Over the past decade, the process for admission to MBBS programs in India has transformed significantly with the introduction of National Eligibility cum Entrance Test (NEET). Data indicates that the number of MBBS seats has doubled in the last 10 years. However, there are huge regional disparities with the Southern states leading the availability.
The unexpected postponement of NEET (PG) 2024 just hours before it was scheduled to take place left thousands of aspiring medical students in shock and uncertainty. This postponement comes amidst the cancellation of the UGC-NET 2024 exam held on 18 June 2024 and ongoing protests over discrepancies in NEET (UG) exam results, where 64 candidates received full scores of 720, nearly 1,500 were given “grace marks” to compensate for lost time during the exam, and allegations of a paper leak emerged.
In response to these concerns, the Ministry of Education announced on 22 June 2024 the formation of a seven-member panel to oversee the conduct of examinations through the National Testing Agency (NTA). The panel, headed by former Indian Space Research Organisation (ISRO) chief K. Radhakrishnan, has been tasked with ensuring that future exams are conducted transparently, smoothly, and fairly.
In a country where marks and degrees shape students’ futures, exam controversies cast serious doubts on the integrity of testing agencies. These leaks undermine the immense efforts of students who invest their time, money, and energy in preparing for such highly competitive exams.
Amidst these issues, we explore the origins of the NEET and NTA, the severity of paper leak allegations in NEET (UG), and the current state of medical education in India.
A ‘NEET’ Leap: Evolution of Medical Entrances
Over the past decade, the process for admission to MBBS programs in India has transformed significantly. From a multi-level and multi-state examination to a unified, single-stage national examination known as the National Eligibility cum Entrance Test (NEET), the process of gaining admission changed significantly.
NEET was first introduced in 2013 by the Medical Council of India (MCI) but was struck down for violating the provisions of Articles 19(1)(g), 25, 26(a), 29(1) and 30(1)by the apex court in a 2-1 judgement in Christian Medical College, Vellore & Ors. vs. Union of India & Ors. When this judgement was challenged, a five-judge bench was formed in 2016 to hear the review petitions, which almost recalled the original judgement, without stating reasons in details for the same. From 2017 onwards, NEET became the sole entrance exam for undergraduate medical and dental admissions, replacing the All India Pre-Medical Test (AIPMT) and other state-level tests.
As per Section 14 of the National Medical Commission Act, 2019 (NMC Act), the NEET (UG) is mandated as a standardized and uniform entrance examination for admission to undergraduate medical programs across all medical institutions in India. Similarly, Section 14 of the National Commission for Indian System of Medicine Act, 2020, requires a uniform NEET (UG) for admission to undergraduate courses in disciplines such as Bachelor of Ayurvedic Medicine and Surgery (BAMS), Bachelor of Unani Medicine and Surgery (BUMS), and Bachelor of Siddha Medicine and Surgery (BSMS), covering all medical institutions under this act. Additionally, NEET (UG) is also required for admission to the BHMS course as stipulated by the National Commission for Homeopathy.
Further, the NMC Act established NEET as the sole entrance exam for all medical colleges, including prestigious institutions like AIIMS and JIPMER. The bill also introduced the National Exit Test (NExT), a standardized final-year MBBS exam that will serve as the entrance test for postgraduate courses and licensure to practice medicine.
National Testing Agency envisioned as a Premier Testing Agency
The National Testing Agency (NTA) was established by the Government as a premier, autonomous, and self-sustained testing organization to oversee entrance exams for admissions and fellowships in higher educational institutions across India. This system is aimed to benefit students by reducing the need for multiple exams for activities such as engineering admissions.
Following Cabinet approval on 10 November 2017, NTA was registered as a Society on 15 May 2018, under the Societies Registration Act of 1860. Since its inception, NTA has conducted 125 exams. In the fiscal year 2022-23 alone, it administered 26 exams, primarily in a Computer Based Test (CBT) format, except for NEET (UG) and All India Sainik Schools Entrance Exam (AISSEE), which were conducted using pen and paper.
The NEET exam’s administration shifted from the Central Board of Secondary Education (CBSE) to the National Testing Agency (NTA) in 2019. Despite the trend towards computer-based exams, NEET remains an OMR-format test conducted in 13 languages (in 2024), including English and Hindi.
NEET(UG) sees a remarkable 105% rise in student participation
Since its introduction in 2017, the NEET examination has seen a significant rise in participation. In 2017, around 11.38 lakh students registered to appear for NEET, out of which 10.9 lakh students appeared, of which 6.11 lakh qualified for the examination. Forward to 2024, more than 24 lakh students registered, out of which 23.33 lakh appeared while 13.16 lakh qualified. In terms of growth, student participation grew by 105% during this period. On average, around 57% of students qualify each year.
MBBS seats across India cross 1 Lakh for the first time in 2023-24
India’s medical education system presents a unique paradox. Despite producing a substantial number of physicians who significantly contribute to the global healthcare workforce, many Indian students choose to pursue medical education abroad, bypassing the country’s prestigious institutions.
As of 2023-24, India boasts one of the world’s largest medical education systems, with 706 medical colleges. Yet, the demand for undergraduate medical seats far exceeds the supply, with approximately 2 million aspiring students competing for limited spots annually. The availability of postgraduate seats similarly falls short of demand.
Over the past decade, the number of medical colleges in India has more than doubled, rising from 335 in 2011-12 to 706 in 2023-24. Between 2011-12 and 2022-23, Government colleges increased from 154 to 355, while private colleges grew from 181 to 295. In a significant milestone, the number of MBBS (UG) seats crossed 1 lakh for the first time in 2023-24, up from 41,569 in 2011-12. Postgraduate seats also saw substantial growth, increasing from 20,828 to 54,834 during the same period.
Despite this impressive expansion, the demand for medical education in India continues to outstrip the supply, underscoring the need for further reforms and strategic planning to address the growing aspirations of the nation’s future healthcare professionals.
Regional disparities in distribution of MBBS seats across India
Concerns about the quality of medical education and healthcare delivery in India further complicate the challenges surrounding the Indian medical education system. A major challenge is the uneven distribution of medical colleges and seats, predominantly in urban areas, leaving rural regions underserved.
In the 2023-24 period, the distribution of medical seats among the large states revealed stark disparities. Telangana led with 22 seats per lakh population, followed by Karnataka with 17, Tamil Nadu with 15, Kerala with 13, and Andhra Pradesh with 12. In contrast, the national average is about 8 seats per lakh population, with many states falling below this benchmark. Uttar Pradesh has only 4 seats per lakh population, while Bihar and Jharkhand have just 2. Effectively, states towards the southern part of India fare much better in providing medical education opportunities as compared to their peers in the rest of the country.
To address these regional disparities, the National Medical Commission (NMC) issued new guidelines on 16 August 2023. These guidelines, titled “Guidelines for Undergraduate Courses under Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses & Assessment and Rating Regulations, 2023,” included a key provision mandating a ratio of 100 MBBS seats for every 10-lakh population in each State and Union Territory. While this provision aimed to ensure a more equitable distribution of medical seats, it also restricted further expansion in states that already had higher seat allocations, particularly in the South.
Due to objections to these restrictions, the NMC announced on 15 November 2023, via a public notice, that Chapter 1 of these guidelines, including the seat allocation provision, has been put on hold. This decision reflects the complexities of reforming medical education to balance regional disparities while accommodating growth in regions with existing robust infrastructure.