Tamil Nadu’s Opposition of National Eligibility cum Entrance Test-Undergraduate

‘Happy #WorldHealthDay! Today, we champion the right of everyone, everywhere to have access to:- quality health services, education, health information, safe drinking water, clean air, good nutrition, quality housing, decent working, environmental conditions, freedom from discrimination #MyHealthMyRight’ – Dr Tedros Adhanom Ghebreyesus, Director General of World Health Organization, 7th April 2024.[1] Meenakshisundaram et al. emphasise why does Tamil Nadu oppose National Eligibility cum Entrance Test-Under Graduate (NEET-UG) in the Medical Education section. The authors got their article published in April–June 2024 issue and is a nicely drafted/informative/piece. The knowledgeable authors include a member of the State Planning Commission although with a caveat of sharing his personal opinion there.[2] However, the State Executive – represented by its Chief Minister – has the same view.[3] Therefore, there is a pressing need to examine the issue on its merit and rationale. The authors begin their write-up on NEET UG with its brief history, the changes that emerged at a certain interval, the way it acquired its modern shape and also, its lack of merit as per their opinion/justification. By using the phrase of reinvention of a discarded wheel, they underscore why the test does not assess appearing candidates properly/equitably and comparably. The authors state that the common entrance test skews the competition landscape against the disadvantaged, the rural folk, the marginalised and the poor. Although I agree with all the points, I am bewildered as to why the authors corner out the medical entrance test and are touchy about engineering, management and other coveted tests, including for selection of top bureaucracy (civil servants). They highlight the distortionary effect of costly coaching classes resulting in a high participation cost selection mechanism for aspirants. Yet that is true for the aforementioned fields too. Nonetheless, those coaching classes advertise many courses for parallel streams on their home pages. Here is a web link to the home page of Physics Wallah[4] and here to Unacademy.[5] By some accounts, these are two of the most popular and most visible centres enrolling a large web of students every year. If according to the authors, this preparation further makes the competition between haves and have-nots unequal and the meritorious young students lose the race due to lack of study material and resources; why do they pick and choose only the medical entrance examination to opt-out and not others, I am perplexed. All the tests stress out adolescents and youngsters to some extent, but somehow, there is discussion only about one group of students alone to my surprise. Under a header of The Experiments of Tamil Nadu with selection mechanism, the authors depict how female candidates lose out to their male counterparts when it comes to having admission to engineering courses. Nonetheless, when Tamil Nadu makes a bond policy to make postgraduates and super specialists serve after completion of their training period for another 5 years, what effect does it have on newly entering women candidates, I want to know.[6] The authors refer to the educational website careers360 in their article. The same website mentions service bonds and penalties for different states. Here also, one can get NEET PG bond details and NEET SS bond details state wise 2023.[7] Previously, the bond duration for super speciality training was 10 years. Why does that mean that after completion of her training, a degree-holder was mandated to serve for the next 10 years in remote and rural areas – sometimes without basic and proper setup. I ask the authors to enlighten us on which woman after getting a super speciality degree will be willing to serve for another 10 years in your state if she belongs to another one. Is it really about the woman or about the state politics and appeasement of the electorate, I wonder. Why are the authors concerned about competition and its shortfalls due to unfavourable conditions only before admission to a medical college and not after that, I am puzzled. The authors correctly highlight the difference between the level of the state board and the central board (Central Board of Secondary Education), resulting in the lack of success of local students in competitive examinations. When the state provides poor-quality education, those who cannot afford private tuition are the losers in the race.[8] It is a straightforward and easy-to-grasp calculation and outcome. However, the remedy does not lie in the withdrawal of competition but in elevating the state board to a desirable level and beyond. The Chief Minister is aware of the concern and has been making earnest efforts in this direction during his tenure by providing supportive services.[9] Union Government’s reforming the examination to suit state board candidates, is also a desirable and overdue gesture. In a federal structure, states should air their concerns and the union should lend an ear to them. Together we progress, should be the central theme of cooperation and mutual consideration. In the introduction of the article, the authors mention robust public health infrastructure and the role of the state in building and maintaining it. They emphasise that the policy of the elected representatives should be given due importance because it occurred due to the hard work of visionary leaders who were ahead of their times. Only now, the model of providing free/subsidised healthcare and education to the masses is being emulated elsewhere. They build a case that the poor people of the state otherwise cannot pay the costly and astronomical fee of private medical colleges of other states to obtain admission there which sometimes runs in crores (tens of millions). However, here is a web link to the best private medical colleges in Tamil Nadu itself.[10] Then, who is the beneficiary of these colleges; who has been earning profit by building this sort of infrastructure and have been profiteering from them, should be disclosed. I do not put my finger on the quality of education at the ivory towers of our times or the relationship between paying capacity and merit of a candidate but when the authors describe the high-fee structure of private medical colleges of other states, why do they leave out their own state, I am confused. Is this act an instance of sheer ignorance or happen by some intelligent design to confuse/mislead the reader, I am interested to know. Public health activists and academics at top echelons of society display their plethora of information about scenarios in other states yet are bereft of wits about their backyard, which is as much amusing as awe-inspiring. Under a header of failed promises of NEET, they take note of the reduction of cut-off marks and underscore that by adopting such a policy, meritorious performers are losers. I agree with this point. This policy was indeed bad and instead of cut-off, fees of the colleges should have been reduced.[11] Policymakers and lawmakers should pay attention to the point and formulate rules so as not to repeat the mistake. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.