Education or Horse-race? Understanding NEET-PG Postponement: Analysing the Impact, Exploring Solutions and Bigger Realities of Life

NEET-PG was postponed at the last minute, resulting in a wave of reactionary comments and criticisms. This article aims to analyse the root causes behind the event, possible long-term solutions, and the impact it has had on thousands of young, bright minds across the country.

The last-minute cancellation of this high-stakes exam has been sensational news in the world of Indian medical education this week. Around 1 lakh qualified doctors were looking forward to the exam, most of them having taken a break in their careers purely to prepare for it. It must be noted that most of them did not earn any money during this phase, nor did they engage in active clinical practice. They literally invested a year purely for this three-hour exam. The stakes of getting a choice of career depend entirely on the outcome of this exam?—?you get a better rank, you deserve the seat you preferred; otherwise, you don’t.

Though hard to believe, it is a fact that most of these well-educated professionals were almost completely dependent on this exam.

What is the impact that it has? Candidates are unaware of the new date for the exam. This means that they might have to resubscribe to the platforms they used for preparation, which costs money?—?remember that most of these NEET-PG aspirants are not employed. The postponement has a huge impact that can happen both directly and indirectly.

Why India still delivers quality training?: The Indian population is huge. It is not practical or justifiable to compare a country with 75 years of independence to those which have been ‘free’ for centuries. Clinical exposure in a good public sector hospital in India would give one the ability and confidence to perform well anywhere in the world, thanks to the large population and the traditional diligence.

Where does the issue actually lie?—?Is NEET-PG a Fair System?

Managing a huge population needs efficient systems, and these systems should be based on values. Rather than looking at this issue purely as a ‘failure of operation,’ it might be useful to consider this as an opportunity to reflect on whether this is a ‘fair operation’ at all.

NEET-PG is a common medical entrance exam for entering residency in any specialty. No matter if you are interested in Histopathology, Neurosurgery, or Community Medicine?—?you have the same set of questions and you are ranked accordingly with every candidate. Get a top rank, and you get your specialty of choice. Otherwise, you have to compromise your choice with the specialty that is available for your rank. Or, you start from scratch and sit for the exam next year. Do you think this is a healthy system?

What can we do to address this?

What an individual can do: Let’s talk about some basics first. Forget your identities for a moment. Forget that you are trained to be a doctor.

Do you think that it is a wise idea to centre your entire life around a 3-hour test?

Obviously, the results are of high stakes. The career opportunities are accessible only through the exam. It would be misleading if someone advocated against sitting for the exam.

What is suggested here is purely to emphasise not making this exam the Sun of your solar system. You should be the Sun of yourself, not anything else.

One has to take the exam as if their life does not depend upon it. Like a game. Obviously, in the current scenario, with the societal construct where doctors without ‘PG’ are looked down on, this state of mind is quite challenging to adopt.

What can we do?

1. Working post-MBBS: Taking a career break to prepare for an exam is extremely unusual outside India. Exams are considered milestones to be collected along the journey, not the destination itself. How about all doctors decide to work at a junior level after MBBS for some time, develop real practical experience and knowledge, and prepare for this exam on the side?

There are several advantages of working soon after you graduate:

• You will have continuity of clinical practice, which means you will not lose touch with seeing patients. No matter how many hours you put in front of coaching classes and books, the experience gained by seeing a patient is always incomparable.
• You will have some money of your own, which will teach you that life is more than your career. Living on your own shows you the real face of the world and offers you the opportunity to learn the basics of managing finances. This will empower you to rise above the level of a ‘doctor’ to a quality human being. You can develop your managerial and administrative skills as well.
• You can explore various fields and figure out which specialty resonates with you. You tend to learn and explore more naturally when you don’t have the compulsion to do them. You have the flexibility to switch roles accordingly.
• You will have an upper hand when you enter residency, as you will already have a good amount of clinical experience beforehand. You will also have better communication skills and better subject matter knowledge.
• If you are interested in research, you can work as a research officer in quality institutions, where you will gain a different perspective on what science really is and how it is changing. Your perception of medicine as a science will alter to have a better understanding.

Some practical factors that might seem to be hindering this path:?

Opinions by family, friends, and?society:?

An average human society is rooted in the values, recognition, and opinions given by others, due to the evolutionary causes we discussed earlier. When our peers enter residency and we choose to work, there will be external pressure for sure in most cases, this is because we are fearful of not being able to enter residency at all.

This might be true when you are the only person opting for this alternate path. However, when everyone starts to prefer working soon after graduation, the scenario will change.

Why is NEET-PG super-hard?? Can we do something about?it?

The difficulty level of the exam is super high because the competition is high. Competition is high because the demand is high, and supplies are limited. The basic principles of economics apply here: when the demand becomes less, the competition automatically becomes less, and the difficulty level naturally comes down, incorporating more quality questions?—?nobody will ask questions like the length of the eustachian tube in females.

Here is where the government’s role comes in. The board should ensure to make questions that are not easily answerable by rote memorization of facts and concepts. They should evaluate one’s clinical experience and quality in a holistic way. It can be worthwhile to consider what is being done in the West.

