CLINICAL TRIAL:OPPORTUNITES IN INDIA

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Clinical Trials: Growing Opportunities for India

The US$65-billion (in 2005), global R&D pie is expected to grow to US$l00-billion by 2010. If India secures even a small share of this, it could grow 2-billion business.

Thus, pharmaceutical R&D, whether outsourcing or indigenous, is likely to emerge as a multi­billion dollar industry, including contract research and manufacturing, clinical trials, etc.

Indian clinical trials market in 2006 was US$ 140million and is growing at a CAGR of 40% for the last 3 years. India is fast emerging as a favoured destination for clinical trials outsourcing, in view of the country's advantages like large pool of patients, faster patient recruitment, well trained English speaking physicians and IPR (Intellectual property rights) protection, besides lower labour costs. Over 100 pharmaceutical companies, including big multinationals such as Pfizer and Merck, are currently outsourcing clinical trials in the country. Also, there is an increased awareness regarding ICH-GCP (International Conference on Harmonisation - Good Clinical Practice) guidelines for conduct of clinical research. Besides, India's inherent advantage in IT skills helped in outsourcing of high-end activities like data management.

The new drug discovery is a complex process. It involves screening of around 10,000 compounds over a period of 8-10 years before a new drug discovery is successful. It also involves huge investment to the tune of almost US$1-billion. The major cost in the drug discovery process is the clinical trials [1,2].

India is uniquely placed to undertake clinical trials, due to the following reasons:

1.Very large population base available;

2.Diverse ethnic groups available;

3.Well equipped hospitals;

4.The law, including on ethics, is in place;

5.The expertise has been developed; and

6.Most importantly, the cost is substantially lower than in the West.

In spite of the above, out of the global clinical market US$50-billion, India's share is as yet only US$100-million.

Phase I trials

This stage involves introduction of a new drug into healthy humans, to determine the metabolic and pharmacological actions of the drug, its side-effects and effectiveness. The trial evaluates drug metabolism, structure activity relationships and the mechanism of action in human. The number of subjects is typically from 20 to 50.

Phase II trials

These are controlled clinical studies for obtaining preliminary data on the effectiveness of the drug for subjects with the disease. The objective is to determine the short-term side­-effects and risks of using the drug. The number of subjects runs into several hundreds.

Phase III trials

This phase of the trial is carried out with the aim of gathering additional information about the effectiveness and safety of the drug. It provides a basis for extrapolating the results to the general population and putting that information on the label. The number of subjects ranges from several hundreds to several thousands. If the cost of new drug discovery is to be reduced, it is imperative that clinical trials are carried out effectively at a lower cost. This is where India is uniquely placed.

Indian clinical scenario

80 Indian hospitals are presently involved in clinical trials. This figure is likely to go up to 14,000 and will mean an involvement of 5 lakhs doctors, 7 lakhs bed's, 17,000 medical graduates in 160 medical colleges.

While India has many advantages for carrying out the clinical trial work meeting the stringent requirements of the west, there is competition from other countries (Table 2),

As can be seen, while India is rated high for its available patient pool, it scores average in comfort level of sponsors. In spite of competition, India is still cost competitive (Table 3).

New drug discovery is a complex process, involving screening of 10,000 compounds over a 8-10 year period and costs about US$1-billion before a new drug is successfully inducted into the market.

The major cost in drug discovery are in the Phase I, II & III clinical trials and India is uniquely placed in carrying them out due to various advantages, including substantial lower cost.

Cost-savings are a significant draw card for many pharmaceutical companies when deciding to outsource clinical research to countries in emerging markets such as India.

In the last 10 years, skyrocketing costs of R&D have led to a growth explosion in the clinical services industry as pharma companies scramble to cut costs [2,3].

CROs in India

1.Clinigene

2.Dr Reddy's Laboratories Limited

3.GlaxoSmithKline

4.Lupin Limited

5.Novartis

6.Pfizer Limited

7.Ranbaxy Laboratories Limited

8.Torrent Pharmaceuticals Limited

9.Vimta Labs Limited

10.Zydus Cadila

11. Asian Clinical Trials Limited

12.Bioserve Clinical Research Pvt. Ltd.

