Coming Clean: The NEET business and a look at ecosystem it has spawned

For a year, Tathagat Awatar woke up at dawn and spent the next six hours confined to his room looking at his laptop screen. After a quick lunch, he would get back to his screen for another six to seven hours. The day ended with a brief chat with his parents, dinner, and bed.

This routine did not do much for his social life, but it got him 720 out of 720 in the National Eligibility Cum Entrance Test (Undergraduate), or NEET-UG of 2024. 

Awatar attributes his success to an edtech company in the country’s burgeoning test-prep market. "I don't think I would have achieved this without them," he tells Business Standard.

On Monday, the Supreme Court started to hear petitions about alleged irregularities and paper leaks in this year’s NEET-UG test, conducted on May 5. This concerns no less than 38 petitions. Rahul Gandhi, Leader of the Opposition in the new Lok Sabha, has been raising the issue and expressing concern for the aspirants.

Conducted by the National Testing Agency, an autonomous government body, NEET-UG is now the sole test for admissions to medical colleges in the country, marking a shift from a two-tier selection process to a common examination. Until NEET came into the picture, aspirants appeared in the All India Pre-Medical Test and multiple state-level exams.

In 2013, the Apex Court suspended NEET's implementation, reacting to petitions filed by private colleges which feared a loss of institutional autonomy. Later in 2016, it was restored after a five-judge Constitution Bench recalled the earlier verdict and allowed the government to implement the common test. From the endless lists of exam applications to running from one teacher to another for selective tutoring, medical preparations were an adventure until this centralised test came along.

There are 704 medical colleges in India, offering a combined 109,170 seats, according to the National Medical Commission, a statutory government body that regulates medical education in the country. The tally of Central, government, private, and deemed colleges stands at 7,382, 264, and 51, respectively. An estimated 2.4 million aspirants took the NEET-UG this year.

Wherever there is so much at stake, an industry usually grows around it. And so it has around NEET-UG, catering to the likes of Awatar, who seek their goal through test-preparation institutes. Allen Career Institute, Resonance, Bansal, Aakash, Career Point, Physics Wallah, and Unacademy are some of the big fish in the pond. And there are too many small fish to name.

Big fish, small fish

Take, for example, the Delhi-based Study Point, housed in a 20x20 feet room atop a noisy market in Laxmi Nagar, a bustling locality across the Yamuna in East Delhi. A five-minute stroll around the nearest Delhi Metro station will show you many such rooms housing coaching classes announced by hoardings and posters.

A year’s NEET preparation at such an institute would cost around Rs 80,000 to Rs 1 lakh. But there are discounts, packaged as “scholarships”. Says a person from one of these institutes: “If the aspirant has scored well above 80 per cent in his class 12th, they would get a 25 per cent discount on the fees. And this can be negotiated further.”

Apparently, there is market research and internal calculations deciding the quantum of discounts.

Albert P'Rayan, an education columnist, says NEET has led to the proliferation of several coaching institutes. Several schools tie up with coaching institutes to start an integrated programme. "These institutes favour the urban and rich. Institutes charge fees up to lakhs. And ultimately the whole debate boils down to affordability versus meritocracy," he says.

Ritika's (she does not want to divulge her second name) parents had to take a loan to pay her coaching fees. But with her current score, she fears that she might have to opt for a private college.

The fear is genuine. A Bachelor of Medicine, Bachelor of Surgery (MBBS) degree from a private college in India would cost Rs 70 lakh to Rs 75 lakh, according to a data analysis by Careers360, an information provider on higher education. The same degree would cost around Rs 6 lakh in a government college. 

The cost factor

A 2023 report on the Indian Coaching Classes Market by Infinium Global Research LLP, a consultancy firm based in Pune, says that for numerous students and families, especially those with a low income, coaching expenses are prohibitive. Average preparation cost ranges from Rs 70,000 to Rs 2 lakh. The smaller, single-centre institutes are cheaper and dole out “scholarships”.

“The exam prep market is very competitive, and in front of these giants we have no choice but to reduce the fees,” says a person working with one of the smaller institutes.

According to Infinium, the coaching market was valued at Rs 58,089 crore in 2021 and is expected to reach Rs 1,79,527 crore by the end of this decade. The firm projects the industry's growth at a compound annual growth rate of 14.07 per cent during 2023-30.

NEET's cut-off for medical seats hovering around 20 per cent, as opposed to a general pass percentage of 35 per cent, raises its own issues.

This year, 1,316,268 students qualified for seats in medical colleges. There are only 56,405 seats in central and government colleges. Those who do not get into these colleges, either join a private college or try again next year. 

Not everyone can afford a seat in a private college, as seen in the fee structure mentioned earlier. Maheshwer Peri, founder of Careers360, says this is what reservation for the rich looks like. Having more government seats could solve the problem. 

Medical college admissions are based on the percentile calculated through the marks scored in the NEET, rather than the state board exams marks.

S Anitha, daughter of a daily wager from Tamil Nadu, scored 98 per cent in her class 12th state board exams, but, due to a low score in the common medical exam, she could not secure an MBBS seat. She died by suicide in 2017, at the age of 17.

Not so smooth

Dravida Munnetra Kazhagam has been vocal against the exam since its inception. The party's Tamil publication, Murasoli, in an editorial earlier this year, said 26 aspirants had lost their lives due to NEET in Tamil Nadu alone.

Allegations of anomalies — leakage of question papers, allocation of compensatory marks — in the exam paper surfaced this year. Many aspirants urged the government to conduct a retest.

In an affidavit filed before the Supreme Court on Friday, the education ministry said holding fresh exams would not be rational. “In the absence of any proof of any large-scale breach of confidentiality in a pan-India examination, it would not be rational to scrap the entire examination and the results already declared," the affidavit said. 

To be fair, the intention behind NEET was clean. The government was of the view that bringing in a common medical exam would provide a level playing field, put an end to capitation fees levied by private colleges, and funnel more than 40 exams into one.

Is it about to turn a corner?