Proposed reforms in National Eligibility cum Entrance Test (NEET-UG examination) in 2025

Dear Editor,

I went through a thought-provoking and ambitious Editorial by Ranjan et al.[1] in the December 2024 issue of the Journal. The writers therein went through all the malaise plaguing the students aspiring for entering the coveted temples of the medical education, what are its pitfalls, how to fix it and what are the ways to reduce possibilities of malpractices and mismanagement. It compares the test with other countries’ systems as well which includes assessment of other streams relevant to health care system. I agree with all the points raised by the authors as this year has been extraordinary in the sense that without anybody’s wits and wildest guess, few students got grace marks-something unheard of in the game till now.[2]

Nevertheless, there is one point of disagreement too therein where I want to put my idea on the table with its reasoning. The authors want to lay more emphasis on biological subjects due to their proximity with illnesses whereas less on abstract one - physical sciences having predictable results. But nowadays medicine, as practiced at the bedside rests on the foundation of physical laws. Principles of basic blood- pressure measuring instruments to sophisticated and evolving imaging and fluoroscopy demand a fundamental knowledge of rules of physics. Basic chest X-rays, ultrasound, ElectroCardioGraphy (ECG), ElectroEncephaloGraphy (EEG) and bedside monitors have certain limitations, new applications, unknown and unfathomable defects and uses which could be ascertained only by those who know how the electricity flows. During COVID times we learned this lesson at an unprecedented scale.[3] Wearables and artificial intelligence are waiting for our wisdom to increase to reveal and enhance their true meaning.[4]

Nations which got the secret early, built on basic education of their masses to develop high-end diagnostics, manufacture state-of-the-art medical imaging for scans, surgical equipment, and implants. At present our country heavily relies on the imports of such goods.[5] As a result we have a trade deficit-resulting in weakening of rupee and overall economic weakness.[6] United Nations data hub shows rising merchandise trade balance here.[7] Sensing the prevailing competition, emerging opportunities, imposition of tariffs amidst global trade-war, Government of India recently launched a scheme to give a lift to medical device industry.[8] We need young students, who are ready to go through rigors of medical -education training and thereafter provide much needed input to generate next-wave of indigenous yet low-cost equipment and repurposed devices or surgical disposables to solve local challenges so that our reliance on such imports is reduced.

Hence, I am skeptical of the idea of agnosia or less emphasis on physics and abstract sciences for future medics.

In the aftermath of fiasco created due to incompetent and mismanaged affairs of conduct of the examination, the Supreme Court of India formed Radhakrishnan Panel. It provided its recommendation shortly ago.[9] Unsurprisingly, on several issues, the authors and the panel are on the same page. Both want multi-stage test, hybrid models of question papers and have several other similar proposals and ideas.

The authors suggest some training seats to be allocated to local students who reside in that area. As far as the issue of reservation is concerned for local students, I want to share my experience. My several batchmates and seniors/juniors originally belonged to villages and small towns. Nonetheless, after obtaining training and university degree, almost all of them settled in cities and Metros. I am unable to recall meeting with someone who decided to stay in his small village of his own choice to serve the underprivileged and marginalized population. Hence how many newcomers to the profession will go to villages and serve the unserved, I am at sea to ponder about. Trained professionals want to stay in cities sometimes due to reasons unrelated to their job and training -history. Villages may not provide good schooling facilities for their kids, recreational facilities after duty hours, redressal facilities for their grievances, security issues for female medics and myriad other reasons for others.

Wishful thinking to continue to have them in their training campus in due course may be a too farfetched aspiration for our planners and policy-makers. The best way forward may be first to lend an ear to them and try to get a hang of reasons for making their choices regarding their location. Such an insight may open avenues for further conversation to relocate them in the areas where shortage of manpower exists. Two-way communication between the classes opens-up novel ways of dialogue and resultant exchange of ideas, we sorely miss in our times.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.