NEET is a much-needed reform in medical education — Dr Bipin Batra

Prof (Dr) Bipin Batra is an eminent radiologist and executive director of the National Board of Examinations (NBE), the body entrusted with conducting the National Eligibility-cum-Entrance Test (NEET) for admission to postgraduate courses in medical and dental colleges across the country. In an exclusive interview, Dr Batra talks about NBE, DNB and NEET.

We know you as executive director of the National Board of Examinations. Please tell us about the path that led you here and your experience along the way.
I am a radiologist with passion for education, excellence and quest for learning. I have been fortunate to work with the doyens in the field of radiology, medical education, student assessment, accreditation and public health. Each of these leaders has left a lasting impression on my abilities to be a physician with passion for care, compassion, manage change for good and innovate for the betterment of medical education ultimately leading to improved health outcomes.
I am glad to have planned, executed and steered some of the complex reforms as NEET, computer-based testing, competency-based assessments, single window admissions for PG residency and introduction of more than 15 new programmes.

For someone not very familiar with the National Board of Examinations, how would you introduce it? What all exams does the board take charge of?
NBE today is one of the largest educational bodies dealing with complete cycle of postgraduate medical education. Starting from conducting the entry examination, counselling, formative assessments, thesis-research, exit examinations and institutional accreditation are being conducted by NBE.
NBE conducts major entrance tests such as NEET Medical PG, NEET Dental PG, NEET Super Speciality, DNB CET (Diplomate of National Board – Centralized Entrance Test), PDCET (DNB Post Diploma CET) and CETSS (DNB CET Super Specialty). Besides, NBE also conducts the licensing exam as the FMGE (Foreign Medical Graduates Examination). The DNB exit test or the final exam is the largest national exam in this part of the world for the assessment of clinical competencies.

Again for the beginners, please tell us about your team, panel etc. Who are all involved in preparing questions, what do they expect from a candidate etc?
For every exam we have a different panel of faculty who are involved in preparation of questions. The expectation from examinees varies from exam to exam, say for licensing exams, it’s more of an inclusive test designed to qualify candidates who possess minimum basic knowledge in the syllabus prescribed.
For the competitive tests such as NEET or AIPGMEE (All India Post Graduate Medical Entrance Examination), the test is designed to differentiate between the knowledge levels of examinees and rank them. The exit exams are designed for the assessment of knowledge, skills and competencies required to practice the specialty independently.

How DNB programmes are different from other PG courses like MD/MS? Also, are there any programmes to orient the medical students to various branches so that they make an informed decision about their speciality?
NBE offers courses at two levels — one after the MBBS i.e. at the postgraduate level and second at the subspecialty level, after basic PG DNB or MD/MS. While, DNB and MD/MS courses are fundamentally structured on the same lines, the DNB programme is tailored to produce specialists with proven competence and readiness to serve the healthcare system at the end of training.
The introduction of a programme to orient the young MBBS graduates is necessary to help them identify the speciality and career pathway of choice. With DNB courses in 35 plus broad specialties, 17 super and 12 sub-specialty areas, the aspiring candidates have a lot of choices to make.

Let’s get to the hot topic of these days, what’s NEET? What’s happening with it? Tell us about both UG and PG NEET.
The National Eligibility-cum-Entrance Test was introduced by way of amendments to the regulations governing the UG and PG programmes notified by the Medical Council of India (MCI) with the prior approval of the Government of India in the year 2011-12. NEET as a part of the UG and PG regulations is a subordinate legislative process executed by the Government of India by way of an amendment to the Indian Medical Council Act duly promulgated by way of an ordinance under the Constitution. The President of India introduced NEET as a part of the Indian Medical Council Act by way of introduction of Section 10D to the Indian Medical Council Act and Section 10D to the Dentist Act.
The introduction of NEET as an entry examination by way of amendment to the Indian Medical Council Act and Dentist Act granted the statutory status to NEET, making it law of the land. With such a move there are no exceptions and extensions on the applicability of NEET, it is now universal across all institutions.
NEET-UG is for entry to the MBBS and BDS courses at the graduate level. NEET-PG is for entry to the postgraduate (MD/MS) courses whereas NEET-PG (MDS) is for entry to graduate level dental courses. NEET-SS is for entry to Super Specialty courses i.e. DM/MCh.

