Original Article

A retrospective study of association between

demographic features of NEET‑based selected candidate
and final outcome in undergraduate medical education
Rajalakshmi Mahendran1, Shivayogappa S. Teli2, Sunil S. Shivekar3
1
Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India, 2Department
of Physiology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India, 3Department of Microbiology, Sri
Manakula Vinayagar Medical College and Hospital, Puducherry, India

A bstract
Introduction: The National Eligibility‑cum‑Entrance Test (NEET) has standardized medical entrance examinations in India but has
faced criticism for favouring urban students and CBSE‑based syllabi, potentially disadvantaging rural and state board students.
This study aims to assess the association between NEET, higher secondary scores, and first‑year MBBS performance to evaluate the
predictive value of these metrics. Methodology: A record‑based retrospective study was conducted at a private tertiary care teaching
hospital in Puducherry, South India. Data of 150 first‑year MBBS students from the 2017–18 batch were analysed. Sociodemographic
factors, NEET scores, higher secondary marks, type of syllabus (state board/CBSE), and first‑year MBBS results were collected. Blinding
and coding ensured confidentiality. Statistical analysis was conducted using SPSS version 24.0, with associations determined using
the Chi‑square test (P < 0.05 considered significant). Results: Among the participants, 54.3% were male and 45.7% were female.
All students were urban residents, and 84.8% studied under the state syllabus, with 15.2% following CBSE. Most (77%) attempted
NEET only once. A significant association was observed between the type of syllabus and first‑year MBBS performance (P < 0.05).
Students from state syllabi had a higher pass percentage compared with CBSE students, irrespective of their NEET scores. NEET
scores (100–450) did not significantly predict MBBS performance. Conclusion: This study highlights disparities in NEET preparation
and performance linked to educational backgrounds. Despite securing admission through NEET, students from state board syllabi
performed better in the first‑year MBBS examination compared with CBSE students. These findings suggest the need for targeted
academic support for students from varied educational backgrounds and equitable educational resources and reforms in the NEET
syllabus to bridge gaps among students from diverse educational systems. Policymakers should consider adapting NEET to ensure
a level playing field for aspirants across different educational backgrounds.

Keywords: Competitive examination, demographic, undergraduate medical education

Introduction brought several changes in undergraduate medical education

polices, i.e. NEET as a qualifying examination, CBME pattern
In recent years, the Government of India has shown more curriculum, AETCOM, and NeXt examination.[1] As a result, there
emphasis on the quality of medical education. For this, they have were many agitations regarding the all‑India undergraduate medical
entrance test (NEET). Particular sections of people opine that
Address for correspondence: Dr. Shivayogappa S. Teli,
Department of Physiology, Sri Manakula Vinayagar Medical
NEET Favor’s the urban students, who have access to coaching
College and Hospital, Puducherry ‑ 605 107, India. centres, digital materials for preparation, which are not available
E‑mail: [email protected] for rural and underprivileged students. The NEET examination
pattern is also based on CBSC and NCERT syllabus which is tough
Received: 28‑11‑2024 Revised: 06‑12‑2024
Accepted: 24‑01‑2025 Published: 31-05-2025 This is an open access journal, and articles are distributed under the terms of the Creative
Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to
remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is
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How to cite this article: Mahendran R, Teli SS, Shivekar SS.

DOI: A retrospective study of association between demographic features of
10.4103/jfmpc.jfmpc_1937_24 NEET‑based selected candidate and final outcome in undergraduate
medical education. J Family Med Prim Care 2025;14:2013-7.

© 2025 Journal of Family Medicine and Primary Care | Published by Wolters Kluwer ‑ Medknow 2013
 Mahendran, et al.: Association of demographic factors with NEET selection and medical education outcomes

for the state government school students who study only state education (English/native language), type of syllabus (state
board. They argue that the examination’s focus on a standardized board, CBSE, ICSE, NCERT), attempts in NEET and 12th std,
syllabus and does not adequately account for the diversity of score in competitive entrance examination, high school
educational systems across states. The NEET examination is examination, higher secondary examination, and undergraduate
primarily conducted in English, which poses a challenge for academic performances in internal assessment examinations and
students who have received their education in regional languages.[2] first professional year. All the above information of the students
was available in the college office. To maintain the confidentiality
The present study was planned to understand the association of the student’s information, blinding was conducted. The data
between the score of a candidate in higher secondary examination entry was conducted by the separate investigators to maintain
and NEET score with their performance in undergraduate confidentiality by following anonymity by using coding system
medical course. instead names of the students. First and second year faculty
involved in the study was doing the coding, since the students
Objectives already completed first year MBBS and they will not be influenced
To find out the relationship between scores in competitive by the teachers. Data analysis was performed by the separate
entrance examinations (NEET, 10th and 12th std marks) and investigator who was not involved in data coding [Figure 1].
undergraduate medical examination performance.
Statistical analysis
Materials and Methods Data were entered in the Epi info (version 7.2.2.6 developed by
Centre of Disease Control, Atlanta, USA and WHO) software
Study setting package, and analysis was performed using Statistical Package
The study was performed by Department of Microbiology, at for the Social Sciences (SPSS) software version 24.0 developed
a private tertiary care teaching hospital in Puducherry, South by (SPSS Inc. Chicago, Illinois, USA). Description of categorical
India. The study was conducted according to the Good Clinical variables was expressed in percentages and association of
Practice guidelines and the Declaration of Helsinki, which ensure university results, and the NEET score was determined using the
the integrity and reliability of the data. Chi‑square test. P < 0.05 was considered statistically significant.

