INDIA’s medical education sector is in a mess. The National Testing Agency (NTA) recently cancelled the National Entrance and Eligibility Test (NEET), which it had conducted for admission to medical colleges, following a question paper leak. In July last year, the Central Bureau of Investigation uncovered a large-scale corruption scandal allegedly involving several medical colleges and officials of the Health Ministry as well as the National Medical Commission (NMC).
All such instances raise serious concerns about the integrity of medical education as a whole and its impact on the quality of healthcare delivery. The sector needs an overhaul, not minor tinkering.
Becoming a doctor in India is a tough process. Students need to compete for a medical seat. The number of seats has gone up substantially in recent years — it stands at 128,000 MBBS seats spread over 800 colleges. Another 50,000 undergraduate and post-graduate seats would be added over the next three years, as per the government’s plan. Still, the competition is high. Some 22 lakh children appeared in the now-cancelled NEET. If selected, one has to go through five-and-a-half years of training in a medical college, and three years of specialisation in a residency programme (after taking another entrance test).
Since the NEET score is the sole criterion for admission in the present system, the integrity of this examination is critical. Therefore, the debate after the current fiasco has focused on the NTA and ways to ensure the integrity of the system. Various technological and physical means being suggested include computer-based testing, security systems like encrypted ‘just-in-time’ question papers, multiple sets of question papers and randomised AI-driven selection of questions. The K Radhakrishnan Committee, formed after the 2024 NEET scam, had also made several recommendations to make the test foolproof.
Such technological quick-fixes and measures to ensure the physical security of test papers may be helpful in the short term. The process of medical college admission needs fundamental structural changes.
Standardised tests determine admission to all levels of medical training in India, unlike the system of holistic assessment followed in many countries. Score-based admission is not the best way to assess the suitability of students for medical training; it is inequitable in many ways. NEET is structured around the Central Board of Secondary Education (CBSE) syllabus as well as some topics that go beyond the school syllabus. Children from non-CBSE schools that follow the state board syllabus have an inherent disadvantage.
Even those coming from CBSE schools are not fully prepared because there are topics not covered by school subjects. To bridge the gap, both sets of students have to undergo some sort of preparation for NEET. And this has given rise to the multi-billion-dollar coaching industry. It has created another barrier for many students as they can’t afford high coaching fees. It is a double disadvantage if they are from schools following the state board curriculum, and from non-English-medium schools.
To begin with, the admission process needs to be decentralised. For a country with diverse educational systems and regional disparities, a “one size fits all” approach like NEET is not effective. Such a standardised assessment test does not account for diverse learning environments and student backgrounds. In addition, a centralised system is more vulnerable to scams, manipulation and paper leaks, as seen in 2024 and 2026.
Let states decide their own process for admission based on local factors, while ensuring accountability and transparency of the process they choose. It could be a hybrid system based on high school marks and entrance test scores for admission to government medical colleges or a separate eligibility test for private colleges. There could be additional criteria or test for admission to the “all-India” quota in state colleges.
The nature of medical admission tests has to change. At present, NEET is basically a rote framework based on the syllabus of biology, physics and chemistry. It is not designed to assess preparedness, aptitude or academic potential for a higher education course like medicine. Students should be assessed more for critical thinking and reasoning, problem-solving skills as well as behavioural and social science concepts. For post-graduate seats too, it is inadequate to have a purely score-based admission test.
An undesirable byproduct of NEET is the coaching industry, which has invariably figured in every NEET-related scandal. The very nature of the test and diverse learning backgrounds of students have given rise to this industry. Coaching institutes claim that for an average high school student to excel in NEET, he/she should start preparing as early as the sixth or seventh grade, which is almost seven years before a student appears for NEET. For this, they create dummy schools and intermediate colleges where students are enrolled formally but have to spend most of their time in coaching centres.
Thus, the coaching industry is not only undermining the formal schooling system but also turning children into NEET zombies, depriving them of the essential learning experience of high school and junior college life. These children lose out on critical thinking, ethics and communication skills — necessary for the development of their overall personality, irrespective of their career paths. In addition, the stress of coaching and parental expectations is taking a heavy toll on the mental health of youngsters.
Dummy schooling is thriving as state education departments have turned a blind eye. Instead of discouraging the coaching industry, states encourage it. In Rajasthan, the government provides financial assistance to students from underprivileged classes to attend coaching sessions. Subsidies are directly transferred to coaching institutes. The Telangana government has tied up with coaching companies to provide educational material and digital tools to students preparing for NEET and other competitive exams. In effect, state governments are helping the coaching industry replace learning with rote training.
The latest NEET scam has provided another opportunity to the government to clean up the mess in the medical education sector and introduce reforms. All the institutions involved, be it the NTA, NMC or medical colleges, need to be made accountable, transparent and corruption-free.
