NEET is often described as a standardized nationwide examination, yet it operates within a framework of unequal access, tilting the balance in favour of CBSE-educated students and those who can afford costly coaching, while disadvantaging state board and rural learners.
Opponents contend that the exam emphasizes rote learning rather than qualities like empathy, adaptability, and resilience, traits that are essential in real-life scenarios, particularly in rural medical practice.
Beyond policy-level discussions, NEET is reshaping family choices, student mental health, and long-term aspirations.
In Tamil Nadu, NEET (National Eligibility cum Entrance Test, a medical entrance exam) is no longer unfamiliar. It has become a deeply embedded, yearly occurrence—arriving every May with a mix of inevitability and anxiety. Public protests are no longer unusual. Equally concerning are the recurring narratives that precede them: students overwhelmed by stress, families rethinking ambitions, and a repetitive cycle of anger followed by reluctant acceptance.
What has evolved is not the exam’s format, but its influence on everyday decisions. NEET is no longer just a Class 12 milestone; it determines how early students begin preparing, which education boards they select, whether families relocate, and how much they can invest in coaching.
For parents like Jayanthi Thiagarajan, the concern is no longer about the fairness of NEET in theory, but its practicality in real life. “Actually this year I stopped her NEET class as I felt she is struggling so much with both the portions,” she explains. The “both” refers to the CBSE syllabus her daughter is officially studying and the parallel NEET syllabus, which is more demanding and less forgiving.
This dual academic load represents one of the less-discussed divides within the NEET system. While it is promoted as a uniform national benchmark, the preparation pathways are far from equal. CBSE students, whose curriculum closely aligns with NEET, experience a smoother transition. Meanwhile, state board students—especially those in government schools—must essentially adapt to a second academic framework, often relying on private coaching that may be expensive or geographically inaccessible. As a result, the ability to prepare effectively becomes a sign of privilege.
Dr. Vivek Karthikeyan, a Family Medicine specialist and rural practitioner in KC Patti, Dindigul district, observes the long-term consequences of this system. “We must understand that the practice of medicine is both art and science,” he notes. “While students first learn the scientific aspect—facts, figures, and concepts—the actual practice leans more towards human connection, soft skills, and real-world experience, which unfortunately receive less focus in medical education.”
He believes this imbalance begins at the admission stage itself. “Given the gap between what is taught and what is practiced, entrance exams like NEET contribute very little to the medical profession,” he says. “The exam format encourages memorisation, turning students into fact collectors rather than individuals with resilience and grit.”
His criticism becomes sharper in the context of rural healthcare. In areas like KC Patti, medical practice demands adaptability, cultural understanding, and trust—qualities that are neither assessed nor necessarily developed through high-pressure, multiple-choice exams.
“The coaching-driven preparation model is highly technical and accessible only to a privileged segment,” he adds. “It does not equip students for the realities of rural medical service.”
The disconnect between NEET’s evaluation criteria and the demands of the medical profession has long been central to the debate in Tamil Nadu. Prior to 2017, admissions to medical colleges in the state were based on Class 12 board exam scores. While that system had its own drawbacks, it enabled broader access. Students from government schools, tribal communities, and marginalized groups entered medical education in notable numbers, contributing to a more inclusive healthcare workforce.
NEET changed that dynamic. Its reliance on a CBSE-oriented syllabus and intensive coaching systems shifted advantages toward those with better resources. This has sparked ongoing concerns about equity and representation in the medical field.
The human impact of this shift is often reduced to statistics, but even those figures are alarming. Since NEET was introduced, Tamil Nadu has witnessed multiple student suicides linked directly or indirectly to exam-related pressure. Each incident is unique, yet collectively they reveal a troubling pattern that is hard to ignore.
Despite widespread criticism, NEET has remained firmly in place—legally, politically, and institutionally. Its supporters argue that standardisation ensures merit, prevents opaque admission processes, and establishes a national benchmark that promotes mobility.
However, the very definition of “merit” continues to be questioned.
Politically, Tamil Nadu has consistently opposed NEET. As political analyst D.I. Aravindan explains, “The official stance of Tamil Nadu’s mainstream political parties remains strongly anti-NEET… framed as a defense of state autonomy against perceived federal overreach.” Yet this resistance has encountered the practical constraints of India’s federal system.
This has created a noticeable gap between political messaging and public behaviour. “A clear divergence has emerged between political discourse and civic pragmatism,” Aravindan observes. While earlier public sentiment aligned with political opposition, “students and parents now increasingly view NEET as an unavoidable reality.”
This shift is evident not only in growing registration numbers but also in the rapid rise of coaching centres across the state. What was once resisted is now being adjusted to. Families may not fully agree with NEET, but they are learning to work within its framework. Aravindan describes this as a “fatigue of expectation,” where political resistance coexists with a practical inclination toward the “path of least resistance” in securing children’s futures.
However, this adaptation is not evenly distributed. Those with access to quality coaching, CBSE-aligned education, and financial stability are better equipped to navigate the system.
For others, the consequences are far more serious. As Aravindan highlights, “This transition has not been uniform. While those with access to coaching have managed to adjust, it has simultaneously widened the equity gap for students from rural and economically weaker backgrounds. For them, this ‘reality’ represents not just a change in exam structure, but a systemic barrier that limits their ability to compete at a national level.”
In essence, the system continues to claim uniformity while producing increasingly unequal outcomes—a contradiction that political stakeholders may eventually need to address.
Returning to his clinical experience, Dr. Karthikeyan suggests an alternative approach to selecting and training future doctors, especially for rural service. He proposes a model similar to civil service examinations: “A three-stage process involving prelims, mains, and interviews could help identify and train candidates genuinely interested in rural healthcare, thereby improving equity across urban and rural populations, as well as across socio-economic groups.”
For families dealing with these realities, decisions are rarely ideological. They are immediate, practical, and often emotionally taxing. Should they invest heavily in coaching at the risk of financial strain? Should students manage dual syllabi at the cost of burnout? Or should they step away, as Jayanthi did, and redefine success beyond the narrow path NEET appears to dictate?
These choices are not made in policy discussions but in homes—during late-night conversations, at dining tables, and in quiet moments of understanding a child’s limits.
In Tamil Nadu, NEET is no longer debated as a possibility—it is an established reality. What continues to evolve, however, is everything surrounding it: who prepares, who persists, who withdraws, and who never enters the competition at all. When an unequal system starts to feel inevitable, resistance does not vanish—it transforms. Over time, that transformation can resemble acceptance. And in that process, merit itself becomes something shaped by access—costly to attain, uneven in preparation, and emotionally demanding to endure.
The discussion has moved beyond just an examination. It now concerns the kind of doctors being trained, the nature of the healthcare system being built, and the many individuals who, early in life, begin to understand their place within it.