 Welcome to Newsclick. Since the national eligibility come entrance test, or what is known as the need was made mandatory for medical admission in 2017, there has been heavy backlash from Tamil Nadu. Those protesting this medical entrance test argue that it is stacked against the socially and economically backward sections. But what does the committee set up by the state government to study the impact of need in Tamil Nadu tell us? Newsclick has carried out a detailed examination of the findings of the Justice A.K. Rajan committee and here is a summary of what we have found. It turns out that the biggest losers since the need was implemented are the students with Tamil as their medium of instruction. From around 18% before the introduction of need, the intake of Tamil medium students has plunged to a mere 2.14%. Same is the status of students in state board schools. The students educated in CBC board schools have started to fare better in the last three years. Unable to compete in the CBC oriented entrance exam, the share of state board students has fallen from 99.3% before need to a vast 65.7%. While the share of CBC students has increased from 0.35% to nearly 32%. One of the main objectives of the committee was to study the adverse impact of the need-based admission process on the students belonging to rural and poor sections. Rural students have lost out their share to their urban counterparts post need. The share of rural students has reduced by around 10%, which is seized by rural students. The applicants from rural areas have also shown a downward trend from 58.5% in 2016-17 to 47.5% in 2020-21. The committee's findings that urban, English medium and CBC board students are able to fare well in the exam reveals that the exam is socially and economically biased towards privileged sections. On the other hand, students from lower income groups are facing difficulty in getting admission to medical courses. Those falling under a cap of 2.5 lakh annual income have reduced by 15% since the need was introduced. Moreover, the total students who secured admission in 2019-20, 99% of students have received prior training or coaching before they appeared in the need, revealing that affordability and accessibility to coaching is a necessity for medical admission. The committee criticizes the commercialization of medical entrance coaching and the bias towards the financially well-off. The report has also found that the average fall in the admission of first-generation graduate students in medical colleges since 2017 stands at approximately 10%. Districts with high human development index have shown stability or increase in the number of students getting admission to MBBS courses. And inevitably, those with low development index are faring poorly. Besides these, students from a wide social groups cracking the exam under the general cut-off has also dropped, showing a dangerous tilt towards the privileged castes and communities. Since 2016, the share of the Tamil Nadu doctors started declining when the super-specialty seats of the state were opened up for the all India candidates. As a result, almost two-thirds of the seats were lost to other state students. With an increased number of out-station students claiming Tamil Nadu domicile, the report cautions of malpractices in the entrance exam. In short, the report read, Neat causes mental stress to students and leads them to the extent of committing suicide. It says, as India is a diverse country with so many boards of education which have different syllabi, a common entrance exam is not applicable to all. Neat is paving the way only for students who are economically advanced, studying in CBSE schools and spending lakhs for their private school education and coaching classes. This explains Anitha Suicide, a medical aspirant from the backward Arelu district, who studied in a Tamil medium school and was amongst the toppers in her district. She was the only student in Arelu district to score 100% marks in maths and physics in the 12-standard board exam. On September 1, 2017, she died by suicide that created a major controversy. That was the tipping point in the state, grasping attention from all sections. Since then, more medical aspirants have taken their lives fearing failure in the exam. Around the entrance exam this year alone, three students killed themselves and some suicide attempts reported. Upon projecting the immense data and detail, the AK Rajan committee report concluded saying, Ultimately, Tamil Nadu may go back to pre-independence days, where in small towns and in villages, only barefoot doctors were catering for the needs. And Tamil Nadu as a state would go down and rank among states in the medical and healthcare system. In their struggle against the centralized medical exam, the Tamil Nadu government is trying to take the campaign outside the state as well. But we have to see how long this would continue considering the political and legal challenges ahead. Thanks a lot for watching.