13.Clininvent Research Pvt. Ltd.

14.Clintec International

15. Eli Lilly and Company (India) Pvt. Ltd

16.Igate Clinical Research International

17.Intas Pharmaceuticals

18.Johnson& Johnson, India

19.Lambda Therapeutic Research Ltd

20.Lotus Labs Pvt. Ltd.

21.Matrix Laboratories Ltd.

22.Merck Limited

23.Novo Nordisk India Private Ltd.

24.Pharmanet

25.Quintiles Research (India) Private Limited

26.Reliance Clinical Research Services

27.Roche India Ltd.

28.Sanofi-Aventis (Aventis Pharma Limited)

29.Siro Clinpharm Pvt Ltd

30.SRL Ranbaxy

31.Sristek

32.Synchron Research Pvt. Ltd

Table 1: Success Rate in New Drug Discovery

Activity

Drug

screening

Preclinical

testing

Phase I

Phase II

Phase III

Market

launch

Probability of success

High risk of failure

Low risk of failure

Number of

candidates

5000

250

20

16

9

5

Probability

of entering

next phase

5%

8%

79%

58%

57%

---

Source: R. Vipranarayanan & Dr. A.K. Mukerkee; Chronicle Pharmabiz

Table 2: How India Fares in Global Clinical Research

Country

Population

(Available

patent pool)

Comfort level

of sponsors

Intellectual

property/regulation

Cost

Attractiveness

India

3

2

1

3

China

3

1

1

3

Eastern

Europe

1.5

2

2

2

US

1

3

3

1

Ratings: 1 = Low; 2 = Medium; 3 = High;

Source: 2005 study by US consultancy Proximare. Source: Business Week

Source: Pharmabiz, Cygnus Research

Table 3: Cost Competitiveness of Indian R&D

Phase

US Costs

Indian Costs

Phase I

US$ 20 million

<50% of US cost

Phase II

US$ 50 million

<60% of US cost

Phase III

US$ 100 million

<60% of US cost

Source: Pharmabiz, Cygnus Research

Table 4: Drug Discovery Pipeline of Indian Pharma sector

Company

Pre-clinical

Phase I

Phase II

Ranbaxy

5

3

2

Dr Reddy's

5

2

1

Wockhardt

-

-

1

Nicholas Piramal

-

-

1

Lupin

-

-

2

Orchid

2

1

-

Torrent

19

-

-

Glenmark

1

1

-

Dabur

29

1

1

Total

64

12

4

Source: India Brand Equity Foundation

The average cost of running a US-based clinical trial per patient is $5,404 for Phase I, $6,538 for Phase II and $7,635 for Phase III clinical trials. According to an analysis last year by Rabo India Finance, conducting a clinical trial in a lower-cost destination such as India , for example, can cost up to 60 per cent less than in the US. However, while quickly gaining momentum, India 's much hyped clinical research industry is still yet to really take off.

A report by analysts at McKinsey estimated that clinical research in India will be a $l billion (€800,000million) industry by 2010, although many analysts expect it will be closer to half that. To make India a preferred destination for drug testing finance minister has proposed to exempt clinic trial of new drugs from service tax in the Budget for the year 2007-08. Also, total exemption from service tax is being provided to technical testing and analysis for testing of new drugs, vaccines and herbal remedies, on human participants by a CRG (Clinical Reference Group) approved to conduct clinical trials by the Drugs Controller General of India.

It is a well-known fact that the world is looking at India as a clinical trial destination of choice. However, is India capable of handling large, complex clinical trials? India must pay immediate attention to handle large clinical trial projects effectively and to sustain a steady growth in the clinical trials market.

There is a large influx of clinical trials from across the globe heading towards India . Major pharmaceutical companies and global Contract Research Organizations (CROs) are expanding staff and business activity in India . In this situation, it is mandatory for India to tackle issues to sustain in the industry keep other competing countries at edge. A recently held conference on Clinical Research and Development in India held by the Institute of Clinical Research in association with DST, has highlighted following issues for the Indian attention.

