NEET's Socio-Economic Bias: 10 Takeaways from Tamil Nadu's A K Rajan Report

AK Rajan report found that NEET further alienates students of underprivileged socio-economic backgrounds.

A recent study conducted by a high-level committee headed by Justice A K Rajan, a retired High Court judge, has found that the practice of preparing for and taking the National Entrance cum Eligibility Test (NEET) has led to a radical decrease in the enrolment of students belonging to weaker socio-economic backgrounds, to MBBS courses across government and self-financed medical colleges in Tamil Nadu.

The report, which was submitted to Tamil Nadu Chief Minister M K Stalin, on 14 July, aims to disprove the claim that the NEET is meant to free medical aspirants from the burden of multiple entrance examinations, increase transparency in selection process, and improve the quality of education.

In its findings, the report states that the percentage of applicants who have completed their higher secondary education from the Tamil Nadu State Board of Secondary Education (TNSBSE), fell from 95 percent in the pre-NEET period (before 2017) to 64.27 percent in the academic year 2020-2021 – amounting to a 31 percent drop in enrolments over a short four-year period.

With the support of calculated figures and trends, the study warns of NEET-based admissions adversely affecting healthcare sector in Tamil Nadu. “There may not be enough doctors for being posted at the various Primary Health Centres. There may not be enough expert doctors for being employed in the government hospitals. Further, the rural and urban poor may not be able to join the medical courses,” the report warns.

Here are the 10 points which make the crux of the report.

Underprivileged Overwhelmingly Against NEET

For the purpose of compiling this report, the committee issued a notification calling for public opinions in July 2021. It received 65,007 opinions in opposition to NEET, even as 18,966 replies were in favour of the test. A total of 86,342 submissions were made before the commission. From the submissions, the committee was able to collect 20 unique statements against NEET as opposed to seven unique statements in support of NEET.

NEET Does Not Offer Holistic Student Evaluation

Unlike developed countries such as the UK, USA, China, and Australia, where a holistic mix of academic and performance indicators (standard test scores, personal statements, higher secondary education marks sheets, interviews, etc.) are used to evaluate a student’s candidacy for MBBS courses, NEET makes no effort to effectively and compositely measure a student’s learning capabilities and aptitude. The fact that a student’s NEET score is the sole criterion to gain admission to the MBBS course, “exceeds all scientific forms and principles of an entrance exam,” as per the report.

Promotes Coaching Over Learning

The commission notes that NEET has led to the mushrooming of coaching centres, 400 of which have come up since 2017, in Tamil Nadu. The coaching business has grown into a Rs 5,750 crore industry in the state, the commission observes. Emphasis on coaching has given undue advantage to students from financially and socially privileged families who can gain extra mileage over others with the help of such dedicated classes. “The prospective medical aspirants do not get opportunity to acquire all-round skills, including cognitive, reasoning, creative, social and behavioural skills, that are very much essential prior to enter medical studies,” the report informs.

NEET Has a CBSE Bias

The study has found that students completing Class 12 from the Central Board of Secondary Education (CBSE) have been securing MBBS admissions at a disproportionately higher rate since the introduction of NEET in Tamil Nadu. The rate of CBSE students obtaining admissions in government medical colleges has gone up from nil in the academic year 2015-16 to 26.83 percent in the year 2020-21. In the case of self-financed medical colleges, the numbers for CBSE student enrolments have gone up from a negligible 0.07 percent in 2015-16 to 12.01 percent in 2020-21.

NEET Syllabus Duplicates State Boards, Making These Redundant

NEET is a standardised criteria-referenced test that uses a fixed set of predetermined criteria or learning standards to measure a student’s performance. The standards include concise descriptions of what students are expected to know and be able to do at a specific stage of their education. The Class 12 Board examinations, compulsory for all higher secondary students, also use the same standardised criteria-referenced test. Therefore, the NEET duplicates the Boards, making these redundant, doubles the hardships for the students, and by no means is a superior examination than the state Board exams, the commission observes.

NEET Repeaters at an Advantage

Since coaching centres have largely become a means to be successful in the NEET, financially affluent students who can afford to pay coaching fees year after year and take the test repeatedly, have increased in number and are able to secure admissions to medical colleges at a much higher rate than before. The percentage of repeaters who have secured admissions in MBBS programmes rose to a shocking 71.42 in 2020- 21 from 12.47 in 2016-17. As per the report, a repeater has to invest Rs 10 lakhs on average, only for their coaching, hence throwing the reins of medical education into the hands of the affluent.

NEET Not Tested for Efficacy and Validity

The testing mechanism of NEET has failed to self-introspect and test itself for its validity, veracity, and biasness in evolving times. In the USA, starting this academic year, the University of California and over half of the country’s universities have done away with mandating SAT and ACT scores for admissions after a 2019 lawsuit said that college entrance tests were biased against the poor, mainly Black and Hispanic communities. Thus, any testing framework being used in admission to higher education should provide academic validity, predictability, reliability, and equity for all students irrespective of their socioeconomic backgrounds, race, or gender. Such imperative checks have not been made in the case of NEET.

MCI, DCI Shouldn't Regulate Medical Admissions

In 2013, the Supreme Court of India held that the Medical Council of India and Dental Council of India have no power to regulate admission of students to medical and dental colleges. Challenged by the Christian Medical College, Vellore, in 2012, on the grounds that such practices violated its minority rights to conduct admissions to its college, the Supreme Court had held that the MCI and DCI have no such powers. In 2016, when the MCI filed review petitions against this order, the five-judge bench recalled the judgement made in the case of Christian Medical College Vellore and made NEET operational in the state of Tamil Nadu. The report has termed this a ‘judgment per incurium’ i.e., a judgment that is passed in ignorance of a relevant statutory provision, or without considering binding precedent of a coordinate or larger bench.

NEET is Opposed to the Country’s Federal Structure

The conduct of NEET would be tantamount to Union Government taking complete control of all the universities established by state Legislatures and subjugating the state government to the Union government in all matters on education. This corrupts the federal structure of the country and is in violation of one of the basic tenets of the Indian Constitution, the report states.

Commercialisation and Degradation of Medical Professionalism

The NEET discourages students from developing cognitive, reasoning, creative, social, and behavioural skills that are pivotal to the practice of medicine. The culture of NEET does not encourage educators to impart holistic education or the medical aspirants to work towards achieving it. In the context of modern coaching trends, a student is reduced to a ‘marks scoring machine’ and the large financial investments such activities demand are leading to the commercialisation of medical education. The increasing number of private medical colleges that are selling seats for exorbitant prices do no help the situation. This would eventually mean the degradation of the medical profession and the corporatization of the healthcare sector across the country, the report observes.