Removing the age limit for NEET aspirants makes medical education accessible to a larger talent pool. Some may even have specific training that can help them improve their health care.
“You can’t stop me from learning. You can’t stop me from studying.’ So says Hunter “Patch Adams” in the movie of the same name in which Robin Williams portrayed the real character of a middle-aged medical student. Adams wants to become a doctor to provide compassionate care for patients. Motivated by his own experience while being treated for a mental illness, he aims to provide healing through love, laughter and tenderness rather than the cold, impersonal, strictly technical approach that became the credo of the white coat wearer.
When this maverick is threatened with expulsion from medical school, he defiantly replies, “You treat a disease, you win, you lose. You treat a person, I guarantee you, you will win no matter the outcome.” His win in the case conveys two messages. No one is too old to learn and practice medicine. Age and experience provide a better understanding of human nature and the social determinants of health that can broaden a student’s learning and improve the quality of medical care.
Recently, a higher age limit for access to medical studies for undergraduates was set in Indian courts. The age limit to participate in the National Eligibility cum Entrance Test (NEET) for MBBS was set at 25 years for students in the general category and at 30 years for students in the SC/ST/OBC categories. This limitation was legally challenged by petitioners who argued that there was no higher age limit in the earlier pre-medical tests (PMTs) conducted by state governments. They wondered why a higher age limit was imposed when the NEET subjugated them.
Earlier, the former Medical Council of India (MCI) put forward two arguments for imposing the age limit. First, younger students were likely to absorb new knowledge faster compared to older ones. The second was that older students would have the ‘unfair’ advantage of a more extensive prior education compared to young students just out of school. While a higher age of entry was portrayed as a barrier to future learning, experiential knowledge was profiled as creating competitive groups from diverse backgrounds.
While the Supreme Court was investigating the case, the National Medical Commission announced the abolition of the age restriction. Applicable from NEET 2022, there would be no upper limit, but the lower limit of 17 years remains. Health Minister Mansukh Mandviya tweeted “Good news for the aspirants of NEET-UG! … This decision will greatly benefit aspiring physicians and further help strengthen medical education in the country. †
This is indeed a welcome development. There are many who aspire to change tracks after training in other courses or gaining work experience useful for the later practice of medicine. For example, a nurse would have had a lot of experience in primary care in the community or patient care in a hospital. If such a nurse cleans up NEET, that experience would be very helpful both during medical studies and after their qualification as a doctor.
Some may have financial needs met by working after school for several years before appearing for the medical entrance exam. Such people are now engaged. The clause that prevented students from open schools from being eligible for NEET has also been removed, potentially making medical education accessible to many more students.
In the US and Canada, medical schools require a person to complete 3-4 years of undergraduate collegiate education before being eligible for admission to medical schools. This gives the students a level of maturity where they not only absorb the technical content of the education, but also appreciate the social obligations and ethical dimensions of the profession. Such prior education often exposes them not only to the sciences, but also to the humanities, which makes the medical student appreciate the social and psychological dimensions of health and disease. Some American students also earn a degree in public health before entering medical school, making them better doctors and researchers.
There is no reason to believe that anyone over 25 is too old to learn. Several years ago, a member of the bioscience engineering faculty of IIT Delhi, who had previously obtained engineering, science and PhD degrees in India and the US, took part in an MBBS program in Delhi so that he could gain a better understanding could get the human body in health and disease. Even in other fields of education, there have been many who have successfully completed formal education in old age and even completed a PhD.
While returning Indian medical students from Ukraine are usually under the age of 25, those who are at an advanced stage of interrupted education can benefit when they are older. Even if special exemptions allow for side transfer, they may still need to pass the NEET. The rule change is well timed to help such students. Even in the long run, enabling more mature students to become doctors is likely to improve the quality of health care by adding life experience and empathy to a technical mix. Will those who qualify as doctors in old age be more likely to become general practitioners and general practitioners, to fill gaps in primary care? Time will tell.
The author is President of the Public Health Foundation of India (PHFI). Views are personal.