Infrastructure:

Creating large-scale exclusive clinical trial facilities in India are a must. There is a need for hospitals to create special beds for clinical trials. Research institutions and pharmaceutical companies should establish clinical trial centers that do not overlap with the existing R&D facilities.

Manpower:

There is an acute manpower attrition in India. Qualified and experienced clinical trial investigators are the need of the hour. Experienced investigators who can take decisions in adverse situations have to be strengthened. According to an estimate it presently requires about 4,000 experienced Principals Investigators for major trials. There is a requirement for experienced nurses, biostatisticians, researchers and coordinators in every clinical trial, and India must train the manpower available in these areas to suit clinical trial evaluation. India has a crunch in auditors, who can audit the effectiveness of a clinical trial.

Data Management:

Effective data collection, storage and maintenance need to be strategically adapted in India . Electronic data storage and analysis need could help streamline some cumbersome process and would also save significant time.

Regulatory Compliance and Ethical Issues:

Although, the Indian Government has revised the ethical guidelines for clinical trials in 2007, CROs mllst practice and follow the guidelines diligently. A number of such isslles are bogging down on clinical trials industry in India . It is essential for the government to work in coordination with CROs, regulatory bodies and patients to help India gain the earmark as the best destination for clinical trials [1-3].

References:

1.Chemical weekly, April 17, 2007, p. 1985-87

2.Budget Speech, 2007-08

3.Conference on Clinical Research and Development in India, April 14-15, 2007, Bangalore

