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The Supreme Court verdict that brought in NEET gives two important reasons. The verdict observed that medical education should not be a profiteering enterprise and that capitation fees were a form of corruption. And NEET will help prevent that.

The apex court looked upon NEET as a mechanism to prevent undeserving candidates from becoming doctors purely because they could afford to pay exorbitant capitation fees. The court believed that the entrance examination will help deserving students get medical education at affordable cost.

Some years into NEET and politics over the examination, it does appear the test has indeed helped to rein in a system that had no check on capitation fees. In Tamil Nadu, the era of capitation fee seems over although much higher fees is now charged in “white” by private institutions. Money still rules and deserving students are often left out of the race because of mounting costs. Paying for coaching classes only adds to the burden of students.

In Tamil Nadu, the era of capitation fee seems over although much higher fees is now charged in “white” by private institutions

An opinion piece in inmathi.com said that Tamil Nadu has 69 medical colleges, one of the highest numbers in India, with the total seats standing at 10,375. Of these, 37 are government medical colleges with 5,125 seats and 32 are private colleges and universities with 5,250 seats. The State has recently added 11 new medical colleges in the government sector with 1,450 seats. Thus, now Tamil Nadu has a total of 6,575 seats in the government sector which accounts for 12% of all medical seats in India in 2021.

Out of 99,610 students who sat for NEET in 2020, 57,215 students qualified for these government seats that are available after a deduction of 15% for central pool. The tuition fees for a government seat is Rs 13,500 per annum while management seat at a self-financed private medical college or deemed university costs Rs 17 to 22 lakhs per year through fees. This fee is collected in white and it does appear no capitation fee is being collected separately.

A student affixes a passport-size photo of herself on her hall ticket. The way things stand, even if a poor student qualifies for NEET with a high rank, someone who is at the bottom of NEET ranking can still get a medical seat because he or she can pay an exorbitant fee to private colleges whereas those who scored higher cannot because there aren’t nearly enough subsidised seats.

Before NEET was introduced, the rank list for medical seats were prepared based on the cut-off marks derived from physics, chemistry and biology subject marks the student scored in Class 12. Based on merit, the open category and various reservations were filled first in government medical colleges.

Private medical colleges have to set aside 65% of their seats for government quota. Once the government medical college seats were filled, the rank list was then shifted to these seats. The state government laid down fee amounts for that quota. The rest was management quota for which the fee used to be typically Rs 5 lakh to Rs 7 lakh per year in addition to which was capitation fee in the range of Rs 40 lakh to Rs 1 crore. The exact amount depended on how well regarded the institution was, the academic record of the student as well as the references he or she had such as from political leaders.

Deemed to be universities didn’t and don’t have to set aside any govt quota seats for students. They could utilize all the seats at their will. A pass in Class 12 was enough. The institutions fixed tuition fees as well as capitation fees as they wished. The rates were similar to management quota seats in private colleges that came under the Directorate of Medical Education.

After NEET, the merit list derived from the cut-off rank was replaced by the NEET ranking. Based on NEET ranking and reservations, the government medical college seats are filled, followed by the government quota in private colleges. Once they are exhausted, the management quota is filled as pere NEET ranking. Deemed universities need to follow NEET ranking too.

Already having exam jitters, students are put through elaborate security checks before they enter the exam hall, and are not allowed to wear jewellery, dupattas and scarves, or have any buttons on their clothing, which authorities feel could contain cameras or Bluetooth devices that could help the students cheat.

The state Directorate of Medical Education’s website states Rs 2.30 to 2.80 lakhs for government quota seats in self-financed private colleges. But the private colleges often find their own means to squeeze these students admitted under government quota. “They gave six books and 10 note books and charged Rs 1.5 lakh. The college management did not allow us to procure books on our own,” said Lakshmi (name changed) a medical student. These students studying under government quota in private colleges may end up paying Rs 4 to 4.5 lakhs per annum in this manner.

The private medical colleges as well as deemed universities don’t insist on capitation fees but have ramped up the annual tuition fees significantly. The tuition fees which used to hover around Rs 5 to Rs 7 lakh rupees for management quota students before NEET is now between Rs 17 to 22 lakhs per annum. Deemed Universities collect between Rs 22 and 24 lakhs per annum. “Everything is in ‘white’ now. If so, why can’t the government start taxing private medical colleges under the GST? They are for-profit institutions,” says D Nedunchezhian, social entrepreneur and educationist.

Besides, attending coaching classes is a must for passing NEET. The coaching institutions charge some Rs 1 lakh per year.

The Supreme Court reasons that NEET will improve the quality of the candidates getting admitted into medical colleges. Educationists say NEET achieves this goal to an extent but not fully. Take the case of Prabha (name changed) who managed to crack NEET in 2020. But she decided to walk away from a medical seat she could get under management category in a private college. “I couldn’t imagine paying Rs 1 crore as tuition fees and squeeze the finances of my family,” she said.

Once there are no takers like Prabha for these seats, deemed universities and private colleges start filling the seats using walk-ins. “Ultimately, a student who is at the bottom of NEET ranking still can get a medical seat because he or she can pay such an exorbitant fee while the qualified students can’t study due to the huge gap between the rank and availability of subsidized seats,” says Nedunchezhian.

Besides, attending coaching classes is a must for passing NEET. The coaching institutions charge some Rs 1 lakh per year.

“I won’t suggest studying MBBS at management quota. You would get a salary of Rs 30,000 out of which one can’t pay the EMI of educational loan,” says Dr Abinesh.

The National Medical Commission, on Feb. 3, issued a regulation asking private medical colleges and deemed universities to keep the fees of 50 % seats on par with government medical college fees. Though it sounds like a relief to parents, it is very likely to run into a legal hurdle. “The announcement comes at the wrong time when the first round of counseling is complete,” adds Nedunchezhian. College managements say it would be financially impossible to run institutions under such strictures.

Medical practitioners say that the medical degree after spending a fortune would be nightmarish for students from ordinary backgrounds. It isn’t worth considering the fee they pay for the degree. “I won’t suggest studying MBBS at management quota. You would get a salary of Rs 30,000 out of which one can’t pay the EMI of educational loan,” says Dr Abinesh.


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