Breaking News: NMC releases Draft gazette on NEXT with details, invites comments; Check out complete Breakdown

Published On 2022-12-28 17:00 GMT | Update On 2022-12-29 05:48 GMT

New Delhi: Waiting for the end for thousands of medicos across the country, the Apex medical regulation, National Medical Commission has finally released the proposed draft regulationsrelated to National Exit Test (NExT) clearly specifying that it will serve as both a licentiate exam for the purpose of practice of modern medicine for both Indian Medicos and Foreign Medical Graduates and also as...

The draft further provides all the details related to the NExT exam detailing its objective, applicability, its bifurcation into STEP 1 and STEP 2 and how these two steps examinations be conducted as well as the calculations and validity and the uses of the NeXT scores. Currently, it is not specified which body will conduct the exam. The draft notes that NEXT step 1 scores will be used towards PG entrance and NEXT STEP 2 will be a qualifying exam. The validity the NEXT STEP 1 scores towards PG entrance shall be 3 years and at the same time there is no limit on the attempts at both the exams provided that the candidate has passed both NExT Step 1 and NExT Step 2 Examination within 10 years of joining the MBBS Course

Comments are invited to be shared on the draft regulations at the following email ID - comments.regulations@nmc.org.in in MS Word (.docx) format or machine readable PDF format within 30 days of publication of this notice with a subject tagline 'Comments on draft regulations regarding National Exit Test (NExT) that is 28th December 2022

Here is the complete Breakdown

Objective

The objective of these regulations is to bring in uniformity in the summative evaluation across the countrywith reference to the minimum common standards of education and training of a medical graduate

What will NExT serve as?

The National Ext Test (NExT) shall form the basis of

(i) Certifying the eligibility ofthe medical graduate to register to practice modem system of medicinein India and therefore serve as a Licentiate Examination

(ii) Determine the eligibility and ranking for the purpose of admission ofthose desirous of pursuingfurther Postgraduate Medical Education in the country in broad medical specialities and therefore serveas an entrance Examination for admission to courses Postgraduate Medical Education

Who Will Conduct NExT?

Currently the draft regulations have not specified who will conduct exam stating that the Commission or an appropriate body or authority or institution as approved by the commission shall conduct the National Exit Test as specified hereunder (2)

Who Will be eligible for NExT (Applicability of NExt Exam)?

The National Exit Test (NExT) shall be applicable to

(i) All undergraduate medical students pursuing the degree ofMBBS in all Medical Colleges asapproved by the National Medical Commission through the Medical Assessment and RatingBoard as well as the Undergraduate Medical Education Board

(ii) All Foreign Medical Graduates approved by the National Medical Commission for the purposeof obtaining licence to practice medicine as a registered medical practitioner in India and forenrolement in the State Register or the National Register, as the case may be in such manner asmay be specified by regulations.

(iii) Any other person with a Medical Degree for purpose such as pursuing an academic course,observership or any other purposes as may be specified and approved by the National MedicalCommission through due notification or regulations from time to time

What will happen to the current exam Structure and the previous batches?

As per the draft, It is implied that whenever the NExT is in force, the corresponding equivalent existing Examinations shall be phased out/cease to be applicable for purpose for which the NExT shall be appropriate. However, if for previous batches the existing examinations are applicable as may be decided by the Commission Central Government, State Government, Universities, applicable laws, and rulings, then the existing examinations shall continue for such time as may be appropriate with the understanding that the NExT shall be eventually replace the corresponding equivalent existing examinations. The use of scores and normalization of different examinations and the NExT, when applicable concurrently, for such purpose as may be appropriate, shall be determined as the when necessary and notified by the Commission.

"The Commission shall specify, from time to time, by appropriate regulations and /or notification the applicable manner of utilizing the results of the NExT for the purpose of admission to Postgraduate Courses in broad medical specialties through mechanisms such as common counselling by designated authority," the draft also added.

Conduct of NExT in 2 steps- The draft confirms that the NEXT shall comprise of two separate of examination called as "Steps". Of these NExT Step 1 will be a Theoretical Examination, whose scores will be used towards determining merit for the purpose of admission to Postgraduate courses in broad specialties as well as may be used by State governments for employement, scholarship and other purposes. These scores will have a validity of three years NExT 2, on the other hand, will be a Practical /Clinical and Viva Voce Examination covering seven clinical subjects/disciplines where results shall be declared as only Pass / Fail based.

