Feature: ‘Unequal Footing’ for Kashmiri MBBS students

Protest demonstrations led by MBBS students across Kashmir demanding revocation of the decision to pool post-graduate National Eligibility cum Entrance Test (PG NEET) seats in the ‘all India quota’ appear to have brought to fore the reality of the chaotic aftermath of reading down Article 370, shockwaves of which continue to reverberate across the erstwhile state.

Until J&K had the ‘special status’, students told The Wire, around 537 seats* for PG NEET, which refers to the speciality courses the doctors pursue after finishing their graduate programmes, were reserved only for local candidates. There are around seven government institutions that churn out around 1000 MBBS graduates in J&K every year, who then compete amongst each other for a few hundred PG NEET seats.

However, last month, the Medical Counselling Committee (MCC) under the aegis of the Union Ministry of Health and Family Welfare in an official release said that the counselling for the eligible candidates for NEET PG courses across the country will be “held as per schedule.”

The release also contained two fresh provisions that appear to have provoked the demonstrations.

While reiterating the requisition of 50% ‘all India quota’ in seats across all states, it said that “this year Jammu and Kashmir is likely to participate in All India Quota counselling subject to confirmation from competent state authorities.”

Furthermore, 100% quota in ‘Deemed Universities’ has also been prescribed, which in J&K’s case means the allocation of all such seats at Sher-e-Kashmir Institute of Medical Sciences (SKIMS), a premier tertiary care facility on the outskirts of Srinagar city, to a national level competition.

That, the students claim, translates into the reduction of PG NEET seats from the current 537 to just 204 for locals. (And to only 117 for students competing in the open merit category, when adjusted for another tier of affirmative action system at the local level).

This also means that for the remainder of seats (around 270), the competition will no longer be amongst a few hundred regional aspirants but the 1.5 lakh students who complete MBBS programmes across the country every year.

Kashmiri students fear this will upend their dreams of pursuing medical careers in the Valley. The entry of non-local doctors to the speciality care facilities in J&K might either be hamstrung on account of the language barrier or will prefer relocating to their own cities and towns, leading to a shortage of specialists in the Union Territory (UT), aspirants say.

The protesting students substantiate this assertion by citing a 2017 decision by SKIMS to adopt NEET for admission to its 14 advanced-level DM and MCh courses, opening avenues for candidates from outside the state. As per reports which The Wire could not confirm independently, around 70% of aspirants studying in these super speciality courses at SKIMS hail from other states.

During several interviews, The Wire also came across locals, academics, businessmen and laypersons who were supportive of the move, saying that it will increase the competition and bring in better doctors. But they refused to be identified.

In the politically febrile Kashmir Valley, where all kinds of political activism and mobilisations are subject to certain restrictions, the protests have opened up new avenues for regional political leaders who are competing for influence and traction, especially ahead of the proposed assembly elections likely to be scheduled for the next year.

Nearly all political parties have been vehement about the matter and have slammed the decision and supported the students’ demand to roll it back.

‘Consider the situation’

“We are not saying that we are short of caliber to compete at the national level,” said Murtaza Shah, an MBBS student at SKIMS Medical College. “But before taking such a decision, they should have considered the situation we are in.”

Shah referred to the tumultuous political nature of the Valley. “Our studies are experiencing disruptions repeatedly since the 2016 agitation [after the killing of militant commander Burhan Wani]. After August 2019, Internet services remained either shut or restricted for more than a year. For students doing PG courses, the Internet is indispensable,” he said.

In absence of private coaching centres for PG NEET exams, Kashmiri students shell out anywhere between Rs 30,000-1 lakh to get tutored through online platforms like PrepLadder and Marrow.

“When we face situations like year round closure of the Internet; when our resources and opportunities are unequal, how can we compete at the national level? There’s no equal footing,” he said.

This is not the only worry which seems to have plagued the students. The absence of a legal bond system – which mandates a retention period for specialists after having completed their degree – is another. SKIMS does not have this system, which has meant that doctors, after finishing their super-speciality courses, choose to return to their own home states resulting in the loss to J&K’s health sector.

Most states elsewhere in the country have a proper legal bond system in place which ensures “retention” of doctors. Doctors acting in contravention of this bond are liable to pay penalties that range from Rs 10 lakh to even two crores.

“A medic pursuing PG also gets a hefty amount as a stipend,” said Bilal Yousuf, another student. “These doctors will get their degrees here and then return to their states. In the process, they will also be drawing stipends from the privy purse of the government. They will ultimately have a parasitic relationship with the J&K state exchequer.”

Yousuf also said that they are unhappy with the kind of advocacy they are receiving from political parties. “One politician said that the government should have informed us before holding our exams for PG NEET which was conducted in mid-September. But how will that help? It will only provide respite to this batch. What about the next?”

At the regional level, medical colleges in J&K are likely to allocate 15% seats to the ‘all India quota’ in MBBS courses. This is besides other forms of affirmative action such as 50% reservation of seats for women students, which has no precedent elsewhere in the country.

The National Medical Committee mandates all states and Union Territories to pool such a quota. However, the former state of J&K had been exempted from making such an allocation.

“This is a complete injustice to us as students,” complained Shafaq Shahid, another MBBS student. “Unlike in Delhi, Srinagar has no private medical colleges. It’s not that we won’t qualify but to get to the kind of curriculum and education as our counterparts in the rest of the country experience will take time. There is a disparity and it should have been first bridged properly before such a step was taken. When I was in my pre-finals, the Internet was shut down the whole semester. During my final year, I experienced at least three months of Internet disruption. On top of that, we are now expected to show the same level of competence as students everywhere else.”

These apprehensions are overlaid by other concerns that J&K’s health sector stands to lose if more specialists turn out to be non-locals. “Most patients of SKIMS come from far-flung rural areas. They speak typical Kashmiri and they won’t be able to explain their illnesses in the manner in which they can to Kashmiri doctors,” said Sartaj, a senior doctor.

Substantiating this point, Haleem Khan, an MBBS student from the Rajouri region of Jammu said that he finds it difficult to interpret the Kashmiri patients during examinations. “Even I face the problem of language here in Kashmir, to say nothing about the doctors who are from other parts of the state,” he said.

Political parties in Kashmir are unanimous in their opposition to the MCC’s decision. “They must consider a reverse quota in all India colleges for J&K students,” said Adnan Ashraf Mir, spokesperson, People’s Conference. “MCC will have to either reconsider this decision or the number of seats allocated under the quota will have to be compensated. Besides nowhere in the country is there a 50% reservation for female students. We are putting a lot of students in disadvantageous positions. We will take this issue up with the Lieutenant Governor and request him in his official capacity to call off this decision.”

The National Conference has also denounced the move, saying that “unelected governments” must refrain from taking big moves that have far-reaching consequences. “Are people of J&K not the stakeholders in the decisions about their lives?” asked Ifra Jan, additional spokesperson NC. “After the deadly second wave, any reasonable government would have started working on health infrastructure on the war footing. And here, we have steps which put even the existing minimum healthcare at a mammoth risk.”

The People’s Democratic Party termed it a “systematic decimation” of the healthcare sector in J&K. “If non-local specialists study here and then leave this place, who would serve the people of Kashmir?” said Najmu Saqib, spokesperson, PDP.

The Wire rang Shafiq Ahmed Raina, chairman of the J&K Board of Professional Entrance Examination (JK BOPEE). “We are only the implementing agency,” he said, “We cannot comment on protests. If government writes to us saying this should be implemented, we will do that.” Courtesy The Wire