The Supreme Court's order allowing Tamil Nadu to allocate 50 percent of the super-speciality seats in government medical colleges to NEET-qualified in-service candidates is being lauded by the medical fraternity as a great incentive for doctors to serve in rural areas. This will greatly impact the accessibility of quality medical care by poor and rural people and also serve as an advantage for doctors working at government hospitals.
This comes at a time when the Tamil Nadu government is waiting for the anti-NEET (National Eligibility cum Entrance Test) Bill that was adopted recently by the state Assembly, to be forwarded to the Centre for presidential assent.
Chief Minister MK Stalin termed the verdict as a victory for social justice. The DMK-led government will continue the legal battle against NEET which has shattered the medical dreams of the rural students, he said in a statement.
The Supreme Court on Wednesday, 17 March, refused to stay its decision allocating 50 percent super-speciality seats in government medical colleges to NEET-qualified in-service candidates.
The super-speciality tests are the basis for selection of students who want to specialise in fields such as cardiac surgery or neurosurgery after their post-graduation.
After a number of hiccups, the test for the super-speciality batch of 2021, which was scheduled to be conducted in November last year, was finally held this January. The counselling process was in a lurch due to this pending order at the Supreme Court.
As many as six petitions against the GO of the state government are still pending adjudication in the top court.
Reservation To Address the Dip in Number of Service Docs Pursuing Super Speciality Courses
The state government has argued that this move will help in encouraging more doctors in government service to purse education to super speciality courses, as the state had witnessed a drastic fall when NEET was introduced in 2017-18. Doctors had warned that if the trend persists, there won’t be enough specialists in government service in a decade.
According to data from the Directorate of Medical Education, less than 17 percent of service doctors got super speciality seats post-NEET, compared to over 40 percent before 2017.
The following graph shows that in the first year of admissions based on NEET, only six percent of service doctors secured seats.
The numbers improved in the next three years, but the representation of service doctors has not reached the pre-NEET figures.
"One of the main reasons for the initial slump is that as a doctor at a government hospital, you are overworked and are working at a disadvantaged location. So it is very difficult to prepare for a competitive exam like NEET," said a senior doctor at a government hospital in Madurai.
However, the number of non-service doctors applying for these courses grew post NEET from 115 in 2016-17 to 126 in 2017-18 and 261 in 2020-21.
It is important to note that, before NEET, Tamil Nadu reserved 50 per cent seats for doctors in government service. However, in 2016, the Supreme Court directed the state to forgo the policy of providing super speciality seats only to domicile students and allow those from other states also to apply.
Tamil Nadu prides over being the state with the most number of doctors in the country with the density of doctors per 1,000 people to be as high as four. The number in Delhi is 3 and 1.5 in Kerala and Karnataka. The state government has pointed out that the reservation policies are the reasons why Tamil Nadu has a robust healthcare system.
"These state-sponsored initiatives are what have kept Tamil Nadu at the top of the race. This will ensures a regular quota of doctors working in rural areas and will save the doctors working at government hospitals to be at the mercy of the black market where medical seats are bought for crores," said PB Prince Gajendra Babu, general secretary of State Platform for Common School System TN (SPCSS-TN).
Reservation WiIl Give Better Chance To TN Students To Serve Home State
A key reason for Tamil Nadu to take up this cause is that the state has the highest number of super speciality seats – 369 – in the country, the number of seats in super speciality courses were increased from 189 in 2014 to 369 in 2020-21. Since NEET was introduced, senior doctors highlighted that many of these seats were filled by persons from other states.
The state government pointed out in the petition to the top court that about 70 percent of non-service candidates do not fulfil the bond conditions of compulsory service. Therefore, the state is unable to sustain institutions and hospitals due to lack of doctors.
"The backbone of Tamil Nadu’s health care system is the 50 percent reservation for service doctors. That is the reason the state government never faces any problem in opening new medical colleges. Even in government headquarters hospitals, a patient gets super speciality care. However, if our own people don’t get a seat in these courses, then how will we have a reliable stable healthcare system? Doctors from other states will study and leave the state so who is left to serve the people?" said the senior doctor.
"Government hospitals ensure close monitoring; there are many cases for doctors to work on so the experience these in-service doctors gain is massive. This order is an incentive to encourage doctors to serve in areas that are in need of medical help," said Dr Mahilmaran, head of Thoracic Medicine at a government hospital in Chennai.
Unfair in an Already Competitive Space: Opposing Students
However, doctors from other states and those working at private hospitals have opposed the order stating that it is "unfair at such a higher education level."
Citing the Supreme Court’s response to the state plea in February, Dr Ravindran* (name changed) said that the reservation is in clear violation of Article 14 of the Constitution as it creates an "impermissible classification" and is contrary to the law.
"No reservation based on caste, domicile, or special provisions should be provided for the super speciality courses as this disrupts the equal playing field. As it is there are very few seats and doctors are expecting that these seats will be open for all candidates. This puts people from other states at a major disadvantage. It is unfair to impose such rules in an already competitive space," he added.
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