The National Eligibility-cum-Entrance Test (NEET-UG) was introduced with the promise of ushering in fairness, standardization, and meritocracy in medical education across India. At first glance, it appears to have succeeded — replacing state-level chaos with a national-level uniform entrance system. However, a deeper analysis reveals that NEET has also created a more insidious structure of exclusion and privilege, particularly through its poorly understood and easily manipulated 50th percentile eligibility criterion. This mechanism has inadvertently (or perhaps intentionally) legalized the backdoor entry of underqualified but wealthy candidates into private medical colleges, all while marginalizing thousands of meritorious but economically disadvantaged students. What we are witnessing is not an accident of policy but a systemic betrayal of the very values NEET claims to uphold.
The core issue lies in the use of the 50th percentile as the qualifying benchmark, rather than a fixed percentage of marks. In a pool of over 12 lakh test-takers, this means nearly 6 lakh students qualify each year, while India has only about 1 lakh MBBS seats — half of which are in government colleges. This creates a vast pool of surplus eligible candidates.
One may argue that such a buffer ensures inclusivity and provides opportunities for students to enter allied medical fields. But in reality, this bloated qualification base primarily serves a far more cynical purpose to feed the commercial engine of private and deemed universities. These institutions, often owned by political syndicates or business conglomerates, need legally “eligible” students to fill their overpriced seats. Thus, NEET’s percentile-based qualification becomes the legal stamp that converts a failing candidate into a paying customer.
The biggest beneficiaries of this system are clearly the private medical colleges. TheY exploit the legitimacy provided by NEET qualification to offer seats to candidates with ranks as low as 5.5 lakhs This is not an aberration; this is the business model. The eligibility net has been cast so wide that even students performing in the bottom 10% are now a valuable market segment for these institutions.
Politicians too have their share in this ecosystem. Many private medical colleges are directly or indirectly operated by political trusts. These institutions flourish under regulatory blind spots and benefit from policies that expand eligibility but do little to control quality. The illusion of merit-based admission helps them deflect criticism while quietly preserving a robust revenue stream. Middlemen, agents, and education consultants also thrive in this system, legally brokering “management quota” admissions for candidates who would otherwise never see the inside of a medical college based on academic merit alone.
The tragedy is not just in who gets in, but in who is left out. Consider the student ranked 45000, who misses a government seat by a few ranks and cannot afford the exorbitant private fees. Meanwhile, a far less qualified peer with is ranked beyond 5 lakhs buys entry into the same profession. The idea that NEET ensures equal opportunity collapses in the face of such economic discrimination.
This skewed dynamic does not merely harm students .It damages the very fabric of the medical profession. The country is gradually producing doctors who may not have entered the system based on ability or passion, but because they could afford to. This threatens the ethical, academic, and clinical integrity of the profession. Over time, it will erode public trust in doctors and healthcare itself. Furthermore, the use of wealth to bypass academic rigor is fundamentally anti-Constitutional. Reservation in education is meant to uplift the socially backward, not to empower the economically elite. By allowing rich mediocrity to flourish, the NEET system insults both merit and social justice.
The system’s design is cunning in its illusion of fairness. NEET’s structure with percentile-based eligibility, decentralized counseling, and layered quotas appears technical and neutral. But it’s a carefully crafted mirage. The Supreme Court rulings that upheld NEET (TMA Pai Foundation vs. State of Karnataka, 2002; and Christian Medical College vs. Union of India, 2020) emphasized fairness and uniformity. Yet today, the same system legally validates an admission model where the top 10% merit students compete for government seats, and the bottom 40% enter through payment, wrapped in a veneer of legitimacy.
NEET should be made as entrance test not eligiblity test
It is time to end this farce. The first reform must be simple but fundamental: eligibility should match seat capacity as UPSC,IAS exams. Only students up to 1.2 times the total number of MBBS seats should be deemed qualified. This ensures that only competent and competitive candidates enter the counseling process.
If India truly wants to select its doctors based on their wisdom and dedication, and not the power of the bank accounts, it must rethink NEET’s qualification model. Otherwise, the country is heading toward a future where healthcare is not just privatized but intellectually bankrupt.
Final message
NEET as model for national entrance is welcome But, only the methodology is wrong .
Realise , when some one says they cracked NEET, by merit, it may sound as if they conquered mount Everest.
Do you know , what exactly it meant this year? All that is required, is to score atleast 144 out of 720 , ie 19% marks, a score, even the back bencher will be ashamed to tell.
It is strange , only medical profession suffers from this. Can you ever think of buying an IIT, Charted accountant or IAS seats , by making lakhs of students eligible through percentile system of examination ?
References
- National Medical Commission (NMC) Regulations on Graduate Medical Education (2023).
- Supreme Court of India. Christian Medical College vs. Union of India, 2020.
- Medical Council of India data on MBBS seats: www.nmc.org.in
- Times of India (2023): “70% of private medical college seats filled by students with ranks >4 lakh”.
- The Hindu (2021): “NEET: Fairness or False Hope?”
Dr.S.Venkatesan MD 