Pathway to an ideal?scenario

Consider establishing separate pathways for different specialties. Say if someone is interested in Surgery and they want to enter Surgical residency, they will have to apply for ‘Surgical Training.’ The candidate has to demonstrate their commitment to Surgery in their application, by relevant work experience, observerships, or research. The candidates can be evaluated by an exam unique for Surgery and maybe interviews to assess the genuineness of interest and quality of the person.

If we can adopt the medicine, education, and political system from the West, why can’t we adopt this training pathway system if this is something that might be transformative?

Exploring the root cause behind the issue?:

The issue here is not the way of conducting the exams. The issue here is the principle behind this exam itself. One size never fits all. Adding to this chaos, we have numerous platforms that are incredible sources of quality information, however, unfortunately, worsening the issue by feeding information passively into your notes and devices, leading to increased performance in the MCQ exam, leading to inflated ranks.

Obviously, one who takes a year off, shuts their doors to the external world, and devotes their mind, body, and energy to this three-hour-long exam will have better chances of getting a higher rank when compared to one who chooses to increase their clinical experience by working and exploring the aspects of the real world.

Devoting an entire year or two will make one a better reservoir of information. The downside is, the independent thinking process declines gradually for an average person. If one is used to easily digestible information, the process of seeking and questioning gradually declines and blunts off.

This is why the Western world is writing books, and many Indian systems excel at mastering and following them. Rarely do we question them. The Western world produces quality evidence and books because they encourage the habit of seeking.

Knowledge Consumers to Knowledge Producers: We are all excellent consumers of knowledge. We memorise facts, understand concepts, and are well-versed in passing on this information to subsequent generations. How about evaluating the quality and genuineness of existing knowledge and generating new knowledge?

Science is all about research. Research encourages the habit of seeking. Seeking is the one quality that distinguishes human beings both inwardly and outwardly.

Exploring real freedom?—?have we really evolved inwardly?

We are excellent and unstoppable in accumulating knowledge about the external world, be it medicine, science, engineering, finance, or politics. Yet, do you think that all knowledgeable people are liberated and exuberant? Undoubtedly no. One reason is that we know, or constantly strive to know everything about what’s outside?—?the latest technology, updates in novel drugs and diseases, innovations in space, and possibilities of living on Mars. Yet, there are still insufficiencies, leading to distress, fear, and hatred.

We have progressed outwardly from hunting animals in the wild to building satellites. However, inwardly, we are still the same?—?we have the same fear, insecurity, and insufficiency?—?in different dimensions.

Early humans were fearful of wild animals, while modern humans are anxious about deadlines, careers, success, and failure.

In the past, individuals felt insecure if they were not part of a tribe, as isolation decreased their chances of obtaining food, reproducing, and ensuring safety. Similarly, today, people crave recognition, pride, and praise to feel like a vital part of a group.

In the past, jealousy arose when others had more food, leading to attempts to take it. Today, people are envious of others’ success and seek personal benefits from it.

There are numerous examples like this. Our minds have always been so occupied that we are never free to think above the level of material knowledge. We have been programmed to believe that knowledge means accumulating information and success means applying that accumulated information to earn a good living. Our education system and societal constructs endorse this. It definitely leads to better chances of survival by ensuring food, security, and recognition. However, does it lead to inward liberation and unconditional freedom?

It is a never-ending race. The race might seem to end after securing a PG seat, but it doesn’t. It continues as long as one views life and career as a race.

If not NEET-PG, what else? What’s the solution? Should I move out of the?country?

Absolutely not. Moving out of the country is a big decision and it has to be one’s independent choice, made completely free from external influences. This is a period of high vulnerability and uncertainty, where there are increased chances to be carried away by ‘attractive’ influences. Seek information from reliable sources and make an informed decision. No place is certain. If you decide to work and train outside India purely because of the uncertainty of NEET-PG, that might not be the best rationale for all. No place is absolutely free from volatility, and they are often in different shapes. It all depends on your risk appetite.

Aligning Career Paths with Personal?Values

See what is more important to you in life. Forget that you are a doctor and imagine that you are free from societal constructs. See what you really value and care for. Spend your time creating something you really value. See your current possibilities and find a way to match them with your values. Otherwise, take a different route.

Be aware of the reasons behind what you think and do. Understand what you really are. Observe your fears, see them separate from you, and acknowledge them. Once you observe them, they tend to disappear gradually. When there is no fear, there is unconditional freedom.

More importantly, never passively follow anyone or any book, video, or posts, including this article. Following something without questioning is not the best use of highly evolved human faculties. Free your thoughts, observe the patterns you have been programmed with, and seek for yourself what real life is about. Then decide your thoughts and actions.

If you are really aware of what you are doing, and have your own rationale, being aware of the patterns and being absolutely devoid of fear, then you cannot be defined or restricted by the illusions of success or failure. You will experience unconditional freedom and love, which is the highest experience of existence.

Embracing a Balanced Perspective on Exams and?Life

Thus, one will benefit by taking this exam as a part of their life, not life itself. It is important to have a broad mind, with a view of the higher truths. A person taking the exam with such a mindset will enjoy the process for sure, leading to a better overall experience.?

Life is all about the profoundness of one’s experience, isn’t it?