The commission notes that there is no restriction to the number of attempts to appear in NExT Step 1 and NExT Step 2 exams provided the candidate has passed both NExT Step 1 and NExT Step 2 Examination within 10 years of joining the MBBS Course

NEXT Step 1

On the explanation of NExT Step 1, the draft notes the following

(i)NEXT Step I shall be a Theoretical Examination

(ii)The Questions shall be one or more than one type of the Mulitple Choice Type

(iii) The Examinations shall be delivered by a Computer Based /Online mode

(iv) This shall be a Centralized Common All India Examination to be conducted by an authority/Body/ authority for the purpose by the commission

(v)The Examination shall consist of Six papers covering subjects of III MBBS /Final MBBS , both Part 1 and Part 2:

a.Medicine and allied disciplines

b.Surgery and allied disciplines

c.Obstetrics and Gynaecology

d.Paediatrics

e.Otorhinolaryngology

f.Ophthalmology

g.Applied aspects of all subjects covered under I MBBS and II MBBS

h.Applied aspects of all subjects covered under III MBBS /Final MBBS Part 1

(vi) All those students who have completed the III MBBS /Final MBBS course from a medical college recognized by the Commission shall be eligible to appear in the examination

(vii) There shall be a regular NExT Step 1 Examinations held once a year prior to the University Practical Examination for the III MBBS (Part2)/Final MBBS preceding Compulsory Rotating Internship

(viii) A NExT Step 1 Supplementary Examination shall be held once a year and is restricted to only those candidates who have failed in one or more of the six papers and are required to repeat those particular papers /subjects

(ix) Those who do not pass both the NExT Step 1 Regular and the Supplementary Examination of a particular year shall be able to appear for the NExT Step 1 Regular Examination only in the following year

(x)There is no restriction to the number of attempts to appear in NExT Step 1 provided the candidate has passed both NExT Step 1 and NExT Step 2 Examination within 10 years of joining the MBBS Course

(xi)There is no restriction to number of attempts to appear in the NExT Step 1 Regular Examination to improve scores provided these examinations for improvement of scores are taken at least after one year of completion of NExT Step 2

(xii) The NExT Step 1 shall replace the conventional university/institutional Theory Examinations of III MBBS /Final MBBS Part II. III MBBS /Final MBBS Part 1 and III MBBS/ Final MBBS Part II Practical/ clinical examinations shall continue to be held conventionally unless otherwise notified by the Commission

NExT Step 2

On NExT Step 2, the fraft notes the following

(i) NExT Step 2 shall be a Practical /Clinical and Viva Voce Examination covering seven clinical subjects/disciplines;

a.Medicine and allied disciplines

b.Surgery and allied disciplines

c.Obstetrics and Gynaecology

d.Paediatrics

e.Otorhinolaryngology

f.Ophthalmology

g.Orthopaedics and PMR (Physical Medicine and Rehabilitation)

(ii)The examination shall be Objective Structured, Clinical Case Based, Simulated Cases /Patients aimed at evaluating Practical /Clinical skills, clinical decision-making and communication skills expected of an Indian Medical Graduate

(iv)The examination shall be held in person /live and shall be conducted by the respective state Health Universities / Institutions following the standards and guidelines provided by the Commission. Where state Health Universities do not exist the Commission shall decide on the University/ Institution authorized to conduct NExT Step 2 for respective colleges.

(v)There shall be a Regular NExT Step 2 Examination once a year

(vi) A NExT Step 2 Supplementary Examination shall be held once a year and is restricted to only those candidates who have failed in one or more ( upto 3 Subjects) of the seven subjects and are required to repeat particular subjects.

(vii) Those who do not pass both the NExT Step 2 Regular and the Supplementary Examination of a particular year shall be able to appear for the NExT Step 2 Regular Examination only in the following year

(viii)There is no restriction to the number of attempts to appear in NExT Step 2 provided the candidate has passed both NExT Step I and NExT Step 2 Examination within 10 years of joining the MBBS Course

NExT Scores

(1) Nature of Scoring- The draft notes that NExT Step 1 will have raw scores while NExT 2 will be a mere qualifying exam with pass or fail. The draft states

i.The marks in NExT Step 1 shall be calculated as whole number which shall serve as the Raw Scores with appropriate decimals and subsequently corresponding Percentages [marks out of a maximum of 100] with appropriate decimals may be calculated if required

ii.NExT 2 Examinations results shall be declared as only Pass / Fail based on the acquisition ofappropriate competence that is being evaluated

Minimum scores for passing

i.The minimum marks for passing shall be 50% [50out of 100] OR half of the maximum possible Raw for NExT Step 1

ii. For the NExT Step 1, in each of the six papers a minimum of 50% [ 50 out of 100] OR half of the maximum possible Raw Scores r should be scored to pass the examination

iii. The criteria for passing NExT Step 2 shall be satisfactory demonstration having acquired the competencies that are evaluated that shall be declared as a Pass /Fail result.

