By Ann M. Koenig, AACRAO International Education Services
Recent reports from India detail an organized fraud operation there involving medical school entrance examinations and medical education at public institutions. For at least 10 years, and possibly as far back as 1994, unqualified applicants with financial means have been able to tap into an organized fraud network to gain admission to medical schools through fraudulent channels. The fraud ring involves students, parents, mediators, and even police, government, university and examination board officials.
A common method employed by the fraudsters was to identify students enrolled in test preparation courses who appeared to be not very strong academically but to have the financial means to benefit from the scam. The fraudsters also recruited strong students, “scorers”, to pose as proxies with false identification papers to impersonate the weaker students, or to sit near the weaker students and allow them to copy their answers. Applicants allegedly paid sums as high as $40,000 to $70,000 for these examination “services”. Some examination officials were complicit in the fraud.
While the fraud ring described here operated in the context of examinations for entrance to public medical schools, allegations of fraudulent admissions practices have also been made against some private institutions, where the practice of “selling seats”, money changing hands between administration and students, is a problem.
Medical School Admissions
Admission to a medical degree program in India, the MBBS (Bachelor of Medicine and Bachelor of Surgery), is highly competitive. It is based on graduation from secondary school (comparable to 12th grade in the United States) and the results of entrance examinations. The examination scandal has resulted not only in qualified admissions applicants losing their opportunities for medical education, but also in medical schools with sub-par students and a medical profession with some doctors of dubious quality.
Until 2011, the examination for admission to public universities was the All-India Pre-Medical Test (PMT). In the State of Madhya Pradesh in central India, the examination board that ran the PMT is under intense scrutiny. Dozens of officials with the Madhya Pradesh Professional Examination Board (MPPEB) have admitted to participating in the fraud operation, as far back as the PMT of 2004, including a former Controller of Examinations. Evidence of fraud in other professional examinations was also connected to an MPPEB official. An education minister from Madhya Pradesh has resigned in connection with the PMT fraud scandal and has been alleged to have been involved in fraud involving other examinations as well.
According to one whistle-blower, a doctor and health activist who has encountered and reported fraudulent clinical trial reports, fraud operations have been going on since 1994. Despite making complaints to authorities, he feels that the scam was covered up because it involved MPPEB officials.
Based on statements given by arrested “scorers”, the Madhya Pradesh police identified the mastermind behind the fraud operation as a doctor living in Indore, the largest city in Madhya Pradesh. He was arrested in July 2013 and admitted to running the fraud operation for years, often with examination officials as accomplices. Other doctors allegedly involved in the fraud operation were being sought by police as well.
Impact on Medical Education
A Madhya Pradesh Special Task Force (STF) investigation has uncovered over 1,000 fraudulent admission cases so far, and the enrollments of those students have been cancelled. One study looked into the results of the PMT in 2008 through 2011, and as a result cancelled the examination results of over 300 test-takers. This decision has infuriated students who are in the advanced years of their medical programs, are about to enter their medical internships, or indeed may have graduated and are currently practicing medicine. Police are bringing charges against all of them.
How is it possible for an unqualified or underqualified student who gained admission based on falsified test results to graduate from a university medical program? Apparently the same type of fraud is perpetrated in some universities, with the knowledge of university administrators. University officials at four Madhya Pradesh universities have also been implicated, Jiwaji University, Devi Ahilya Vishwavidyalaya, Barkatullah University and Rani Durgavati Vishwavidyalaya.
Further, how is it possible for a medical school graduate admitted and graduated under fraudulent circumstances to get a license to practice medicine in India? The Medical Council of India (MCI), which regulates the medical profession and licenses physicians, is embroiled in a scandal of its own at the moment, involving the fraudulent licensing of Indians with medical degrees from China and Russia.
A culture of corruption appears to exist in the Indian medical community from admission to medical school through the process of professional licensure as a physician. The Indian press is filled with articles about fraud in public and private medical school admissions, inspections of medical schools, examinations, and licensing, in states all over India.
Medical School Admission Testing Going Forward
Current medical school aspirants in India are understandably confused about the situation with entrance examinations since the investigations in Madhya Pradesh began. Until 2011, the All-India Pre-Medical Test was overseen by the Medical Council of India (MCI). In the wake of the scandal, the test was reorganized as the National Eligibility cum Entrance Test (NEET), with divisions for applicants to the MBBS (NEET-UG) and to graduate-level programs (NEET-PG). The 2012 test was deferred, and following an Indian Supreme Court ruling in July 2013 that the MCI is not allowed to conduct these examinations, the NEET-UG was taken over the Central Board of Secondary Education (CBSE), the national examination board that administers secondary-level examinations. The NEET-UG was given in May 2013.
The All-India Pre-Medical Test was reinstated in 2014, under the administration of the CBSE, as the common entrance examination for the 15% All-India merit positions in medical and dental colleges of India. According to the Supreme Court decision, Indian public universities may use this examination as well, while state governments may also conduct entrance examinations to their public institutions. Private institutions retain autonomy in managing their own admissions procedures.