January 12, 1999: According to the final MBBS results declared by the University of Mumbai, over 300 students had failed in the Preventive and Social medicine (PSM) paper. Out of these, 64 students had failed only in PSM.

January 25: The university declared that it had granted eight grace marks to all 1,100 students who had appeared for the examination. As a result, all 64 students passed this examination.

February 2: The Maharashtra Medical Council (MMC) made a representation to Dr Daulatrao Aher, Maharashtra’s minister for health, saying that such granting of grace marks was against the rules of the University.

February 3: The governor of Maharashtra, P C Alexander, asked the university vice-chancellor, Dr Snehalata Deshmukh, to submit a report explaining the university’s action.

February 4: Dr Aher declared that the MMC was empowered to conduct an inquiry according to Section 27A of the MMC Act.

April 7: The governor set aside the university’s decision.

Meanwhile, in February, 61 of the 64 students had moved the Mumbai High Court asking for re-evaluation of the papers. The court upheld the governor’s decision. According to the final results declared after re-evaluation, 19 students failed the PSM paper, the rest passed.

The main players in this drama were: a silent University Vice-Chancellor and Dean of the medical faculty, a very active minister for health, an obstreperous MMC and a governor nudged into action. Surprisingly, no one heard much from either the affected students or the paper-setters and examiners of the PSM paper. Students claim that the press refused to listen to their side of the story and the paper setters said they were bound by government directions and could not speak out until the judgement in which the high court upheld the governor’s decision, was passed. The Vice-Chancellor maintained all along that the university acted within its rights when granting eight grace marks, and it did so because the PSM paper was difficult.

The media held that the University gave eight grace marks to all the students in order to ensure that two students (who had failed only in PSM) got distinction in two other subjects. At stake were postgraduate seats in surgery and gynecology (both branches very much in demand). Both the VC and students refuted this claim.

According to Dr Seema Pai (one of the affected students), the review of PSM results started with representations made by over 300 students who had failed in the subject. A less complicated, if equally corrupt, ‘solution’ would be for the two students to apply for re-evaluation and “settle the matter at the going rate of the examiner”. According to this theory supporting the VC, she did not need to add these eight marks if her intention was to favor these two students.

A little known fact is that the students had not asked for grace marks. Their representation to the VC simply states that students could not attempt questions worth 18 marks to the best of their capabilities as doctors, and that the VC should look into the matter.

The large number of failures in the PSM paper this year (unlike preceding years) indicates a change in the standard of questions asked. There is also a widespread perception that the average Indian doctor (especially the medical student) lacks general knowledge. Senior medical teachers admit that the occasional medical student who can hold forth on a subject outside the prescribed textbooks is considered brilliant. This contradicts the reactions of various lay readers and spectators of the PSM drama that “they too could have attempted the so-called difficult PSM paper”.

One of the affected students maintains that they could well write short notes on subjects such as Alcoholic Anonymous, barrier nursing, CRY and the efficacy of the BCG vaccine, but from a layman’s point of view. For a medical perspective, such essays must be documented with references and statistics that are not part of their textbook. However, a paper-setter maintains that AA may not appear in the PSM textbook but is a topic in psychiatry, and barrier nursing is an integral part of clinical practice. All the topics in the examination paper are relevant, important and have been part of government public education programmes.

According to one of the paper-setters of the PSM paper, the paper could have been perceived as difficult because the medical faculty often does not bother to update itself in the issues concerned with its subject. “As a result, important issues that are not included in the text are not taught to students” she says. The paper setter also points out that the PSM faculty and deans of various medical colleges had taken up the issue of collecting the signatures for the representation made to the University by the 300 students who had failed in the subject. This conveys that PSM teachers (excluding the paper setters of course) believed that the paper had been difficult.

Both teachers and students agree that the “PSM scandal” was actually a political game played between people at the highest level, over issues and enmities unconnected both with preventive and social medicine, and the students.