Battling NEET coaching and boredom: Why AIIMS Delhi is changing the way it teaches

NEW DELHI: Fourth-year MBBS students at All India Institute of Medical Sciences (AIIMS), New Delhi are now experiencing improved classroom lectures. Attendance has also increased over the past few months. This change came after a committee of 11 faculty members recommended reforms in the pattern of teaching, training and evaluation of final-year MBBS students.

“We were consulted by the panel members and we suggested more practical-based clinical learning classes along with theoretical classes, where multiple subjects should be touched for a single topic for the benefit of students. Our experience of lecture classes has improved and that will help us. They got to know about the areas where they were lacking and now focusing on improving them,” Saras Kumar, fourth year MBBS student of AIIMS Delhi told Careers360.

“Practical tests which used to be conducted on a monthly basis are now being conducted weekly. Only things that can be done to make classes more interesting are regular clinical postings. The best way to learn the skills is to interact with patients and the addition of modern techniques and tools in classes will help us,” he added.

The AIIMS Delhi administration discovered that final-year students’ attendance was “poor” and they were more engaged in coaching classes for the entrance test for post graduate (PG) medical courses such as the National Eligibility cum Entrance Test – Postgraduate (NEET PG). On January 25, the institute constituted a committee of faculty members to suggest reforms for teaching methods, clinical training and final-year MBBS examination.

The committee has submitted its suggestions to the dean of academics at AIIMS Delhi.

“We have suggested several teaching reforms in our suggestions and have submitted it to the dean of academics, AIIMS New Delhi for implementation. More clinical-based classes, inclusion of modern tools and techniques and constant revision of important topics are among the major suggestions. We are hoping to improve attendance and learning among final-year students through these suggestions,” said a panel member who wished to remain anonymous.

Although there is a “positive impact” of these suggestions, students and medical organisation leaders said that a lot more must be done to improve learning, including countering the negative impact of coaching. The NEET PG is set to be replaced by the two-step National Exit Test from 2024; AIIMS Delhi will conduct the NExT Step 1 from May 2024. What impact the NExT will have on coaching’s grip on students is yet to be seen.

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MBBS, PG courses, NEET coaching

The intense competition for the few postgraduate seats in medicine is a major reason for low attendance. In India, there are 66,898 PG medical seats compared to 1,05,163 MBBS seats.

“It is difficult to say whether fourth-year MBBS students are skipping lectures in all the medical colleges but it is happening at AIIMS. We observed it and decided to improve attendance through several reforms,” said the panel member.

Kumar goes to lectures and finds that at least 50-60 out of 90 students always attend. “I think it's a good strength even though it is poor from the administration’s perspective,” said Kumar.

According to him, a student has to study 10 different subjects while preparing for PG medicine.

“Lectures give you an in-depth view of concepts and give you a base of knowledge and understanding. But if you are trying to get a good rank in the PG medical entrance exam in a short period of time, then you should go to coaching classes. Most of my seniors who got good ranks had attended both the lectures and coaching classes,” he added.

“It is not that lectures are not enough but they aren't targeted towards cracking PG entrance exams,” said Suyash Singh, a fourth-year student at AIIMS Delhi.

Tushar Tiwari, another fourth-year MBBS student has joined a coaching institute to prepare for NEET PG. “I also attend lectures but my main focus is to study the material provided by the coaching institute. I don’t skip classes which I feel are important for me but I don’t attend classes of subjects in which I have pretty good knowledge,” he said.

Final-year MBBS students

Dr Aviral Mathur, president of Federation of Resident Doctors Association (FORDA) said a decade ago, coaching institutes targeting MBBS interns and those who had completed their internship. But now, they have realised that students start preparing for PG medical entrance exams early and started targeting fourth-year students too.

According to Mathur, students enrolled in MBBS are already coming from coaching institutes and it is natural for them to fall into the trap again. But, this poses a threat. “Students are now finding coaching institutes a good proxy for what is being taught in lecture classes. The advent of online coaching apps has also made it easy,” he said.

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Specialisation after MBBS

The prestige attached to superspeciality doctors has lowered the value of just an MBBS among the medical community, said doctors. Over the years, students have understood that without coaching they won’t be able to crack the NEET PG and specialise.

Rohan Krishnan, an orthopaedic surgeon in New Delhi and an adviser to Federation of All India Medical Association (FAIMA), a network of postgraduate medical students and doctors, said that the concept of a general physician or a family physician has lost its prominence.

“Now, MBBS doctors don’t get the respect among the medical fraternity and society they used to 20-30 years ago. Every MBBS doctor wants to specialise and competition for PG medical seats is getting tougher,” he said. “Medical college teachers don’t prepare students to crack NEET PG exam and students are forced to spend lakhs on coaching. It is wrong but students are not at fault because whatever is being asked in the form of objective-type questions in the PG entrance exam is not being taught in MBBS classes. It is the fault of teachers and exam conducting authority,” he said.

AIIMS Delhi reforming teaching pattern

Singh said that fourth-year students in AIIMS Delhi have suggested adding new clinical aspects to the old pattern of lectures.

“Now, the content is being updated, the irrelevant material and facts are being removed and more targeted material is being provided to students so that students start attending classes again on a more regular basis. Lecture class attendance has surely gone up, a slight improvement,” he said.

Leaders in the medical fraternity have suggested several reforms to improve learning and attendance.

“Seminars, presentation competitions, medical debates among students and new innovations and integrated classes are some of the teaching reforms,” said Dr Prashanth S, state co-convenor of Indian Medical Association (IMA) Junior Doctors Network.

According to Mathur, colleges have failed to take into account the current generation’s ease with technology which has changed the experience of learning for them. “The millennials understand things better in visual formats and often feel that theoretical classes are mundane if only markers and PPTs are used. They want classes full of diagrams, videos, modern tools like Artificial Intelligence (AI) and humor. The AIIMS panel should keep these things in mind and improve the situation,” he said.

Krishnan, however, had a word of caution. “It is a good move to bring teaching reforms. However, the shortage of faculty at AIIMS itself will make it unlikely to happen,” he added. In July 2022, the central government had told Lok Sabha that 720 out of 1,131 faculty posts had to be filled in AIIMS Delhi and that 411 – or, 36.3% – regular posts remain vacant.

*Names of students were changed on request.