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The national college-entrance exam, known as gaokao, is a life-changing event for Chinese students. It determines where you go to school, what kind of courses you take and, to a large extent, what kind of future you’ll have.

Some students fuel marathon study sessions with amino-acid IVs, while anxious girls take birth-control pills to avoid menstruating during the exam. Pressure to perform well on the test has led to fainting spells, nervous breakdowns, even suicide.

Still, some students have it better than others. The test – and the college admission process – favors students from top-tier cities like Beijing and Shanghai.

Most of the leading universities are located in the largest, wealthiest cities, and those schools prefer local applicants. Also, those cities give their own versions of the college-entrance test, which often are easier than the standardized one given in other areas.

Finally, the best schools admit relatively few students from poorer provinces like Henan, which have large populations but relatively few universities. So a student from Henan needs a higher score than his or her counterpart in Beijing or Shanghai to get into a first-class university.

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One of my students recently told me that if she had grown up in Beijing, her test score would have gotten her into Peking University or another top school in the capital instead of a lower-ranked college in her home province.

“The system isn’t fair,’’ she said. “Everyone is not treated the same.’’

That’s a good lesson to learn early in life.