How the Vyapam scam unleashed a health and education crisis in Madhya Pradesh

If you are planning a visit to Madhya Pradesh in the near future, among other things, make sure you carry your own doctor. Going by Anand Rai’s account, there are at least 2000 practicing doctors who have conned their way into the health care sector of the state.

“They either refer their patients to other physicians and hospitals or suggest a lot of tests that would fetch significant commission,” said Rai, who blew the whistle on the menacing Vyapam scam. 

Vyavasik Pariksha Mandal of Madhya Pradesh, or Vyapam, an organisation that conducts tests for entry into medical schools, law colleges and state police service was subverted in the infamous scam. For more than a decade, Vyapam eased the way for rich kids with political links to make it through the highly demanding entrance tests.

Fake doctors, fraudulent practices

The scam has led to dramatic decline in the quality of doctors and of the state's health care sector in the last few years, said Paras Sakhlecha, a former Independent MLA. “Deaths in government hospitals have been palpably high,” he said. “We have not been able to control the infant mortality rate, which is 30% higher than the national average. The death rate of Madhya Pradesh is 15% higher.”

Sakhlecha stressed that doctors have been attacked several times in the last few years by relatives of the patient. “They get angry when they learn of the doctor’s incompetence,” he said. Rai added that the autopsy of Narendra Tomar, an inmate accused of arranging imposters for the pre-med exam for two students, was conducted by a doctor who had taken 10 years to complete a five-year MBBS course. 

Merely a quarter of the way into investigations, hundreds of doctors and doctors-in-training have been stripped off their licenses. The number could swell and touch five digits when the investigations reach its business end, suspects Sakhlecha. Hardly affordable, for a state whose doctor-population ratio is five times below the national average. This in itself is embarrassing by international standards. According to WHO, India has 0.7 doctors for every 1000 patients compared to 3.9 doctors per 1000 patients in Argentina, 4.9 in Belgium, 6.7 in Cuba  and 2.8 in Britain.

Also read: Everything you need to know about the Vyapam scam

A deadly scam​

A scandal that initially seemed like any another has turned into a chillingly notorious chapter even by Indian standards, given that tales of corruption are not a rarity in the country. 48 people related to it have died, mysteriously or otherwise, and nearly 2000 arrests have been made, including high profile people such as the exam controller Pankaj Trivedi, system analysts Nitin Mahendra and Ajay Sen, former technical education minister in the state's BJP government Laxmikant Sharma and many more.

Around 500 are still on the run. Noted doctors, bureaucrats and politicians are among the accused.

However ominous the picture may look, when the system allows thousands of unqualified students an easy ride, it also denies thousands of hardworking and eminent candidates an opportunity to make a mark. It simply dissolves their idealism. Nearly 50,000 candidates burn the midnight oil preparing for the pre-medical entrance exams every year. Only 700 get through.

Failing to make the cut

Zakir Hussain, 24, is one of the numerous students who believed hard work and determination would be enough to fulfill his ambition of becoming an MBBS. In 2009, at the age of 18, he turned his thoughts to medicine. “I studied for more than 10 hours a day,” he said. “Apart from that, I regularly attended tuition classes. I was positive about my chances.”

The results came out and Zakir lost out by one mark. “I cannot explain my state of mind at the time,” he said. However, he pulled himself together and decided to start afresh. He began his preparation again for the following year’s entrance exams. He put in more effort but failed to make it again. This time by two marks.

The ones who had sabotaged the system found themselves comfortably above the cut-off number. The others, thereby, ended up languishing around it.

Also read: Here's why you should care about the Vyapam scam

Zakir, son of a retired Army personnel, went through this frustrating experience four times. “When I lost out in 2012, I gave up and changed my course,” he said. “I had invested time and money. It was too depressing to go through the ordeal every year.”

