How The Coaching Lobby Is Destroying Medical Education In India

When a first-year student joins college for MBBS, her eyes are full of aspiration and hope. There is contentment in her heart as she finally enters the world of her dream of becoming a great doctor after battling one of the toughest entrance exams in the country. 

But soon, she realizes that she has thrown herself into another battle—a battle where people are once again fighting to ace the NEET PG. The desire to win this race often surpasses the dream of being an exemplary doctor. 

The coaching culture

Various factors push a medical student, mostly in the second or third year, towards coaching - the exhaustive syllabus, misguidance from seniors (who were themselves misguided by their seniors), peer pressure, and the deteriorating quality of medical education in some colleges. Above all, during the COVID-19 pandemic, the vulnerability of students and futile online lectures provided fertile ground for the deep roots of the coaching industry to grow.

All these factors have led to a situation where many students limit their learning to the screens of their iPads and tablets. It’s a common sight in libraries to see thick books being used merely as stands for mobile phones. College bookshops that did not adapt by selling pirated coaching study materials remain empty. With easy access to recorded lectures on all possible topics, students often confine themselves to their hostel rooms and avoid clinical postings.

Among peers, the extent of one's knowledge is frequently measured by the number of modules covered with clinical skills, patient care, empathy, and ethics not even making to the list of evaluation metrics.

Marketing strategies used by coaching platforms

Just like any other commercial group, coaching platforms use various tactics to promote themselves and create a "FOMO" (fear of missing out) among medical students. 

The process of trapping students begins in the early years of MBBS. It starts by incentivizing them based on their NEET UG ranks. One well-known platform is known to provide a four-year subscription to NEET PG, promising students that this will help them succeed in their PG exam just like it did in the UG exam.

The first year of MBBS is a rollercoaster ride of ups and downs for most students. They are suddenly faced with a bulky syllabus and the complexity of subjects. Initially, it is rare for them to understand the clinical relevance of basic subjects like Anatomy, Physiology, and Biochemistry. Without proper mentorship from faculty and seniors during this period, students can easily be drawn toward coaching classes.

“As soon as my first-year results were announced, I received scholarship offers from major coaching platforms. When I initially declined, they emphasized that the offers were only valid based on my first-year performance. So, I decided to take the subscription at the start of my second year,” says A, a second-year medical student who was among the top 10 students in his first-year exams.

Additionally, batch representatives are selected to act as intermediaries between students and coaching institutions. These representatives receive incentives, including a coupon code that allows them to earn a share of the subscription payments made using their code. These incentives typically range from 7% to 10% of the subscription fees they manage to sell. Some institutions also offer them extensions of their existing plans. Many students are easily drawn to these offers and enjoy the monetary benefits.

Some institutes are also notorious for emotionally manipulating students. A well-established platform is known to romanticize the idea of finding a "perfect study partner" on Valentine's Day. They also excel at filming NEET PG toppers during emotional moments with their families, emphasizing that their secret to success was watching all the videos available on their platform.

As a medical student enters their final year, the pressure to pass final exams and ace NEET PG simultaneously builds up. The anxiety of a final-year student is targeted through the "CRASH COURSES."  For instance, Medicine—a vast and challenging subject—is condensed into a 10-day crash course. 

Free test series are another frequent offering during NEET PG preparation, often clarifying in their terms and conditions that they reserve the right to use students' photos and names for promotional purposes if they achieve a top rank, regardless of the extent of their use of the platform. It remains a mystery how this year's NEET PG AIR 1 managed to attend coaching from every available platform.

Coaching institutions do not limit themselves to academic involvement. They often serve as lead sponsors for annual fests and other events in many medical colleges. In exchange, they expect students to attend their promotional events. Recently, a renowned medical college struggled to secure sponsorship for their annual fest because, the previous year, they failed to fill the hall for the coaching platform’s promotional event.

While coaching industries are leaving no stone unturned to lure students, medical colleges seem to have turned a blind eye to the declining quality of medical education. Most lectures are reduced to reading from PowerPoint slides, and students are not adequately engaged during clinical postings. There is no proper portal for providing feedback to faculty, leaving no avenue for improvement and making students increasingly dependent on coaching classes.

Impact of coaching

Although a student's reasons for seeking coaching are rooted in the desire to excel academically and be a good doctor, unfortunately, coaching often leaves them with a lot of factual knowledge but weak basic concepts. 

They join the race for NEET PG too early, and the desire to be that superhero doctor gets buried under stacks of coaching material. Coaching often helps with acquiring comprehensive knowledge but fails to provide the clinical skills essential for patient care. “We learn all the facts but because we barely learn in clinical postings, it is difficult to translate that knowledge into proper patient care,” said a recent MBBS graduate who was struggling to clinically diagnose and treat patients with common diseases like pneumonia.

The students also miss out on gaining essential soft skills. Empathy, compassion, and good communication, which make a significant difference in patient care and outcomes,  are picked up by observing experienced professors in clinical postings. The impact that this coaching culture has on medical education, patient care, and ultimately the health system is therefore more serious than it is currently considered to be. 

There is an urgent need to address the evident decline in the quality of medical education in India. This problem is compounded by the sudden increase in the admission seats without a proportional increase in good-quality teaching faculty. To address this, vacancies for teachers in medical colleges should be increased, and the existing faculty should be trained in better teaching techniques.

Additionally, it is high time that colleges start restricting the intervention of coaching platforms within their campuses. Misguidance by immediate seniors who themselves have fully relied on coaching should be replaced by proper guidance from competent and experienced mentors. The focus must be shifted towards creating knowledgeable, skilled, compassionate, and empathetic doctors, not just a greater number of doctors.

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Edited by Parth Sharma.
Image by Janvi Bokoliya.