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 Table of Contents  
COMMENTARY
Year : 2018  |  Volume : 5  |  Issue : 4  |  Page : 317-318

Do we need to align NEET with desired outcomes?


Department of Pharmacology, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India

Date of Web Publication14-Nov-2018

Correspondence Address:
Juhi Kalra
Department of Pharmacology, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjhr.cjhr_112_18

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How to cite this article:
Kalra J. Do we need to align NEET with desired outcomes?. CHRISMED J Health Res 2018;5:317-8

How to cite this URL:
Kalra J. Do we need to align NEET with desired outcomes?. CHRISMED J Health Res [serial online] 2018 [cited 2018 Dec 10];5:317-8. Available from: http://www.cjhr.org/text.asp?2018/5/4/317/245443



A lot of discussions have hovered around NEET, the all India PG entrance examination regarding its relevance, credentials, method of conduct of examination, replacement with the National Licentiate Examination, loss of social mission along the way, and so forth. More opinions have come from educationists and policymakers, rather than from students who are one of the most important stakeholders in the examination. It is as if they are in a control room that has lost all wires of connectivity, where they can hear but will not be heard. We have created psychological torture cells for our students by asking questions focusing on rare syndromes, mere recall in the absence of reasoning,[1] on recent advances rather than on well-established facts that have raised the difficulty index at the cost of utility of such an assessment. Many of these questions cannot be solved by experts themselves, leave aside the students. Moreover, medicine is not a theoretical stream, but it is a practice-based stream where clinical skills need to be taught and assessed. Hence, single-point assessments are not valid or reliable and are prone to high error rates.[2],[3] These examinations carry high chances of being unfair because even countries that have well-established systems in place have raised doubts about the probability of examination being fair.[4] It is sad to see a full-fledged doctor sitting in cramped up spaces, taking crash courses in suffocating rooms collecting heaps of theory without a promise for success in examination or in real life. These purely MCQ-based entrance examinations have become eternally sacred and fanatically resistant to change. Since “assessment drives learning,” the aspirants of higher learning have locked themselves up in the room to reach the ever-receding target. This has snatched away precious days and years from their lives that could have been spent serving the community. These examinations are not even helping us clear the raucous of the ever-enlarging gap of poor doctor–patient ratio in India? After 4½ years of rigorous schedules and infinite syllabi, the intern that once swirled around a senior resident to learn skills such as intravenous cannulation or a Ryle's tube insertion and felt elated hosting tea and pastry with his/her meager stipend in the college mess, has been lost forever.

We have had a robust medical education system in India that has not only benefited India but has also provided excellent doctors world over. I do not say that all is well and that we need to stay frozen in the glorious past. I endorse that change is long overdue, and reforms are needed, but only if they will be gentle enough to nourish rather than the one meant to uproot. Radical changes such as licentiate examination to which the UK has already raised brows and countries with established systems are questioning it, why should these questionable systems be our shield, are we still happily reticent with our colonial hangover?

The simple solution to it is to restructure the curriculum. A hybrid curriculum that maintains the strong theoretical base but has theory built around the objective of making a student competent in all domains will make it a sustainable curriculum. Changing to a complete competency-based curriculum will, however, be another mistake. Embedding competencies in the existing curriculum is the only answer. Five years is a good time to help practice and acquire the competencies in the right context. Harden has suggested simulations as one of the ways to train on crucial life skills as they have been successfully used in the aircraft industry and hence can be used to train medical students for teaching the required learning skills and dealing with common emergencies.[5] Competencies will have to be redefined based on our societal needs and checklists prepared for uniform certification standards. Build and strengthen theory around the competencies and discard the redundant theory. Maintain logbooks and e-portfolios.[6] Videos of the certified doctor performing the skill can be attached with the e-portfolio as a proof of having acquired the right competency and also to help to revisit and improve. Softwares can be designed that check the uploaded videos and give scientific, unbiased feedback based on the predefined checklists prepared by experts. Competency acquisition should be enough of criteria to practice with dignity and will bring along a culture of professionalism and ethics too. It is time we restructured the curriculum because the fault lies with the curriculum and not with the doctor per se. We can work upon the desired endpoints and the roles for an Indian medical graduate mentioned so aptly in the graduate medical regulations 2012.[7] However, sadly, it is only a diligent piece of work on paper until actualized and incorporated into our existing curriculum.



 
  References Top

1.
Gronlund NE, editor. Assessment of Student Achievement. 8th ed. Boston, MA: Pearson Education; 2006. p. 3-13.  Back to cited text no. 1
    
2.
van der Vleuten CP, Schuwirth LW. Assessing professional competence: From methods to programmes. Med Educ 2005;39:309-17.  Back to cited text no. 2
    
3.
Schuwirth LW, van der Vleuten CP. Different written assessment methods: What can be said about their strengths and weaknesses? Med Educ 2004;38:974-9.  Back to cited text no. 3
    
4.
Ricketts C, Archer J. Are national qualifying examinations a fair way to rank medical students? Yes. BMJ 2008;337:a1282.  Back to cited text no. 4
    
5.
Harden RM. Trends and the future of postgraduate medical education. Emerg Med J 2006;23:798-802.  Back to cited text no. 5
    
6.
Carraccio C, Englander R. Evaluating competence using a portfolio: A literature review and web-based application to the ACGME competencies. Teach Learn Med 2004;16:381-7.  Back to cited text no. 6
    
7.




 

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