Study design Ethical consideration

It was a record‑based retrospective study. The study was based The protocol of the study was submitted to the Research
on the secondary data on scores of the MBBS students in committee and Institutional Ethics Committee, and approval (IEC
competitive entrance examination for the professional courses
and the undergraduate academic performances in the first
professional year.
Conducted by: The
Department of Microbiology
Study participants (after IEC clearance)
The study population was records of MBBS Students for the
academic year 2017–18 were included.

Duration of the study

The study was performed for 2 months from July to August 2024 Study design: Record-based
after getting approval. retrospective study

Sample size and sampling technique

The performance records of the students in first year MBBS of
the academic year 2017–18 maintained in the SMVMCH were
obtained after obtaining permission from the management. The
Data collection procedure: Questionnaire
number of students in the batch was 150, and the sample size
was 150 participants.
was developed with the details
on socio-demographic variables,
Data collection procedure medium of higher secondary education,
type of syllabus, attempts in NEET and 12th
After obtaining permission from IEC and the authorities, first
std, score in competitive entrance
year records of the students from academic year 2017–18 were
obtained from the office. A questionnaire was developed with the examination and undergraduate
details on sociodemographic variables such as age, sex, place of
residence (urban/rural), category, medium of higher secondary Figure 1: Flow diagram showing methodology

Journal of Family Medicine and Primary Care 2014 Volume 14 : Issue 5 : May 2025
 Mahendran, et al.: Association of demographic factors with NEET selection and medical education outcomes

number: 106/2023) was obtained. All the information collected Table 1: Sociodemographic details of the
from the study participants was kept confidential, and their students (n=150)
privacy was maintained by coding of the study participants and Variables n %
blinding of the investigator doing the analysis. Gender of the students
Male 82 54.3
Results Female 68 45.7
State
Table 1 presents that more than half of the students (54.3%) Pondicherry 53 35.1
were male and remaining 45.7% were female. About 59.7% of Tamil Nadu 90 59.7
the study participants belonged to Tamil Nadu, 35.1% belonged Kerala 4 2.6
to Pondicherry, while 2.6% belonged to Kerala. As per category, Karnataka 1 0.7
majority (53.6%) were under OBC category followed by 18.5% Uttar Pradesh 1 0.7
belonged to MBC and 11.3% were OC by category. Almost all Madhya Pradesh 1 0.7
the participants (100%) resided in urban area. As per Table 2, Category
all of the participants (100%) completed their higher secondary OBC 81 53.6
MBC 28 18.5
education in English medium school, of which majority (84.8%)
SC 14 9.3
were under state board while remaining (15.2%) were under
OC 17 11.3
CBSE. Nearly all students (100%) successfully completed their
BC 4 2.6
12th grade on their first attempt. More than three‑fourth of the UR 6 4.7
students have given one attempt for NEET examination and Place of residence
23.2% of the students have given two attempts. One‑third of Urban 150 100
the study participants (34.6%) scored from 100 to 170, and about
33.4% of the students scored 171 to 230 score.
Table 2: Details on higher secondary education, syllabus,
As presented in Table 3, only 34.7% of the students who attempts in 12th std, and NEET and NEET score (n=150)
scored 100 to 170 in NEET have cleared in the first year MBBS Variables n %
examination of Pondicherry University. However, only 33.3% Medium of higher secondary education
of the students who acquired 171‑230 as NEET score have English 150 100
passed in the first year MBBS examination of Pondicherry Type of syllabus
University. Among the students who have got 231–450 in CBSE 23 15.2
NEET, about 32% of the students have cleared the first State board 127 84.8
Number of attempts in 12th std
year MBBS examination of Pondicherry University. Of 150
First attempt 150 100
students, there was a slight preponderance of male over female
Number of attempts in NEET
participants [82 (54.3%) vs 68 (45.7%)]. Among the given 1 109 72.2
study variables, types of syllabus studied were found to be 2 35 23.2
statistically significant since P value is less than 0.05. Majority 3 7 4.7
of students studied in the state board syllabus had higher NEET score
chances of clearing/passing the first year MBBS examination 100‑170 52 34.6
of Pondicherry University when compared with those who 171‑230 50 33.4
studied in the CBSE syllabus [Table 4]. 231‑450 48 32

Discussion Table 3: Comparison of NEET score and Pondicherry

The current study provides insights into demographic and University results (n=150)
educational factors influencing academic performance among NEET Pondicherry University results in First year MBBS
score Pass Fail
first‑year MBBS students under Pondicherry University. The
findings highlight significant trends in gender distribution, 100‑170 50 (34.7) 2 (33.3)
regional representation, educational background, and their 171‑230 48 (33.3) 2 (33.3)
correlation with academic outcomes. 231‑450 46 (32) 2 (33.4)
Total 144 (100) 6 (100)
The gender distribution reveals a slight predominance of male
students (54.3%), reflecting a fairly balanced representation. Pondicherry (35.1%) and Kerala (2.6%). This is consistent
Such a distribution may not significantly influence academic with the geographical proximity of these regions to the
performance but provides a foundation for analysing other university and potentially highlights differences in academic
contributing factors. Regional diversity shows that the majority preparedness influenced by regional educational policies and
of participants (59.7%) hailed from Tamil Nadu, followed by resources.

