Members of various student organisations stage a protest against the alleged irregularities in the NEET-UG 2024 entrance exam result, in New Delhi.
Credit: PTI Photo
New Delhi: For more than four years, Sanna had the same daily routine - wake up at dawn, study up to 14 hours a day, eat and sleep - all in an effort to crack a tough exam to get into one of India's premier public medical colleges.
But after two unsuccessful attempts, she has lost hope she can win a highly sought-after spot, especially after the national entrance exam was hit last month by allegations of irregularities, including paper leaks.
"I have zero confidence in this system. What is the point of slogging when others can get ahead by unfair means?," Sanna, 20, who asked to be identified only by her nickname, said by phone from Rajasthan.
"I don't have the patience, time or money to pursue (a medical education) in India."
Instead, Sanna wants to study abroad in China, Russia or Kazakhstan, increasingly popular destinations for Indian students struggling with the high costs of prepping for exams and tuitions.
Exam leaks are common in India, where millions scramble to get into top government colleges to secure degrees that can line them up for well-paying, stable jobs in a country grappling with an employment crisis.
Sanna was one of the 2.4 million people who took the National Eligibility Cum Entrance Test (Undergraduate), or NEET-UG - the only gateway for admissions into undergraduate medical courses in India - in May, competing for more than 100,000 spots in government and private colleges.
An unusually high number of students scored a perfect 720 score in the exam, sparking concerns of possible cheating, and irregularities in conducting and grading the NEET-UG.
Student groups have staged countrywide protests, launched social media campaigns and have gone to courts to demand investigations and a re-test.
The National Testing Agency (NTA) which administers the test said in a statement that there were isolated cases of cheating, but has denied paper leaks and said "the integrity of the examination was not compromised".
The increase in top scorers reflected a rise in the overall number of test candidates, it said.
Neither the NTA nor the education ministry responded to requests for comment.
'Flawed system'
Despite decades of rapid economic growth, India has been slow to reform its higher education system in which aspiring medical and engineering students spend months, or even years, cramming for highly competitive entrance exams that often leave them burnt out and in debt, academic experts said.
"This system is completely flawed. It is not fair, just or meaningful," said Anita Rampal, a former dean at Delhi University, who is also a member of the New Delhi-based India Academic Freedom Network.
"It takes so much out of you in terms of your motivation, effort, money, family resources, your sense of being."
Students can shell out large sums of money to attend test-prep centres and pay for course material. But only a fraction get into public colleges.
Of the total seats for medical students, about 60,000 are at state-run institutes, with the rest at private ones. Students race to government colleges for their affordable fees.
Top scorers in the NEET-UG win placement at public colleges, where a five-year medical course can cost between Rs two lakh and Rs 10 lakh. Private college tuition can cost more than 10 times that.
Sanna said she scored below 500 on two entrance exams, meaning government colleges were not an option.
For middle-class students like Sanna who cannot afford private tuition, programmes in nearby countries offer a cheaper option.
"At least that will get me some return on my investments," said Sanna, whose parents spent more than Rs five lakh for her exam preparation.
In 2022, more than 750,000 Indians went abroad to study - almost double the number in 2018, according to the foreign ministry data.
There is no publicly available data on the number of Indians studying in foreign medical programmes.
But academic counselling websites estimate about 25,000 students leave every year to study medicine in places like Russia, China, the Philippines, Kyrgyzstan and Kazakhstan.
'No real value'
Gagan Arora, a 23-year-old from Rajasthan studying at Asfendiyarov Kazakh National Medical University in Almaty, said his five-year course cost less than Rs 50 lakh, including lodging and meals.
"It is budget-friendly, the place is beautiful and the people are great," said Arora, who has seen a surge of Indians come to Almaty, Kazakhstan's largest city, over the past four years.
But drawbacks include language barriers in classes and a lack of hands-on learning, which is a major focus in Indian medical training.
"Without practical exposure (in hospitals), this degree is just a piece of paper, it has no real value," said Arora.
He would have preferred to study in India.
Arora worries that gaps in his education will make it difficult to clear India's mandatory screening test - the Foreign Medical Graduates' Exam (FMGE) - that allows them to practice in the country.
Similar issues were echoed by at least four other Indian medical students - one in Kazakhstan, one in Georgia and two in Kyrgyzstan - who spoke to the Thomson Reuters Foundation on the condition of anonymity over fears that it could hurt their future job prospects.
About 80 per cent who take the FMGE fail, according to government data.
Students, teachers and health experts called on the government to open more medical colleges.
Making medical seats more accessible, including to rural and low-income Indians, would break barriers that hinder equal access to medical education, Oommen C Kurian, a senior fellow at the Observer Research Foundation think tank, wrote in a research article in January.
Others, including Rampal, urged an overhaul of the NEET-UG to prevent malpractice, and regulation of the fees charged by private colleges and coaching centres.
"We cannot push these issues under the carpet anymore," said Rampal. "This really needs to be the point of no return. We must start afresh."