However, the demeanour of a few students, especially the ones who were academically below average, betrayed the fishy scheme surrounding admissions. “Some students were absolutely sure of going through,” said Poonam Sharma, 24, another student who fell short of the cut-off number by two agonising marks. “Later on, they disclosed they had paid money and everything was taken care of.”

An odd case of impersonation and cheating would not have come as a surprise for anyone who has spent considerable time in India. But the magnitude of the scam in Madhya Pradesh shattered the hopes of lakhs of students. “There has not been any study, but every year almost 500 students go into depression,” said Rai. “They feel they have let their family down.”

Taking matters into their own hand

Poonam, daughter of a police constable, said losing out on a seat would not have rankled as much if the successful ones had made it on their merit. “They were mediocre students who barely studied,” she said. “These students would brazenly ask me, 'Why aren't you getting your admission done through money?”       

The psychological damage the Vyapam scam has done to aspiring doctors is severe. “Students in their early 20s have gone berserk, committed suicides,” said Rai. “If this is going to be the reward of investing precious years of life along with hard earned money, then one cannot expect a bright picture.”

Many renounced their dream of earning an MBBS degree and settled for other disciplines. A friend of Rai is now a veterinary physician. Zakir is in the middle of a course in the Government Dental College at Indore. Three years later, he would become a Dental Surgeon. “If I had not wasted my four years behind MBBS, I would have already been one,” he said, in a wistful tone.

Poonam, who has four more sisters, secured a seat in the Aurobindo Medical College in 2014, but only after the state’s pre-med exams were scrapped after increasing pressure from activists and media and the colleges started admitting students through the All-India Tests.

However, Poonam, not shy of a confrontation, lived the life of an activist before finally bagging a seat. As the Vyapam scam unfolded, the fraudulent practices became explicitly clear. When some of the kingpins were arrested and a list of candidates was recovered from them, Poonam filed a petition against a government demanding those on the waiting list, like her, be allowed to replace the frauds who had gotten through the exam. The family had to dig deep into their savings but their support never wavered. “I do not know how much money and time I spent on the court procedures,” she said. “But it was a matter of survival. My family knew how important the struggle was for me.”

Poonam, originally from Shivpuri, migrated to Gwalior and then moved to Indore where better education facilities would augment her chances of becoming a doctor. “I lived at a hostel and studied for 12 hours a day,” she said. “My family and friends know how devastated I was throughout that period.” She even went on three hunger strikes along with two of her colleagues to mount pressure on the authorities. The longest, in December 2013, lasted eight days. “My weight dwindled to 35 kilos,” she recollects. “Activists kept requesting doctors to conduct a check-up for us but they ignored our deteriorating health for the first three days. We were referred to the hospital on the fourth day. I had become frail. My glucose level had critically declined.”

The strike was called off on the eighth day when the education minister discussed their demands and promised to look into the matter. 

RTI activist Ajay Dube said the Vyapam scam also forced qualified doctors to endure a crisis of perception. “The defamation it has done nationally and internationally is irreversible,” he said. “Accomplished doctors from the state are looked down upon because of Vyapam. As a result, talented youngsters are migrating en-masse to other states. No student wishes to be tagged as a graduate from Madhya Pradesh.”

Blowing the whistle

Even though an occasional complaint would crop up in early 2000s, the unsettling reality began unfolding in 2009. Anand Rai tipped the Indore police about some racketeers leaking question papers. The police acted upon his information but little happened to nail the culprits. “The supposed beneficiaries of the paper-leak were made complainants in the case,” he said. “It was diluted.”

Whistleblower Anand Rai

The breakthrough came in July 2013 when the Indore police raided a hotel and found a Munnabhai MBBS scenario unravelling on an exponential canvas. 20 people, brought in from other states as impersonators, were arrested that night.

The interrogation divulged names, one of them was Jagdish Sagar, a doctor from Indore. A list of 413 candidates was recovered from him. He had been acting as an intermediary and would “hone the cheating skills of students”, said Rai. The impersonators, said activists, were arranged mostly by doctors because they are aware of the availability and location of brilliant students.

