Education

The buzzword is quality

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Passionate medical aspirants are denied seats in private colleges, merely owing to lack of finance, while some, despite poor sources, sail through. What kind of a future does this envisage, for the country’s healthcare?

A few weeks ago, a couple in Mumbai sued a hospital for the doctors’ failure to notice or report any birth defect in their daughter during pre-natal tests. The new-born is affected with meningomyelocele, and doctors say that the child may not live for more than three or four months. Recently, it was reported that medical negligence, by the doctors of a hospital in Hyderabad, led to the amputation of a six-year-old girl’s leg. Earlier, the girl had injured her leg when a cupboard fell on her. It is alleged that as no proper treatment was given to the girl, the leg had to be amputated. Numerous cases of medical negligence and misdiagnosis have been reported across India. In some cases, doctors and hospitals have been sued. Yet, cases of medical negligence and misdiagnosis are on the rise.

How good is medical education in India? Do candidates, with the aptitude for medicine, join the course? Does India produce quality doctors? Has medical education in the country become just a business? What ails medical education in the country? I have heard people raise these questions on several occasions. The need for improving the quality of medical education has been discussed in various forums. Have sincere efforts been made to improve the quality of medical education in the country?

Beyond the mirage

The National Eligibility cum Entrance Test (NEET) was introduced in 2013 with the objective of standardising medical entrance exams across the country. Now, as per regulations, private medical institutions cannot hold their own entrance tests to admit students to their medical courses. Doesn’t it sound fantastic? For most common people, it may be a sweet melody as they think that the system allows only meritorious students to join MBBS and BDS courses. Is it true? No. Let’s analyse NEET results, qualifying marks and the type of students admitted to private institutions.

The National Testing Agency released the NEET medical results, earlier this month. This year, 14,10,754 candidates appeared for the test and a total of 7,95,031 candidates living in India cleared it. The qualifying criteria for NEET is a minimum of 50 percentile scores for unreserved (UR) category, 45 percentile scores for unreserved physically handicapped (UR PH) category and 40 percentile scores for the reserved (OBC, SC, ST) category. Based on these criteria, the cut off scores in 2019 are: General, UR - 50th Percentile (701- 134), UR PH - 45th Percentile (133 – 120), OBC, SC, ST PH - 40th Percentile (119-107). Those who qualify are eligible for All India (15%) and State (85%) quotas.

There are a total of 68,241 MBBS seats and 27,148 BDS seats in the country. Of the total MBBS seats, 67,771 seats are filled through NEET and the remaining seats (1,407) are filled through AIMS and JIPMER entrance exams. Only 32,013 seats are available in government medical institutions and the remaining 36,165 seats are in private institutions, including deemed universities. All the BDS seats are filled through NEET. Of the total number of BDS seats, only 2,930 seats are in government dental colleges.

Around 7,96,000 eligible candidates compete for 68,241 MBBS seats and 27,148 BDS seats. Based on ranks, meritorious candidates secure admission to government medical institutions, and a certain percentage of meritorious students are admitted to private medical institutions through single window counselling. This year, the competition is tougher as the cut off has gone up by 15 marks in the general category.

As there is a great demand for MBBS and BDS courses, and there are only a limited number of seats in government medical colleges, many aspirants who cannot secure medical seats through counselling will seek admission to private medical colleges which demand a huge amount of money as fees. It implies that only wealthy candidates, who can spend around R75 lakh to R1 crore, can dream of studying in private colleges. Assume that a candidate (Mr. X) who scored 450 marks was not able to secure a seat in a government medical college. This person, being poor, foregoes his dream of becoming a doctor. Assume there is another candidate (Mr. Y) who just qualified with 150 marks. As he is rich, he will be able to buy a seat in any private medical college. This is a clear case of money replacing merit in private institutions. The unjust system forces thousands of candidates with high scores to forego their dream of becoming doctors. Quality is killed on the altar of money.

What next?

A few concrete steps must be taken to improve the quality of medical education in the country. My suggestions are:

The qualifying criteria for NEET should be a minimum of 70 percentile scores for UR category, 65 for UR PH category, and 60 for the reserved category. This will ensure that candidates with relatively good scores alone can secure admission to private colleges. Good intake of medical aspirants can result in producing good doctors.

There should be a common exit exam for all medical students when they complete their courses. The exit exam should test medical students’ theoretical knowledge, as well as clinical skills. The Objective Structured Clinical Examination (OSCE) is used as an evaluative tool to assess healthcare professionals in a clinical setting, in many developed countries. A model similar to the OSCE can be followed in India too. Only those who clear the exit exam should be granted licence to practise.

Private medical institutions have proliferated in the country during the past two decades. It is the moral responsibility of the Medical Council of India and the Dental Council of India to function as effective regulatory bodies and check whether these institutions provide quality medical education. Ultimately what is needed is quality health care for all.

The writer is an academic, columnist and freelance writer. rayanal@yahoo.co.uk T:@albertprayan

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Printable version | Mar 28, 2020 6:47:01 PM | https://www.thehindu.com/education/the-buzzword-is-quality/article27947881.ece

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