MNC & Indian Pharmacos in Clinical Research

1.Abbott, Mumbai

2.Chiron, Mumbai

3.Astra Zeneca Pharma India Ltd, Bangalore

4.Astra Zeneca Foundation, Bangalore

5.AventisPasteur, Delhi

6.Pfizer Ltd, Mumbai

7.Pfizer Biometrics, Mumbai

8.Altana(Zydus), Mumbai

9.Elly Lilly, Delhi

10.Boston Scientific, Delhi

11.Hospira, Delhi

12.Merck, Delhi

13.Sanofi Aventis Syntho Lab, Mumbai

14.GSK, Glaxo SmithKline Pharmaceuticals Ltd, Mumbai

15.Novartis International Clinical Development Center, Mumbai

16.Novartis Pharma, Mumbai

17.Roche, Mumbai

18.Sandoz, Mumbai

19.Wyeth, Mumbai

20.BMS, Mumbai

21.Novo Nordisk, Bangalore

22.Lundbeck, Bangalore

23.Eisai Pharmaceuticals, Mumbai

24.LG Life Sciences, Delhi

25.Bayer, Mumbai

26.GE, Delhi

27.Johnson & Johnson, Jansenn Cilag, Mumbai

28.Cordi Baxter, Delhi

29.BD Biosciences, Delhi

30.Bharat Biotech, Hyderabad

31.Bharat Serum, Mumbai

32.Cadila Pharmaceuticals

33.Cipla, Mumbai

34.Emcure, Pune

35.Fulford India Mumbai

36.Indus Biotherapeutics, Ahmedabad

37.IPCA, Mumbai

38.Shreya Biotech, Pune

39.Shantha BiotechnicsPvt. Ltd. Hyderabad

40.Sun Pharma, Mumbai

41.Torrent Pharmaceutical Ltd, Gandhi nagar

42.USV Ltd. Mumbai

43.Wockhardt, Mumbai

44.Zydus Cadilla, Ahmedabad

45.Biocon, Bangalore

46.Cadila Pharmaceuticals, Ahmedabad

47.Intas Pharmaceuticals Ltd., Ahmedabad

48.Glenmark Pharmaceuticals Ltd., Mumbai

49.Himalaya Drugs ,Bangalore

50.Lupin Ltd., Pune

51.Nicholas Piramal,Mumbai

52.Panacea Biotech, Delhi

53.Ranbaxy Research Laboratories, Delhi

54.Ranbaxy Research Laboratories, Gurgaon

55.Serum Institute of India, Pune

56.Torrent, Ahmedabad

List of Major CROs

» Quintiles Ahmadabad/Bangalore

» Synchron Ahmadabad/Bangalore

» Lambda Ahmadabad

» Siro Clinpharm Mumbai

» I-Gate Mumbai

» Reliance Clinical Services Mumbai

» PPD Mumbai

» Onmnicare Bangalore

» ICON Bangalore

» Clin Trac Bangalore

» PharmaNet Bangalore

» Pharm-Olam Bangalore

» Lotus Labs Bangalore

» Vimta Hyderabad

» GVK Hyderabad

» BioServe Clinical Research Hyderabad

» Apothecaries Delhi

» Kendle Delhi/Gurgaon

» Bioassay Baroda

» Clinworld Bangalore

» Perinclinical Mumbai

» Quest Life Sciences  

» Micro Therapeutic Research Labs Private Limited Chennai

List of Pharmacovigilance Companies in India

List of Pharmacovigilance Companies in India

HYDERABAD: 12

1. NOVARTIS

2. PARAXEL

3. MAKROCARE

4. MAHINDRA SATYAMBSG

5. DR REDDY’S

6. AUROBINDO

7. SRISTEK

8. SHANTHA BIOTECHNICS

9. NEKTAR THERAPEUTICS

10. VIMTA LABS

11. BIOLOGICAL E. LTD

12. MEDHIMALAYAS

BENGALURU: 14

13. QUINTILES

14. SYNOWLEDGE PV SERVICES

15. BIOCON

16. ACCENTURE

17. ASTRAZENECA

18. BLUEFISH

19. SCIFORMIX/STRIDES ACROLABS

20. MMS-HOLDING

21. NORWICH CLINICAL SERVICES

22. HCL

23. OMNICARE CLINICAL RESEARCH

24. MICRO LABS

25. ECRON ACUNOVA

26. G7 INFOTECH

MUMBAI: 11

27. COGNIZANT

28. TCS

29. SIRO CLINPHARM

30. MEDPACE

31. SCIFORMIX

32. PPD

33. SYMOGEN

34. IPCA LABORATORIES

34. RATIOPHARM

35. DIAGNOSEARCH

36. UNIJULES (NAG PUR)

PUNE: 2

37. I 3 GLOBAL DRUG SAFETY

38. SCIFORMIX

CHENNAI: 4

39. ICON

40. ACCENTURE

41. RX MD

42. TAKE SOLUTIONS

DELHI: 5

43. JUBILIANT-BIOSYS

44. APCER, DELHI

45. WIPRO

46. I GATE PATNI COMPUTERS

47. APC PHARMA

GURGOAN: 5

48. KINAPSE

49. MSD (MERCK)

50. I 3 GLOBAL DRUG SAFETY

51. GVK

52. WNS

AHMEDABAD: 2

53. LAMBDA

54. INC RESEARCH

CHANDIGARH: 1

55. QUANTUM SOLUTIONS

What to Do If Unsuccessful in Exams

It is always difficult to forecast the result of the exams; it does not matter whether you are in school or college. It is because exams are scariest part of student life but exams take out the finest ones, predictably or unpredictably. But for some student’s exams results can be a mental disaster and they cannot handle the mental stress of getting failed. Failing is the most disturbing and shocking experience. Only way to manage the mental stress of failure is to talk to the people. Discuss the matter with your family, friends and your mentor who can suggest you with a better approach for future career aspects. Keep in mind that failing in the exam does not mean that it is the end of your life or career opportunities. It is a phase if life which you have to pass through in life sooner or later. We fall to rise again and to rise above failure. Failure gives you strength and makes you stronger. Failures make you understand what it means to fail which was beyond your expectations.

It is always difficult to forecast the result of the exams; it does not matter whether you are in school or college. It is because exams are scariest part of student life but exams take out the finest ones, predictably or unpredictably......

