Dear Editor, We read with great interest the editorial titled “Towards a valid National Eligibility Cum Entrance Test (NEET - UG): Possible implications of the NEET-UG 2025 paper and a framework for Reform in selection for undergraduate medical courses in India” by Ranjan P, Kain S, and Kumar R, published in your esteemed journal (J Family Med Prim Care 2025;14:1575-9). We commend the authors for their thorough analysis of competitive exam design and for bringing the critical issue of medical competitive exams to the forefront, directly impacting millions of medical aspirants. Their discussions regarding increasing stress, over-reliance on coaching, and the rising culture of “dummy schooling” are indeed concerning, and their emphasis on exam validity and relevance is highly commendable.1 We concur with the authors’ assertion that medical aspirants require core competencies in biology, physiology, biochemistry, genetics, nutrition, and foundational psychology, rather than a disproportionate emphasis on advanced physics or chemistry, which are more aligned with engineering disciplines. However, while syllabus reduction is often suggested as a means to alleviate pressure, we wish to offer a nuanced perspective on its potential long-term implications. Medicine is a vast endeavor demanding robust memorization and the integration of extensive foundational knowledge with clinical reasoning. Basic sciences, far from being mere ‘engineering proxies,’ are clinical necessities; for instance, concepts like fluid dynamics underpin cardiovascular physiology, and organic chemistry mechanisms are fundamental to pharmacology.2 Over-simplification of the syllabus could potentially increase the stress of transitioning to the MBBS curriculum, where students face immense information overload. Furthermore, a significantly reduced syllabus might lead to excessive crowding at the top ranks, making the selection process akin to a lottery rather than a truly merit-based endeavor, as highlighted by the authors themselves regarding the NEET-UG 2024 results.1 In line with the National Medical Commission’s AETCOM (Attitude, Ethics, and Communication) module,3 we propose that situation-based questions could be incorporated into the NEET exam. This would assess the emotional maturity and ethical reasoning of aspiring doctors, similar to the ethics-based questions in the United States Medical Licensing Examination, which carry equal weightage as scientific counterparts.4 Such an addition would enhance the exam’s validity by assessing attributes crucial for compassionate, patient-centered medical practice. This aligns with broader calls for reform in medical entrance examinations to address human resources in health for India.5 In conclusion, it is imperative to make NEET fair and relevant, ensuring it effectively filters candidates for academic endurance and retention without becoming unduly diluted. We advocate for a reformed NEET that strategically refines the syllabus, promotes biology, and reduces excessive technical know-how of physics and chemistry, while being cautious of overcorrection. Strategic syllabus refinement, rather than mere reduction, would significantly contribute to the robust selection of competent doctors who will serve the community effectively. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Joshi et al. (Thu,) studied this question.
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