Recent cases of corruption in India's medical school entrance exams in the state of MP are part of wider problems in the country's system for educating its future doctors, say experts. Dinesh C Sharma reports.
More than 600 000 students in India retook the All India Pre-Medical and Pre-Dental Entrance Test (AIPMT) at the end of July after the test they originally sat on May 3 was scrapped by the Supreme Court following evidence that large-scale cheating had taken place.
A police investigation found that a criminal network had gotten hold of a leaked copy of the question paper and sent the answers to candidates via messaging app WhatsApp during the exam. The network had provided several candidates (who had each paid up to 2 million rupees) with tiny Bluetooth devices, vests tagged with microSIM cards, and wristwatches fitted with cameras, so that answers could be relayed in real-time to them via wireless devices. Medical students and doctors were hired to solve the multiple-choice questions. Acting on a tip-off, police caught seven of the people involved while the entrance test was being sat.
Police investigations revealed that the head of the network operated from Behror, Rajasthan state, while his clients were spread across several states. The gang responsible had previously leaked admission test papers for postgraduate medical courses of the All India Institute of Medical Sciences and some state medical colleges.
The Central Board of Secondary Education, which undertakes the AIPMT, has permanently debarred 46 students from taking the retest. “The disclosures, to state the least, are startling and alarming”, the Supreme Court stated in its order that cancelled the rigged test. It justified the retest saying that the examination involved “future generations of doctors who would be in charge of public health, [therefore] their inherent merit to qualify for taking the course can by no means be compromised”.
Fake candidates
Although the full ramifications of the AIPMT scandal are still unfolding, on July 15, the Central Bureau of Investigation began probing a much deeper medical school entrance exam scandal in Madhya Pradesh state after a public outcry over slow investigations by local police. Whistle-blowers alleged that some students gained admission into government medical colleges without actually sitting the entrance test. The candidates had paid huge amounts of money to middlemen who arranged for medical students or doctors to sit the test. The middlemen also arranged fake identity documents with the help of insiders from the government agency—Madhya Pradesh Professional Examination Board (MPPEB)—which oversees the test.
Picture from Hindustan Times
Anand Rai, a Madhya Pradesh government medical officer and whistle-blower, told The Lancet: “I got a whiff of wrongdoing when I appeared for MD entrance test in 2005. I noticed that top rankers in my class did not have good academic background, had influential or rich parents, and came from one hostel block of a particular medical college. From then onwards I started tracking medical entrance tests and giving tip-offs to police, and finally in 2009 I filed a public interest petition in the Madhya Pradesh High Court seeking an enquiry.”
Under pressure from judiciary and the opposition parties, the Madhya Pradesh Government began probing the scandal in 2013. So far, it has led to the arrest of more than 1000 medical students and doctors named in dozens of criminal cases filed by the state police. Investigators have confirmed that 295 students who did not sit the entrance test were admitted to government medical colleges and 721 to private medical colleges between 2011 and 2013. The state government scrapped the MPPEB test in 2013. AIPMT scores are now being used by government colleges to fill all their seats and by private colleges to fill 42% of their seats; the rest are filled through a separate admissions test overseen by the Association of Private Dental and Medical Colleges. However, this test has also come under suspicion of corruption in a petition filed in the Supreme Court on July 17.
Rama Baru, professor at the Centre of Social Medicine and Community Health at Jawaharlal Nehru University in New Delhi, and a former member of Medical Council of India's (MCI) ethics committee, said: “What we are witnessing are the results of the criminalisation of medical education, which begins with licensing of colleges by the MCI. Besides the MCI, this criminal nexus includes promoters of private colleges, real estate lobbies, local politicians, and serving or retired doctors from government colleges. Large amounts of money changes hands at every stage of the medical education chain.”
The admission scandals not only affect the quality of medical education but also the practice of medicine, noted experts. “Candidates willing to adopt fraudulent means to get into medical colleges are not just denying meritorious students a chance to study but are subverting the system with money. They can try similar means to clear exams during the medical course as well”, Anant Bhan, a bioethicist and adjunct visiting professor at Yenepoya University in Mangalore, told The Lancet. “Equally appalling are medical students who agree to sit in entrance tests as imposters to help candidates join medical courses. Willingness to be part of a medical education scam does not augur well for their future in the medical profession.
”
”
Dinesh C Sharma reports in LANCET