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 Mahendran, et al.: Association of demographic factors with NEET selection and medical education outcomes

Table 4: Association of University results and NEET score (n=150)

Variables n (%) Number passed in University exam Chi square value P
Gender of the students
Male 82 (54.3) 80 (97.6) 1.148 0.411
Female 68 (45.7) 64 (94.1)
State of residence
Pondicherry 53 (35.1) 51 (96.2) 0.345 0.997
Tamilnadu 90 (59.7) 86 (95.6)
Others (Kerala, Karnataka, UP, MP) 7 (5.2) 7 (100)
Category
OBC 81 (53.6) 80 (98.8) 8.569 0.128
MBC 28 (18.5) 27 (96.4)
SC 14 (9.3) 12 (85.7)
Others (OC, BC, UR) 27 (18.6) 25 (92.5)
Type of syllabus studied
CBSE 23 (15.2) 19 (82.6) 12.686 0.005*
State board 127 (84.8) 125 (98.4)
Number of attempts in NEET
1 109 (72.2) 104 (95.4) 0.467 0.792
2 35 (23.2) 34 (97.1)
3 6 (4.7) 6 (100)
NEET score
100‑170 52 (34.6) 50 (96.2) 0.007 0.997
171‑230 50 (33.4) 48 (96)
231‑450 48 (32) 46 (95.8)
*P<0.05 is significant

The study found that the majority of participants (53.6%) emphasize holistic admissions criteria that consider other
belonged to the OBC category, with MBC (18.5%) and cognitive and noncognitive skills.[6‑10]
OC (11.3%) making up smaller proportions. However, as all
participants resided in urban areas, the potential influence of The statistically significant relationship between the type of
urban educational advantages on academic outcomes warrants school board and academic performance emphasizes the impact
consideration. of preuniversity education on higher education success. State
board students demonstrated better performance, potentially
All participants completed their higher secondary education due to curriculum overlap or pedagogical methods that better
in English medium schools, predominantly under the state prepared them for the MBBS examination structure. This finding
board (84.8%) compared with CBSE (15.2%). Interestingly, underscores the importance of aligning NEET preparatory
students from the state board exhibited a statistically significant strategies and MBBS curricula to ensure equitable opportunities
higher success rate in clearing the first‑year MBBS examinations. for students from diverse educational backgrounds.[11,12]
This finding suggests that the curriculum of state boards may
align more closely with the expectations and academic rigor of To date, no studies in India have specifically explored the
the MBBS program under Pondicherry University. In contrast, relationship between various admission criteria for MBBS
CBSE students may face challenges adapting to the university’s programs and their impact on first‑year MBBS results. This is
examination patterns or content focus.[3‑5] a critical gap in understanding the factors influencing academic
success in medical education within the Indian context,
A notable finding is that nearly all students (100%) cleared particularly given the diverse educational systems across states.
their higher secondary examinations on their first attempt, However, studies from other countries have attempted to examine
and more than three‑fourths appeared for NEET only once. the relationship between multiple factors, such as admission
Despite this, NEET scores showed limited predictive value processes, premedical education, and student characteristics,
for success in the first‑year MBBS examinations. Among with success in medical school.[12‑15] These international findings
students scoring 100–170, 34.7% passed the first‑year MBBS underscore the importance of analysing predictors of academic
examinations, while pass rates were 33.3% and 32% for those performance to inform equitable admission policies.
scoring 171–230 and 231–450, respectively. These results
indicate that higher NEET scores did not guarantee better In conclusion, the study highlights the complex interplay
academic performance in the MBBS program. This discrepancy between demographic, educational, and systemic factors
raises questions about the efficacy of NEET scores as a sole influencing academic performance in medical education. While
determinant of medical aptitude and suggests the need to gender and regional diversity add context, the type of syllabus

Journal of Family Medicine and Primary Care 2016 Volume 14 : Issue 5 : May 2025
 Mahendran, et al.: Association of demographic factors with NEET selection and medical education outcomes

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Conflicts of interest 9. New Indian Express. TN students raise concerns as

NEET handed over to CBSE. Available from: www.
There are no conflicts of interest. newindianexpress.com/nation/TN-Students-Raise-
Concerns-as-NEETHanded-Over-to-CBSE/2016/04/29/
article3405975.ece. [Last accessed on 2016 Apr 29].
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