Medical education in India got a shot in the arm when the Supreme Court a few days ago gave its nod to hold a common National Eligibility cum Entrance Test (NEET) for admission to medical colleges across the country, be it private, government or deemed university. Now it has got a booster shot with a constitution bench of the court—comprising justices A.R. Dave, A.K. Sikri, R.K. Agrawal, A.K. Goel and R. Banumathi—constituting a committee under retired chief justice R.M. Lodha to oversee the functioning of the Medical Council of India (MCI). Gastroenterologist Shiv Sareen, who is director of the Institute of Liver and Biliary Sciences in Delhi, and former Comptroller Auditor General Vinod Rai are the other members of the committee.
The committee will have overriding powers to review decisions taken by the MCI and suggest remedial measures. The court arrived at this decision based on the observations of the Ranjit Roy committee and the 92nd Parliamentary standing committee report on the functioning of the MCI.
The court observed that “the MCI was repeatedly found short of fulfilling its mandated responsibilities”. It said the “regulatory structure should be run by persons selected through transparent mechanism rather than by election or nomination.” The court took note of the corruption in the MCI and said “expeditious action should be taken to amend the statute and enact a new legislation”. It found the current system of inspections unsatisfactory.
The rot in the MCI came to the fore in 2010 when its president Ketan Desai was caught red-handed accepting bribe from the promoters of a private medical college. Though the council has since had many administrative and structural changes, not much seems to have changed. Currently, it is managed by 80 members who work in small teams and look after different aspects of medical education, such as recognition and approval of new colleges and revision of curricula.
Dr Ashok Seth, a member of the MCI, said it was unfair to blame the current council for the damage to the quality of education in the past 20 years. “The MCI doesn’t have the power to implement; it can only make recommendations to the government. Implementation of a common entrance test, a recommendation of the MCI, took two years. I welcome the court’s decision of setting up the oversight committee. Maybe the MCI now will get its much needed teeth,” he said.
Many experts feel that the quality of medical education in India has deteriorated owing to corruption and capitation fee for admission in private medical colleges. “The medical graduates lack competence in performing basic health care tasks,” wrote Justice Sikri in the judgment. “Instances of unethical practices continued to grow. The MCI was not able to spearhead any serious reforms in medical education. The MCI neither represented the professional excellence nor its ethos.”
The medical fraternity welcomed the court decision, saying NEET would prevent private medical colleges charging huge capitation fees and give merit a chance. However, some states are opposing the court’s decision and are questioning the constitutional validity of NEET. Jammu and Kashmir, Andhra Pradesh and Telangana cited special constitutional provisions to contend that only the state can have the say in holding entrance examination for MBBS and BDS courses.
The J&K government cited Article 370 of the Indian Constitution read with Article 35 A and section 6 of the J&K constitution to contend that the state was entitled to conduct the medical entrance test, and students cannot be admitted to these courses from outside the state through NEET. Besides, the state government has the legislative competence and the Centre cannot interfere.
Said Dr K. Prasksam, former president and spokesperson of Indian Medical Association in Tamil Nadu, “We are not against NEET but before making it compulsory in the state, we would like the Supreme Court to standardise school education throughout the country.” The problem, he said, is 80 per cent students in Tamil Nadu study state syllabus while NEET is based on CBSE curriculum. Also, 50 per cent students in the state study in Tamil medium while the entrance test is held in English and Hindi. “These students, despite being meritorious, would not be able to compete with students who are well-versed in English or Hindi. Besides, in Tamil Nadu, the priority is given to students who are willing to serve rural and hilly areas. I am afraid that the Supreme Court's decision will disturb the state health care system,” he said.
Dr K.V. Babu, a health activist in Kerala, said, “The court should give at least two years to the students to prepare for NEET.”
Earlier, IMA Maharashtra had requested Chief Minister Devendra Fadnavis to intervene and allow MH-CET (the state entrance test) this year, saying the sudden implementation of NEET was confusing for students who had prepared for MH-CET.
The state medical associations are of the opinion that government recognition of the private deemed universities is the main reason for the deterioration of standards in medical education. “The fact is, private medical colleges have been affiliated to government universities and have followed their curriculum,” said Prasksam.
Many experts, however, believe that since NEET is going to be the national eligibility test for all admissions, it will be a setback only to college managements that sell seats. Such payment seats will now go to those who clear NEET. Said Dr George Paul, a health education activist, “The private institutions will now be forced to reveal the fees.”