What are the advantages and disadvantages of NEET and how can it be better implemented?
The National Eligibility-cum-Entrance Test is a much-needed reform for improving the overall general standard of medical education in the country. Most importantly a single reliable examination could help restore the faith of the society with medical graduates and quality of doctors.
There are many advantages of NEET — the first and foremost being the one country one examination whether it is UG, PG or Super Specialty courses, high level of structuring and its consequential impact on the curriculum for the qualifying examination shall improve the level of teaching and learning both in the medical colleges as well as at the student level.
NEET has to be coupled with robust admissions framework. While the government institutions have various constitutional rules, responsibilities and legal obligations to discharge the regulatory pathways, guidelines must be framed for private medical and dental institutions in continuation of NEET so as to promote merit and excellence in admissions.
The deemed universities/institutions shall have to follow the regulations in letter and spirit in this regard.

What would you tell the students who prepare for these exams — learn and understand your subject or train yourselves to attend the questions? What do you think is more important to evaluate?
The students should focus on enhancing their knowledge and analytical skill framework. While many mechanisms may exist outside the traditional medical colleges that allure the students to train themselves in the art of attempting the questions, the fundamental assimilation of knowledge and application of analytical skills to problem solving in modern medicine is the key that shall help the students throughout their life and not just for examinations alone.
The evaluation of students through entrance examinations should be based on their capability to synthesize knowledge into analytical thought process and action.

What’s your opinion on doctors wasting their fruitful years in preparing for entrance examinations for getting into a speciality of their choice?
It is unfortunate that in our country the capacity for PG and sub-specialty education has not expanded compared to the expansion in the graduate medical education space leading to a situation wherein successive batches of medical graduates spend their time preparing for PG entrance examinations. The lack of adequate career pathways on the basis of graduate qualification alone is another contributory factor. The eco-system of medical jobs and employment needs to create a respectable place for plain medical graduates or alternatively the number of PG seats should be enhanced so as to allay the anxiety of medical graduates.

What according to you can help in the betterment of medical colleges and courses in India?
We have to utilize the entire healthcare delivery chain from primary healthcare centres to secondary and tertiary healthcare sector even so-called non-teaching domains and service/practice based hospitals to facilitate high level of skill and capacity building for medical courses in India.
Some of the private medical colleges continuously face the challenge of depleting clinical material and are not able to do justice in terms of their training. We have to adopt the resources of clinical material by innovative means such as community-based education in order to enhance the throughput as well as make our graduates ready to serve the society upon completion of their academic trainings.

It’s apparent that there’s a lot of money playing in UG and PG medical admissions, what’s your opinion on it? How can we prevent it and make medical college admissions more transparent and just?
It is an undisputed fact that the cost of medical education has risen exponentially in the past two decades. The absence of any proactive legislative and regulatory action to curb the menace of capitation fee has made the cost and access to education beyond the reach of aspiring candidates from average families.
The multiplicity of entrance examinations and absence of any standardized mechanism that could verify the claims of these entrance examinations conducted by private universities made the admission process system gullible for capitation fee.
While the law provides for management quota which is a small fraction of total seats, the system must ensure enough checks and balances so as to ensure that the admissions take place on the basis of merit only.
The introduction of NEET is one such development that shall go a long way in controlling this menace. The capping of fees at private or self-financed medical institutions by statutory pathway is another mechanism for addressing this problem.

What’s your message to our readers, young doctors, aspiring doctors and medical students?

I would like to congratulate the young and aspiring doctors, the medical students for making medicine as a career of their choice. A career in medicine is long and requires tremendous hard work but remains very fulfilling, rewarding and prestigious. The young doctors have a lot of potential to take the modern science closely to the people and at the same time contribute towards nation building in an effective manner.

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