September 1, 2017: The day S. Anitha succumbed to the dark side of NEET. Born into a Dalit family in Ariyalur and with her father working as a load man in Trichy, medical education must have been an unthinkable dream. Given the socio-economic milieu of Tamil Nadu, Anitha studied in a government-aided school in Kuzhumur, and scored above 480 out of 500. This allowed her to join Rajavignesh Higher Secondary School in Melamathur, a private school which offered her scholarship that would cover the fees towards tuition and hostel.
Intent on becoming a doctor, Anitha scored a cut-off of 196.75 for medicine. This would have ensured her a seat in the prestigious Madras Medical College – if there was no NEET.
The objective of creating a level playing competition landscape for students to allocate professional college seats led to a series of government interventions – the primary one being reservation. By 1989, the reservation percentage in Tamil Nadu had reached 69%, with the sub-categorisation of Backward Caste quota to create the Most Backward Caste quota due to the persistent struggle spearheaded by Vanniyar Sangam.
Following this, the then Dravida Munnetra Kazhagam (DMK) government under M. Karunanidhi instituted a scheme to grant five marks to applicants for professional courses whose families did not have a graduate. This scheme was caste-blind, wherein an applicant from any caste could benefit. This scheme was later challenged in the court of law and quashed.
Later, under the DMK government of 1996, a scheme to reserve seats for rural candidates was created, in order to overcome the deficiencies placed on them due to their location. This too was quashed by the court. The major intervention was the abolition of improvement examination system by the All India Anna Dravida Munnetra Kazhagam (AIADMK) government under J. Jayalalithaa in 2005. Introduced in 1989, it gave undue advantage to students who were prepared to spend a year or two to improve their scores.
The year of 2005 also saw the first move to abolish Tamil Nadu Professional Courses Entrance Examination (TNPCEE). The DMK government under M. Karunanidhi abolished it in 2006. The underlying policy continuum which exists reveals the political will across party lines to help create a competitive landscape that neutralises the privilege lent by one’s econo-geographical location and socio-economic position.
More recently, the AIADMK government in the face of widespread protests against NEET, unanimously passed two NEET-related bills in Tamil Nadu legislature with overwhelming support from opposition and parties across the state. The key Bill is to annul NEET for admissions into MBBS and BDS and allow students to secure admission in medical courses based upon the marks secured by the students in Class XII. The bills passed in 2017 are still awaiting the assent of the president.
The resistance to NEET in Tamil Nadu, made compulsory by the BJP government across the country – in a departure from its previous status of being an evaluation platform which can be opted by states – was not engineered in 2017.
While Karunanidhi opposed NEET in 2012 when introduced by the United Progressive Alliance government, Jayalalithaa, in her letter to Prime Minister Narendra Modi in 2016, registered her protest as well. She said the rural students and those from poorer socio-economic backgrounds will be unable to compete with urban elite students in such common entrance examinations, designed to favour the urban elite. This observation of hers reflects the findings of the committee under the chairmanship of M. Anandakrishnan, constituted by the DMK government in 2006, to recommend measures for the abolition of the central entrance test from the academic year 2007-08.
Also, Tamil Nadu had policies to retain its doctors in rural services, district and government hospital through the ‘in-service’ quota. Under this, the doctors would receive 50% reservation in the postgraduates courses in Tamil Nadu after a minimum service period of two years. This provision of ‘in-service’ quota was quashed again by court, citing it as unconstitutional. If a state doesn’t even have the right to devise policies in order to build its health infrastructure by retaining its doctors through incentives, I wonder where the concept of federalism lies in this nation.
Prior to NEET and when ‘in-service’ quota was in force, students from various socio-economic strata would enter the government service, even if they were unable to spend money or time for further studies. This reality allowed primary health centres and government and district hospitals to function seamlessly, thanks to a continuous flow of doctors towards government service.
With the introduction of NEET and the quashing of ‘in-service’ quota, the ecosystem that enabled the steady supply of doctors to the government infrastructure has been short-circuited. The incoming students in undergraduate courses are essentially from backgrounds privileged enough to spend for UG entrance coaching.
Given their background and the lack of incentive system in place, the outgoing UG doctors would give government service a miss and proceed towards entrance preparation for PG NEET. This creates a fertile ground for the steady weakening of the public health infrastructure, creating circumstances for the privatisation of these services.
This was also reflected in the letter written by Jayalalitha to the prime minister in which she said NEET would nullify the implementation of policy initiatives (aimed at securing medical graduates for the state medical infrastructure) and socio-economic objectives of Tamil Nadu. She also said it was out of tune with the prevailing socio-economic milieu and administrative requirements of Tamil Nadu. The mere fact that Anitha would now be a second-year student perhaps best illustrates this observation.
This is not restricted to just the case of Anitha. Three girl students have committed suicide this year after failing to crack the NEET. The grave concern is the case of women representation in professional courses. The nature of the examination along with the coaching class ecosystem which has developed common entrance tests has led to a different kind of reality. The reality where the examinations end up selecting individuals not majorly on their abilities but based on the propensity of their families to spend. Naturally, this affects women representation. Women are often overlooked when the question of investing money on their education arises.
Women representation in IIT Madras and Anna University holds the key to understanding this issue with greater depth. The reason for the stark contrast in the representation of women in IIT Madras and Anna University, separated by a single road named Sardar Vallabhai Patel Road, boils down to one single factor – the selection mechanism. The question of whether the selection is based on a system which effectively has low participation cost (higher secondary examination) or high participation cost (joint entrance examination).
As NEET continues to shatter countless dreams in Tamil Nadu, one wonders whatever happened to the resolve of the state apparatus that attempted to deal with varying forms of barriers in the competitive landscape?
Dr P.M. Yazhini is a registered medical practitioner from Government Theni Medical College and is currently based in Chennai.