The Union government’s new directive, dropping the qualifying percentile for the NEET PG exam to zero, once again raises the question of why there are such a large number of vacancies in medical postgraduate courses and what the future holds for public health care in India. According to data from the Union Health Ministry, 3,744 out of 60,202 PG seats (6.22%) remained unfilled in the academic year 2021-22. There was a rise in vacancies in the following academic year when 4,400 out of 64,059 seats (6.87%) remained unfilled in 2022-23. This was despite a huge number of applications in both years (1,75,415 in the first year and 2,06,541 the following year).
The data was released during the monsoon session of Parliament by Dr Bharati Pravin Pawar, Minister of State for Health and Family Welfare. At the time, the Union government had also pointed out that the cut-off percentile for NEET PG had been reduced to 25 for general category students, 20 for Person with Disabilities (PwD) category students and 15 for Scheduled Castes/Scheduled Tribes/Other Backward Classes (SC/ST/OBC) students. So, despite the reduced cut-offs and the huge influx of applications, why did the problem of unfilled seats continue to persist?
Speaking to TNM, Dravida Munnetra Kazhagam (DMK) spokesperson and a medical PG student Dr Yazhini says that the issue of vacancies has persisted for years due to a systemic failure that doesn’t allow students to pursue research-oriented medical courses at the postgraduate level.
“First we must understand that PG medicine is divided into clinical, non-clinical and para-clinical courses.” Clinical courses, Yazhini explains, include general medicine, surgery, or any practice that allows doctors to directly interact with patients. “Subjects like pathology or microbiology fall under para-clinical courses while anatomy, physiology or pharmacology are considered non-clinical courses,” she adds.
“There is no incentive for students to take up non-clinical courses. There aren’t good enough research institutes or proper job opportunities for them. Non-clinical courses are purely research-oriented. How will students carry out research without funding? Does the Union budget for health set aside funds for research institutes where the student will be ensured a job after completing non-clinical courses? It is a systematic failure that is discouraging students from taking up non-clinical courses,” Yazhini says.
Yazhini herself is pursuing pharmacology – a non-clinical subject. “We all know that India is one of the biggest exporters of generic medicines. But the regulations are so bad that many companies in India are being blacklisted by countries like the United States. I am now worried about where I will be able to work after I finish my course when so many industries are being blacklisted,” she says.
Also speaking to TNM, Dr Karthik, former president of Telangana’s Junior Doctors’ Association (JUDA), echoes Yazhini’s sentiments about clinical and non-clinical courses, saying there is an overwhelming preference for the former.
Karthik says, “Until now, vacancies would remain unfilled in the management quota even if students can pay the high fees because they don’t meet the cut-off criteria. Now, this is no longer a problem for them. A person with a zero percentile score can still get a seat. What will happen to a profession that is patient-based when someone who could not even make the minimum cut-off marks—who has no merit, is able to buy a seat? This will have a huge impact on the quality of the public health care system.”
Yazhini also questions the notion of merit as emphasised by the Union government. “The BJP claimed that the reason for bringing in NEET was merit. But now they have reduced the qualifying percentile to zero – is this the merit the BJP keeps talking about? I believe that the only reason for reducing the cut-off percentile to zero is so that anyone, regardless of how poorly they’ve performed in the exams, can secure admission as long as they can afford to buy a seat. This only helps private colleges and deemed universities.”
She goes on to say, “When it comes to reservation for SC/ST/OBC students, privileged castes talk about merit. A student like Anita [who died by suicide after not qualifying in NEET] was not able to study medicine despite scoring over 1100 marks. But now, any person who can afford the high-cost entry barriers can get into PG medicine. I don’t understand the BJP’s concept of merit.”
Yazhini too expresses similar fears. “A doctor is supposed to be empathetic. That is the first and most important social quality for a doctor. When you bring in high entry barriers, you will only let in those who are rich enough to invest crores of rupees in their education. When they start their practice, they will only seek to make back that money. Medical education is being converted into a business, which means health care is becoming a business. One chronic illness is enough to finish off the life-savings of a middle-class family, often they can’t afford treatment even then.”