By Arunima Rajan

Dr Aditya Kelkar is an eminent ophthalmologist with more than 20 years of experience, currently serving as Medical Director at NIO Super Specialty Hospital, Pune.

Specialising in vitreo-retina surgery, he earned the Gold Medal in MS Ophthalmology from the University of Pune and has completed fellowships including the FRCS from Glasgow and the Royal College of Ophthalmologists, London.

In conversation with Healthcare Executive, Dr Kelkar weighs in on the NEET controversies, the coaching industry built around the exam, the push for more medical seats, and why making rural postings compulsory may waste the very specialists it sends.

Dr. Aditya Kelkar, Director, NIO Super Specialty Hospital

Where are you from, and why do you do what you do?

I'm an ophthalmologist. I work in the National Institute of Ophthalmology in Pune as a medical director.

Did you appear for NEET during your time, or was it a state-level entrance exam?

I was extremely lucky that I did not have to go through all this. During those days, our 12th marks were considered as the marks for admission criteria.

Does a fair exam make doctors better at helping patients?

In India, the doctor-patient ratio is extremely skewed. And if our foundation is going to be such that these exams are flawed, and there are some fraudulent practices going on, it's very discouraging.

They introduced NEET to replace separate state and institute exams. That was the original concept

We do require certain form of standardisation across the country as far as the medicine is concerned. But it's not just the failure from the government, but also the people who have let this system down.

So the old system sort of favoured urban students, right?

No, not really, but even the current system. The NEET exam requires the students to join classes right from their 8th and 9th standard. It's not meant for the poor anymore.

Now they're going to make it digital from 2027. So are we just changing the problem rather than fixing it?

It is both ways. The system is working in this weird fashion because there is a demand from some dishonest people to cheat and crack this exam.

The government has announced more medical colleges and seats. Are you worried we are training students too fast?

We definitely need a lot of doctors considering our population, and we need them fast. But this cannot come at a compromise of quality. You need good teachers, good equipment to teach them, good resources.

Over 2 million students for about 1.28 lakh seats, now sitting on different days. What rules must never be broken, and who is responsible if there's a problem?

It's extremely challenging now that the exam is in the next 5 days, which is just within one month of the fiasco that happened. I believe now they have also banned Telegram.

There's also this big coaching business built on the exam system. Can you talk about that?

The students are not very happy at the teaching that happens in the college. That's one of the reasons they have to resort to joining classes. Our mentality is such that unless and until you join some tuition class, you won't be able to do good in the exams.

And a lot of students give up years, and a lot of money, for just one seat.

That kind of pressure that they go through, 23 lakh students appearing for the exam with a very limited number of seats. That's why the coaching classes boom.

Do you think the new exam format will break this entire coaching system?

I just hope that it fixes the problem, but it's a very huge problem, which can't be fixed overnight.

Doctors trained decades ago could handle complex cases, but today's doctors don't have the same skills. Do you agree?

I don't agree with this assessment. The reason why some of the complex cases are not being handled by the younger doctors nowadays is probably because of the pressure from the society to always be successful in terms of outcomes.

Should we screen students on 12th marks, an entrance exam, or both?

There has to be some standardisation across the country, and NEET was one of the first attempts to standardise our medical education right from the entry level, which is good. Unfortunately, the execution hasn't been ideal, from both sides, from the authorities as well as the students who have found ways to crack this exam.

We still don't have enough specialists in villages. If the government adds seats and budget, what would you look at in 5 years to check if this helped patients?

Let's say I'm an ophthalmologist, and I've done my retina super-speciality training, and now you want me to go to a village. That medical setup does not have the facilities to treat a patient with retinal disorders. You are actually wasting my most valuable years and ruining my skills. Maybe there has to be something like a primary health centre, then secondary, and then the tertiary care centre. Just by making it compulsory, it may look very fancy, but you have to look into what facilities are you going to provide them to treat the patients.

Compared to other countries, are there any best practices you think would work here?

Compared to the international standards, I would still believe that Indian doctors are far better trained compared to the doctors abroad. We have a lot of talented doctors, and maybe we can have a proper system that would encourage these doctors to prove their merit.

During your time, what were the biggest challenges for getting a medical seat?

The seats were very limited those days. I remember there was hardly one, two seats for MS in Ophthalmology when I took up my admission, in Sassoon Hospital. But the passing percentage was very poor. The results for DNB exams have also improved from 30% to almost 75% to 80%.

Many states oppose NEET. Tamil Nadu has fought it for years. So if half the country does not trust this test?

The whole point is that we want standardisation, and that's why we want to have one exam across the country. But because it's on such a large and huge scale, to keep tabs on is extremely difficult for this type of exam system.

What do you think, then, is the solution for this problem?

I really wish I knew the solution to this problem, but it's a very daunting task for anyone sitting in the administration to solve this issue.

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