Students worry so much about their failures because they feel that just because of this single failure they are not going to get their dream job or university (college), which is absolutely wrong. Do not let your failures hinder your performance or achieving anything in life. These failures must not convince you that you cannot achieve your goals. Failing in exam does not mean that you are less than anyone who has performed better than you exams.

How to handle such scenario- Advices for students

• The students should: Consider all possible priorities, resources and problems and Follow a stabilized routine at home.
• Should not envision extreme consequences and worst circumstances. Should not amplify failure or degrade self.
• Stay connected with the teachers or counselors when feeling low or worried or disinterested.
• Cultivate alternative managing strategies and de -emphasis from the pain.
• Relax your mind. Be positive and hope for the best.
• Talk to family and friends. Stop worrying. Outcome is not the final influential factor.
• Go for the options available. Find out and update with wide and diverse choices. Your decision should not be influenced by others.be true to yourself. Don’t forget your strengths and your capabilities and your own choices.

Steps required to study with concentration:

1. Eliminate Interruptions: choose a place to study which is interruption free. Where you have lowest noise pollution, your study place is the last place to be interrupted by the guests
2. You need to utilize the time of the day which suits you the best, in which you feel fresh and can easily grasp whatever you study. Researchers have proved that 60 minutes study at morning is equivalent to 90 minutes study at night.
3. You need to focus on the ongoing task and it must be given the utmost priority. We should try and keep ourselves away from the distractions. For instance, you must study for the time you had previously decided without peeping into your notifications on your Facebook account.
4. Set Goals: decide how long you are going to study and what subjects you need to complete before you leave your study table. Always stick to the planned goals.
5. Positive attitude: keep no phrase in dictionary like “I cannot do it” or it cannot be achieved.
6. Rest/Stretch time: take breaks to walk around. Short walks pump blood supply to your brains which eventually increases supply of oxygen to your mind and increases understanding and concentration.
7. Changing the subject: Keep changing the subjects you study. Do not study the same subject for long hours. If you change subject then you absorbs more points than keep studying the same subject and getting fed up of that.
8. Reward yourself: give yourself small treats for achieving the goal. It will keep you happy and fulfilled

if you set your goals ridiculously high and its a failure, you will fail above everyone elses success ― James Cameron

Memory Improvment : How Self testing can Help and Effects of selftesting

The word ‘test’ itself is enough to strike fear into the heart of even the most nerveless of students. Howeveraccording to some researchers tests can help improve our long-term memory and our ability to retrieve important information when we need it. Every individual have their own study strategies, with specific habits, quirks and routines that work best for them. But there is a mounting body of evidence to suggest that the traditional approach to learning may not be as effective as it was believed earlier. In fact , studying until your eyes are almost ready to pop out of their sockets as you approach exam time is one of the most wrong things to do.

The word ‘test’ itself is enough to strike fear into the heart of even the most nerveless of students. Howeveraccording to some researchers tests can help improve our long-term memory and our ability to retrieve important information when we need it.

The Effects of Testing

We consider them to check our intelligence, that how much we are exactly capable of and how much we know. But Psychologists are improvising the concept more and more that test can rather be far more beneficial to us than this. So, know the question arises HOW? Results shows that they can actually make this happen by improving the long-term memory. This makes tests suitable as well as ideal for language learning or key facts and dates storing.  After this, Under-utilizing, or not utilizing it in a more effective way will be more of a shame .

For example, while students may have their own different study habits, their overall approach to study generally looks quite similar:

prepare, prepareprepare, test.

Or it can look like this:

prepare, test, prepare, test.

However, according to researchers, what it should look like is:

prepare, prepareprepare, test.

Or it can look like this:

prepare, test, prepare, test.

, test, test, test.

That’s because studying in this way is a more effective method. Psychologists call this the ‘Testing Effect’.

 Improvement of memory through testing – some research

The influence of the testing effect can be seen in two recent studies, which are outlined below.

Experiment #1

Jeff Karpicke and Henry Roediger, American psychologists, examined a group of college students by conducting an experiment to show the effects of testing on facts memorization and language learning. Students were asked to learn pairs of Swahili and english words followed by preparation of test in different ways. First group were asked to keep testing themselves on all items without skipping what they were getting right whereas the second groupwere told to stop testing themselves on their correct answers.