Calculation of NExT Step 1 Scores for determining merit for the purpose of admission to Postgraduate courses in broad specialties

i.The Total Marks for the purpose of determining merit especially for admission to broad specialty Postgraduate Course shall be calculated from the sum of raw scores obtained in each paper /subject

ii.In the case of failure in one or more subjects, the Total Marks /Percentage of NExT Step 1 for a candidate shall be calculated from the sum of total of raw scores in each subject /paper obtained in both Regular and Supplementary Examination in which the candidate has secured pass —marks

iii.The Total Marks Percentage of those candidates who have appeared in NExT Step Examination to improve their scores shall be calculated from the average /mean of last three consecutive scores

iv.For the purpose of determining merit especially for admission to broad —specialty Postgraduate Course the NExT Step scores shall remain valid for three years.

Utility of NExT Scores

i.Eligibility for Provision Registration in an appropriate body to practice modern of medicine as an intern and eligibility to purpose Internship as governed by the Internship Regulations of the National Medical Commission by an Indian Medical Graduate.

A Medical student from a college recognized by the Commission for imparting undergraduate medical education shall be eligible for Compulsory Rotating Internship provided all of the following criteria are met:

(a)Pass in each of the six Theory Papers of NExT Step 1 as provided in Section 2.2 (ii) as indicated above

AND

(b)Pass in III MBBS/ Final MBBS (Part 2) Practical / Clinical Examination as regulated by the concerned University /Institution

ii.Eligibility for Provisional Registration to practice modern system of medicine as an intern in an appropriate body and eligibility to pursue Internship as governed by the Internship Regulations of the National Medical Commission by an Indian Medical Graduate.

A medical student who has completed undergraduate medical education overseas from a college recognized by the Commission and has fulfilled the applicable requirements provided in the Foreign Medical Graduate Regulations of the Commission shall be eligible for Compulsory Rotating Internship as approved for such students provided the following criteria are met:

(a) Pass in each of the six Theory Papers of NExT Step 1 as provided in Section 2.2 (2) (ii) as indicated above

iii.Eligibility for grant of License to practice modern system of medicine in India and eligibility to the registered in the National Medical Register / State Medical Register /State Medical Registers for such practice

A medical graduate who has qualified in India for overseas shall be eligible to be registered in the Indian Medical Register / State Medical Register and licenced to practice modem system of medicine in India provided the all of he following are met with

(a)Has completed the appropriate duration of Internship as applicable, having fulfilled the requirements provided in Section 2.2 (4)(i) Subsection (a) and (b) as may be applicable

(b)Has passed the NExT Step 2[Practical / Clinical] Examination provided in Section 2.2 (2) (ii) as may be applicable

(c)Any other requirements as may be considered appropriate by the Commission, Concerned University / Institution and duly applicable at that time

iv. Eligibility for admission to Postgraduate Medical Courses in Board specialty subjects in a college/institution approved by the Commission

All those who have been granted Licence to practice and are Registered in the Indian Medical Register / State Medical Register for such practice having fulfilled the requirements in Section 2.2 (4)

Subsection (iii) above are eligible for admission to Postgraduate Medical Courses in broad specialty subjects in a college approved by the Commission provided all of the following criteria are met with

(a) Has been eligible and granted licence to practice modem sysem of medicine in Indian having fulfilled the requirements provided under Section 2.1 (2) (iii) above

(b) Has participated in a process through mechanism such as common counselling by designated authority approved by the Commission /Central Government

(c)Only the actual raw marks or marks/percentages (scores out of a maximum of 100) with decimal fractions obtained in NExT Step 1 (all six papers) in Regular and Supplementary Examinations, as may be applicable, shall be utilized for the purpose of ranking / determining order merit of otherwise eligible candidate for the purpose of the appropriate subject and seat; as provided in Section 2.1 (2) (iii) (d) Subsection (ii) above

v.Utilization of NExT Scores for purposes other than above

The Government of India, the State Governments, any organization of the Government of India, the State Governments, any autonomous or private body /institution may utilize the NExT Step I. Scores for purpose such as employment, scholarship, fellowship etc. provided due permission has been sough and granted for specific use by the National Medical Commission or other competent authorities as may be decided.

Information regarding NExT Step 1

(1) Objective of NExT Step 1

The NExT Step 1 will be a comprehensive computer based examination based on high-quality Multiple-choice Question (MCQs) ensuring objectivity and following nation-wide delivery and conduction with robust fidelity in a secure manner. The MCQ items would address higher domains of knowledge aligned to competencies expected of an Indian Medical Graduate or a graduate practicing modern system of medicine especially in India.

