges were approved across the country, which included 11 in TN under the Centrally Sponsored Scheme for ‘Establishment of new Medical Colleges attached with existing District/Referral Hospitals’.

Student suicides

There have been 16 suicides recorded in Tamil Nadu over NEET. This is not just the story of S Anitha anymore. More students have taken their own lives, either due to fear of failure or performance pressure in NEET examination.

Tamil Nadu is not the only State with such high NEET-related suicides. Kota, the hub of medical and engineering coaching, has reported 20 student suicides preparing for competitive exams. Most of the victims were NEET aspirants.

This year, a 19-year-old in Maharashtra died by suicide over a low NEET score on the day of the NEET results. A 22-year-old jumped from the 19th floor of a tower in his residential building in Greater Noida after he could not clear the exam. Another aspirant from Chattisgarh hanged himself in his rented room in Pragati Nagar on a day before writing the examination.

With 13,089 student suicides by in 2021, the National Crime Records Bureau stated nearly half were reported from 5 states – Maharashtra, Tamil Nadu, Madhya Pradesh, Karnataka and Odisha. At least 9.5% suicides (around 1,246) were in TN.

Parental pressure

While providing mental health counselling to medical aspirants in the State through the 104 health helpline, professionals have been observing a disturbing trend. Youngsters are facing extreme pressure from parents to join the medical profession.

“There are two reasons for the spike in stress level among youngsters: lack of resources and facilities for students from lower economic backgrounds and pressure from parents to choose a career in the medical field. Even if the child does not want to become a doctor, parents push them to prepare for NEET and clear the test. Children fear disappointing and embarrassing their parents if they do not clear the exam,” said a healthcare professional from the helpline.

Professionals in the State are seeing another trend among school children — increase in anxiety mainly due to academic pressure.

“Children in the age group of 14-17 years, especially those seeking secondary education, are being diagnosed with several mental health issues due to academic pressure, fear of failure and the competition and uncertainty around higher education in the country today. We know of students with learning disabilities who choose the medical field because of parental pressure,” said a psychologist at the Institute of Mental Health.

A costly affair

Government doctors said that NEET has made medical education a great business opportunity for many, as the coaching institutes were mushrooming all over the country. Students from economically stronger backgrounds could choose MBBS due to coaching classes, especially, repeated coaching for multiple attempts in NEET if they don’t succeed the first time.

However, students who don’t have the access to these coaching centres lack the confidence to compete with those who studied in them. The former also believes that they cannot keep up with the innovative and technologically advanced methodologies used by these institutes.

“Schools operate under different boards: State board, CBSE and ICSE. But in college, these boards don’t matter. People study the same degree, so a common competitive exam may sound like an equal opportunity. But the problem is that training for these exams is very difficult and expensive. The coaching academies have figured out ways to crack the exam but along with the pressure of board exams, now students also have to prepare for these,” says an academician and PhD scholar working on higher education policies.

Unlike other competitive exams like NET, UPSC, SSC etc that are meant for employment, NEET is for youngsters. “It’s targeted at kids who want a career in a particular profession. Students already have the pressure of public exams and now, this is a huge burden,” he pointed out. “A gap year isn’t normalised either. Also, not every person or family is in a position to wait and give one more attempt. Even then, if they don’t get it, they have to get into something else and this piles on the pressure.”

In a recent popularly televised video, a father of a NEET top scorer clearly pointed out why NEET brings out the discrimination in society. Ammachiyappan Ramasamy from Salem, father of a girl who scored 623 marks in NEET, said: “NEET is not required as kids study for 12-15 hours a day to prepare for a career in the medical field from the time they’re in Class 8. So, these kids can perform well even without NEET.”

He highlighted another important factor — cost of coaching. It costs about Rs 20 lakh to prepare for NEET. “Everywhere we find NEET coaching centres. How can all parents spend so much? Why do students have to struggle so much at such a young age? It might be possible for rich people to prepare and clear the NEET, but what about students who came from underprivileged backgrounds? Even after my daughter has cleared the NEET exam, I want it to be banned,” he opined.

A friend of Jegadeeswaran (19), a medical aspirant from Chromepet, who took his life after he failed to clear NEET, said that the examination was an injustice. “We all heard about students’ suicides but it didn’t affect us as badly as Jegadeeswaran’s suicide. It affected all of us and made us question the need for an exam at the cost of lives. For all these years those who became doctors without NEET, are all of them unqualified now?”

Multiple attempts

Experts also questioned the lack of limitations on the number of attempts, and the age limit, and opined that students with low socio-economic background do not have that choice of multiple attempts after coaching for years.

“Last year, a medical aspirant in his 60s had written NEET. He had qualified in the test but he didn’t take the seat that was offered to him. He said that if someone younger took the seat instead of him, they’d have more number of years to serve the people. This is why we need an age-limit for writing NEET. There are students who write the test for the sixth or seventh time. There are also those who can afford to pay coaching centres and clear the test after studying the syllabus over and over, as there is no limitation in the number of attempts,” observed Dr P Vasanthamani, former Director of Medical Education (DME).

She added that only 30% of students pass in the first attempt, and the remaining clear NEET after at least more than one attempt.

“Even an average student can become a doctor after going for the NEET coaching year over year and the ones who have the money can get the admission,” she pointed out.

Adding that fees and appearing for NEET should not be the only criteria for the admission, Dr Vasanthamani stated: “While there is a universal cut-off mark, eligibility marks need to be decided based on the average cut-off based the past 4-5 years so that admissions to management quota seats are not just based on money. Even if students come from financially stronger backgrounds, they should also be qualified enough.”

Mob mentality

Even members of the selection committee of the DME admitted that affordability plays a very important role in medical education.

While many students don’t get admission as they’re unable to pay the fees or get good marks due to lack of resources to join coaching centres, there are students who don’t hesitate to pay over Rs 25 lakh the compensation to leave the course after getting admission.

Former DME Dr Edwin Joe said that irrespective of NEET or its exemption, the coaching academies and institutions will find a way to earn through it. “NEET marks or Class 12 marks are just a parameter to get MBBS admission. If there is NEET exemption, there will be a competition to score the highest in Class 12. Then, coaching centres will focus on that syllabus to make students crack the exam. It will again become a profession for the rich,” he averred.

Dr Joe added that the medical profession should be treated as any other profession and the mob mentality towards the same needs to stop.

“Students these days don’t want to serve, as most of them become doctors due to parental pressure. And of course, the financial struggle to get admission is also real,” he admitted.

Talking about the 7.5% reservation for students from government schools, he said that only the first batch of students from government schools are from economically weak backgrounds.

“The following year, even students from government schools were taking tuitions outside. It again becomes a challenge for those who cannot afford it at all,” he lamented. “The focus of the government should be on improving the educational infrastructure in schools to ensure that all students, irrespective of the board they study in, could choose the profession they want to pursue.”