Results obtained were outstanding. The students who skipped items from testing, coul recalled about 35% of the word pairs.Those who kept testing themselves even after they had learned them could recall 80% of the word pairs

Experiment #2

CarolaWiklund-Hörnqvist, conducted another remarkable study in 2014 for which he got 83 students to study a series of psychological concepts for four minutesin an undergraduate psychology course. 50% of the students being part of the experiment, continued to study, while each one was presented on a computer screen for 15 seconds.

Remaining students were asked to take six tests in which their task was to suggest concept described on the screen .

At the end of the learning session, all 83 participants who were part of the test, were given a fact and asked to type in the equivalent concept. The same test was given 18 days later and again 5 weeks later.

Tested participants tested outclassed the other students on all three tests.

The students who were tested in the second case were given an additional memory boosterthrough what is known as ‘instant response’ – that is, finding out whether you’ve answered correctly or not straight after you have provided your answer.

Getting how to learn

So if testing improved to be so successful in improving our long-term ability to recall facts, why don’t we use it to implement it in our revision plans? Some commentators have recommended that it may come down to the way that we traditionally feel about tests. It’s probably reasonable to say that most people would view standard study methods as being less intimidating and demanding than tests. As the mind is hard-wired to follow the path of least resistance, learners are more inclined to opt for the easier option.

However, it has also been noted that people show a lack of awareness when it comes to the ways we think and how they can be enhanced upon. These are what psychologist Tom Stafford refers to as ‘mental blind spots’.

So while it may seem unecessary to think that testing yourself when not properly prepared might be a good thing.

what is SAS

SAS is software where in they can use it in their domain and it is comparitively easy to learn as SAS® is neither a menu-driven nor a command driven application. Rather it relies on user-written scripts or “programs” that are processed when requested to know what to do. Because it is a script-based application, the key to being successful using SAS is learning the rule and tricks of writing scripts.

• Can process large data set(s)

• Easy to cope with multiple variables

• Can track all the operations on the data set(s)

• Can generate systematic output

• Summary statistics

• Graphs

• Regression results


WHY SAS IS THE ANSWER:

Clinical data is sensitive information that should be treated as a valuable asset as well as a regulated commodity. Not only can improper management of clinical data cause the invalidation of an entire clinical trial, but it may also result in strict remedies, including serious financial penalties, from the FDA.

At the time of this writing, the FDA has not issued revised CFR 21 Part 11 guidance. This indicates that the FDA is still struggling with the difficult issue of Part 11 requirements compliance for a clinical database. However, it is known that the FDA does request that all clinical DBMS prevent unauthorized access to data. This requires that data be password protected and allow updates only by authorized users of the clinical DBMS.

The FDA also requires maintenance of complete audit trails for clinical data. Both the entry and revision of clinical data is to be logged to indicate the user performing the action, the date and time of the action, as well as the reason for change of data.

These requirements and many others are all easy goals when working with the SAS System. In addition to being easy to use, SAS is also the choice of the FDA for receiving and reviewing clinical data. The FDA is still requesting SAS transport data sets as the standard for receiving electronically submitted data. At a minimum, each FDA reviewer is equipped with the SAS System Viewer.

Since the use of SAS is essential to clinical information management, keeping clinical data in SAS makes sense. SAS is the government and the industry standard for performing clinical analysis. Reporting is also effectively accomplished using SAS.


 Who can pursue SAS

Graduates & PGs from any discipline (MBAs, Commerce, Engineering Life sciences, Arts, Medicine, MCAs Statistics etc) can learn SAS.