Also Read: Whistleblowers explain how kin of politicians, judges, babus grabbed medical seats

One arrest led to another and before one could fathom the gravity of it, the head of Vyapam, Pankaj Trivedi, was behind bars. This was followed by the arrest of Sudhir Sharma, a mining baron with links to RSS and BJP. Then the involvement of Lakshmikant Sharma, the state's Minister for Higher and Technical Education, Culture, and Mining, came to light. 

How they got away with it

Investigations revealed how the irregularities had been institutionalised and middlemen had mushroomed across Madhya Pradesh.

Rai, himself an ophthalmologist, was suspicious of malpractice right from his days as a student, and became confident about it after his 2005 doctoral exams. It was around this time when the rigging got more professional. Rich kids had a bustling market available to them, from which they could chose their bypass route.

By 2008-09, touts had marked out specific territories. Jagdish Sagar, for example, hailed from Bhind. But so did another person called Deepak Yadav. When Yadav realised he had a competitor, he used his contacts in the police force and drove Sagar out of the area. After this conflict, Sagar made Indore his den. Tarang Sharma, another doctor, operated out of Bhopal.

Poonam said a van would pick up a group of students in the wee hours on the day of the exam and give them the question paper. 

However, other than leaking question papers and arranging for impersonators, there were two other ways of mocking the whole process. One is widely known as the ‘train and bogey’ system. A systematic procedure is followed while deciding the seating arrangements of students. Role numbers are generated in a logical way. But the manipulation of the generation of role numbers ensures that a 'solver' ends up sitting next to or in front of the student, allowing him to copy from his answer sheet. The sequence of candidates would be defined by 'fixers' like like Sagar, also refered to as 'doctors'.

The second method merely demanded that the candidate take the effort of arriving at the examination hall. All he had to do is sit in the hall and leave the answer sheet blank. The sheet would be intercepted before being evaluated, and the solvers would fill it up.   

KK Mishra, chief spokesperson of the Congress, said that the students get their signature, photographs, thumb impressions, application forms and marksheets scrutinised at three stages: examination halls, counselling sessions after the results and at the time of admission. “Yet, they got away,” he said. “There are many white-collar people still roaming free. The police needs to nab them.”

Friends in high places

Vyapam, an autonomous body, is evidently plagued with corruption. Its exam controller and staff undermined the procedure and fiddled with the future of the actual candidates. Medical seats were sold off, with prices ranging from Rs.18 lakhs to Rs. 1 crore. The Madhya Pradesh University is under the jurisdiction of the Governor, who is himself an accused in the Vyapam scam. His son handled rates, said Rai.

Given the active involvement of the high ranked, well-connected bigwigs in the state, there is a strong undercurrent of the rot running as deep as the state’s Chief Minister Shivraj Singh Chouhan. From 2008-2012, when the Vyapam scam had been at its peak, Chouhan was in charge of the education of the state. “Is it possible that a scandal as vast and organised as this went on and the CM was completely oblivious of it?” asks Mishra.

In this context, Rai has been insisting on a CBI probe monitored by the Supreme Court. “The CBI belongs to the Centre, run by the BJP,” he said. “If the investigations are not supervised by the Supreme Court, it could well be a cover-up.”

While Rai is suspicious of a botched up investigation, Poonam is confident about it. “Police officers, bureaucrats, politicians— all the powerful people are involved,” she said. “Who will catch whom?”

As a result of the burgeoning Vyapam scam, the health sector of the state is in disarray, and it hardly surprises Rai. “Those who subvert the system have little to do with ethics. Why would there not be corruption?” he asked. “If they have penetrated the health care through immoral means, would they suddenly become ethical after getting a degree? The fact is we have allowed thousands of unintelligent people with a corrupt mindset to become doctors. And they are out there treating people.”