(2) Distribution of Items and knowledge level of Questions

i.To ensure assessment of higher domains of medical learning, a majority of items shall test higher level comprehension, analytical skills clinical problem-solving that are aligned to competencies.

ii.NExT Step 1 format in intended to discourage rote learning by the medical students.

iii.Case vignettes / clinical case scenarios shall be the overwhelming Pattern of examination

iv.MCQ items in all subjects shall be distributed approximately as follows;

•Problems-solving and analytical skills types 65% clinical vignettes 15/ hr of exam

•Comprehension type 25%

•Recall type 10%

However, variations in the distribution may be expected

v.The level of Knowledge related to the acquisition of competencies shall be approximately

•Must Know :60%

•Nice to Know :30%

•May Know :10%

(3) Papers and Distribution of Subjects

i.The NExT Step 1 examination will have six subject papers with respective weightage in items and time allocation

ii.Applied aspects of all other subjects of MBBS including Forensic Medicine and Toxicology (FMT) and Community Medicine will be mainstreamed into the relevant clinical subjects

iii.In each paper 10% items will pertain to applied aspects of Anatomy, Physiology, Biochemistry, Microbiology, Pathology, Pharmacology, Forensic Medicine relevant to the subjects evaluated

iv.In each paper 10% items will pertain to applied aspects of Public health / Community Medicine relevant to the subjects evaluated

v.The following Table 1 provides the subjects in each paper papers will respective weightage in items and time allocated with the provision of 20% of the items distributed according to Section 3.1 (3) Subsections (iii) and (iv) above

Papers	Subjects	No of Items	Duration
1	Medicine & allied subjects	120 Items	3.0 hours
2	Surgery & allied subjects	120 Items	3.0 hours
3	Obstetrics & Gynaecology	120 Items	3.0 hours
4	Paediatrics	60 Items	1.5 hours
5	Otorhinolaryngology	60 Items	1.5 hours
6	Ophthalmology	60 Items	1.5 hours

(4) Proposed Time Scheduled of Papers (Table 2)

Day	Subject	Duration	Break	Subject	Duration
1	Medicine & allied subjects	3.0 hours	2.0 hours	Paediatrics	1.5 hours
2	Rest Day No Examination
3	Surgery & allied subjects	3.0 hours	2.0 hours	Otorhinolaryngology	1.5 hours
4	Rest Day: No Examination
5	Obstetrics & Gynaecology	3.0 hours	2.0 hours	Ophthalmology	1.5 hours

The above schedule is only indicative subject to feasibility and logistics

Information regarding NExT Step 2

(1) Objective regarding NExT Step 2

The NExT Step 2 shall be a comprehensive practical / clinical examination to be conducted after completion of Internship that evaluated competencies in clinical diagnosis , patient and clinical decision-making, practical and communication skills necessary for practice of modern system of medicine especially in India

(2) Evaluation methods

•Each examination would comprise of

•Actual cases

•Objective Structured Clinical Examintion (OSCE)

•Simulations if possible

Depending on the albility of satisfactory performance or unsatisfactory performace there shall be only two level of grading "Competent or "Pass" / "Not Competent" of "Fail"

(3) Distribution of Subjects

i.The following subjects shall be evaluated during NExT Step 2:

ii.Medicine and allied subjects

iii.Surgery and allied subjects

iv.Obstetrics and Gynaecology

v.Paediatrics

vi.Otorhinolaryngology

vii.Ophthalmology

viii.Orthopaedics and Physical Medicine & Rehabilitation (PMR)

(4) Time Schedule

The time schedule and modalities of NExT Step 2 shall be decided by the National Medical Commission and the respective authorized Universities / Institutions after completions of internship and price to the admission process for the Postgraduate Courses of that year

3.3 Time Schedule of NExT Examination and associated events

The time schedule of the entire process of NExT Examination, internship and admission to broad specialty Postgraduate courses shall be announced by the Commission and other bodies authorized by the Commission.

The proposed / likely time schedules are provided in the table below subject to changes as may be necessary from time to time and duly notified appropriately

Table 3: If Successful Supplementary Examination candidates are NOT allowed to continue with successful Regular Examination candidates

Si No	Event	Date of Exam / Commencement	Date of Result / Completion
1	NExT Step I Regular	2" Week December	2n^d Week january
2	NExT Step Supplementary
3	III MBBS /FINAL MBBS PART 2 Practical / Clinical University Examination	1st Week January	4t^h Week January
4	Internship	1S^t February	28 February following year
5	NExT Step 2 Regular	2" Week March	1s^t Week April
6	NExT Step 2 Supplementary
7	Post Graduate Admission	May-June	30^th June
8	Postgraduate Course	₁st _July

To view the official notice :click here : https://medicaldialogues.in/pdf_upload/public-notice-next-regulations-1-195414.pdf

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Meghna A Singhania

Meghna A Singhania is the founder and Editor-in-Chief at Medical Dialogues. An Economics graduate from Delhi University and a post graduate from London School of Economics and Political Science, her key research interest lies in health economics, and policy making in health and medical sector in the country.She is a member of the Association of Healthcare Journalists. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

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Breaking News: NMC releases Draft gazette on NEXT with details, invites comments; Check out complete Breakdown

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