 Applications

SAS applications are used in
• Financial Services
• Banking
• Insurance
• Retail
• Manufacturing
• Media
• Education
• Communications
• Government
• Hospitality & Entertainment
• SAS Solutions for Small to Medium Businesses
• Aerospace
• Health Insurance
• Automotive
• Energy & Utilities
• Life Sciences
• Government
• Federal Government
• State Government

In the given industries SAS can be used in the following areas

• Customer Relationship Mgmt
• Financial Intelligence
• Human Capital Mgmt
• Profitability Management
• Performance Management
• Risk Management
• Business Intelligence
• Reporting
• Query & Analysis
• Microsoft Office Integration
• Forecasting & Econometrics
• IT Management
• Activity-Based Management
• Compliance (Basel II, Sarbanese Oxly Act etc.)
• Service Intelligence • Supplier Intelligence
• Supply Chain Intelligence
• Web Analytics
•On Demand Solutions
• Data Integration & ETL
• Connectivity & Metadata
• Data Cleansing & Enrichment
• ETL
• Migration & Synchronization
• Data Federation• OLAP
• Integrated Analytics
• Visualization
• Analytics
• Statistics
• Data & Text Mining
• Optimization
• Model Mgmt. and Deployment
• Quality Improvement
• Enterprise Intelligence Platform
• Data Integration & ETL
• Business Intelligence
• Analytics
• Intelligence Storage

HOW TO PREPARE FOR COMPETITIVE EXAMS ?

HOW TO PREPARE FOR COMPETITIVE EXAMS ?

Fortunately or unfortunately, competitive exams have become a strict norm for selection to various professional courses in our country. Notwithstanding the demerits of such a system, competitive exams are a reality for the lakhs of students who appear in them every year. 

In such a scenario, everyone wants to success. Success in these exams brings immense glory and confidence to the individuals, besides giving them a clear cut break into the career line of their choice. However, seats are limited and not everyone who appears can be selected. This does not mean that those who are not selected do not deserve a training in these courses. It only means that there aren't sufficient seats to accommodate all the deserving candidates.

Keeping this background in mind, let us explore what it takes to succeed in these competitive exams particularly at the undergraduate level.

To my mind, the first prerequisite for success in these examinations is determination. The candidate must be quite sure of his level of motivation. Without a high level of motivation, no one can go through the rigorous preparation process. Thus, you must be absolutely determined to give your best efforts in your endeavor.

Once one is sufficiently motivated, one needs to be ready to give sufficient number of hours of his or her time in studies. This is real hard work and involves significant sacrifices on the part of the individual. "All work and no play, makes Jack a dull boy". Therefore it is also important that the candidate does take out some time for relaxation either through sports, music or other art forms. Regular exercise ( about 15 - 20 minutes ) every day will help maintain a healthy body which in turn will house a healthy mind.

The third requirement, is selection of the right study material. One should not go for shortcuts. Instead, try to understand the chapters / concepts in detail and practice sufficient number number of questions. Therefore go for standard textbooks, study materials provided, as various correspondence courses and other coaching institutions serve as supplementary and complementary material to the textbook material.

The fourth consideration is an appropriate 'Study Strategy'. A very common question which students ask is, How to balance the school studies with competitive exam study. Think that school studies can be incorporated within the broad framework of one's competitive exams' preparation strategy. One strategy is to look at each chapter as a chapter to be learnt, a material to be mastered; rather than dichotomizing it as school & competitive exam-related study material. Ultimately, if one's clear about the concepts of say, "Current & Electricity", and has practiced sufficient number of questions / numericals ; one can face any examination whether of school or competition. One can use periodical tests in school as an opportunity to master the material that one has collected rather than restricting yourself to the limited knowledge & practice that is needed for doing well in the periodical test itself. Of course, you may not be able to complete all the practice material for one test but clear the concepts. You can use the rest of the practice material for revision and self evaluation at a later time.

 As the examinations come closer, practicing previous years papers is also key to doing well in these examinations. 

Also revise the important concepts, facts, problems that you would have marked during during your 1.5 - 2 years of preparation before the examination.

On the day of examination, keep your cool and attempt the questions. Remember, if you have given your best during the last 1.5 - 2 years, you need not fear anything. Ultimately, only effort and not the result is in your hand. Which you should do to your maximum capability as outlined above. Rest is your destiny or luck. So go ahead, give your best and leave the rest!