|LETTER TO EDITOR
|Year : 2018 | Volume
| Issue : 4 | Page : 308-309
Competitive or competent? – Impact of national eligibility cum entrance test on present-day medical education
V Dinesh Kumar1, P Srinidhi2
1 Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
2 Pondicherry Institute of Medical Sciences, Puducherry, India
|Date of Web Publication||14-Nov-2018|
V Dinesh Kumar
Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kumar V D, Srinidhi P. Competitive or competent? – Impact of national eligibility cum entrance test on present-day medical education. CHRISMED J Health Res 2018;5:308-9
|How to cite this URL:|
Kumar V D, Srinidhi P. Competitive or competent? – Impact of national eligibility cum entrance test on present-day medical education. CHRISMED J Health Res [serial online] 2018 [cited 2019 May 22];5:308-9. Available from: http://www.cjhr.org/text.asp?2018/5/4/308/245453
Despite a great deal of opposition from various segments of our country, the Government of India stays strong in conducting common pan-India postgraduate (PG) entrance examinations. They claim that the National Eligibility cum Entrance Test (NEET) examination creates a fair, transparent, and minimal corruptible system and ensures a baseline merit-based education system. Those who oppose, argue that the prevailing social justice-based equality in medical arena would be lost and students from the rural background would be underprivileged, and in turn, this would hamper the equitable distribution of human resources across our country. As recognition of the principles of social mission and rural health varies greatly among medical schools, the “one-fit” selection process is dreaded to marginalize the social mission aspect of health professional education.
Leaving behind the sociopolitical polemics of the issue, we, through this letter, would like to emphasize the impact of NEET from a different perspective. Reputed medical educators in many countries argue that medical graduate needs to demonstrate the desired levels of competence in all domains of intended practice. When the discipline-based curriculum begins with the question, “What do learners need to know?” and the proposed competency-based medical education is organized around the question, “what abilities are needed of graduates?” The central tenet of the desired paradigm is to ensure that a physician competence is multidimensional, dynamic, contextual, and developmental.
This requires the teachers to reduce the teaching of microdetails of any discipline and focus on broader concepts. However, most would agree that the questions asked in the NEET are completely grounded on the microdetails, and these give least significance to the utility of broader concepts in clinical practice. On the one hand, the question setters are the discrimination index of the multiple choice questions to its heights, by asking about a rare gene involved in an uncommon disease. On the other hand, students are under pressure of “covering everything” and suffer from a cognition overload.
We could enunciate that, despite the societal forces for documented competence among Indian medical graduates, there is no defined movement toward outcome-based evaluation. The curious thirst for knowledge required to crack an entrance examination and lack of definite threshold for achieving competence in attitude and psychomotor domains uproot the crux of competency-based medical education, at its larval stage itself. Is not it indirectly demanding the students to cram the knowledge and be furiously competitive rather than internalizing it by understanding broader concepts? We could witness a mad rush in mushrooming coaching centers, which provided encapsulated knowledge of various disciplines in few months. Ironically, students, who compete to enter government medical institutions for pursuing PG specialty courses, are not able to make use of the knowledge gained from above-said coaching centers. The much-needed understanding of the pertinent problems of the community, health disparities, ability to maintain social/professional values, and inclination toward social mission would be cornered in long run. Students, by virtue of high aspirations to find opportunities (i.e., PG seats), are breeding more competition without any value addition. At the same time, refraining from general practice for entrance preparation often leads to transient wastage of human health resources.
To conclude, we do not question, the notion that certain standards have to be maintained for selecting the candidates for PG specialties. However, we would like to express our concerns, when there is a mismatch between what we expect out of learners and what their primary objective in reality is. To date, we have limited evidence to suggest that the outcomes of the existing trend in the long term. Alas, if we could imagine the medical graduate course spanning between two NEET (undergraduate and PG), we should think, pragmatically, what are we trying to achieve?
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Dehury RK, Samal J. “Exit exams” for medical graduates: A guarantee of quality? Indian J Med Ethics 2017;2:190-3.
Valsangkar B, Chen C, Wohltjen H, Mullan F. Do medical school mission statements align with the nation's health care needs? Acad Med 2014;89:892-5.
Harden RM, Crosby JR, Davis MH, Friedman M. AMEE guide no 14: Outcome-based education: Part 5-from competency to meta-competency: A model for the specification of learning outcomes. Med Teach 1999;21:546-52.
Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA 2002;287:226-35.
Mishra A. Medical Exit Exam. The Times of India. TNN; 20 July, 2015.