All about NExT Exam for MBBS: Exam pattern, Subjects, Eligibility, Schedule

NExT exam, or the National Exit Test, is set to revolutionize medical education and raise the bar for the competency of medical graduates. The full form of NExT is National Exit Test.

The National Medical Commission (NMC) will implement NExT, replacing the NEET PG and FMGE exams administered by the NBE. Furthermore, NExT will also serve as a replacement for the final-year exams held by medical colleges. By standardizing the exit examination process, the NExT exam can potentially enhance the quality of healthcare services in the country. The NExT exam will be a Licensing exam and it will also determine the eligibility and ranking of candidates for admission to postgraduate courses in broad medical specialities.

The NExT exam will have two parts: NExT Step 1, a computer-based exam, and NExT Step 2, a practical exam that will test the clinical knowledge of the students. As the NExT exam becomes a reality, medical graduates should embrace the changes and adopt effective preparation strategies to excel in this crucial milestone of their careers.

The National Medical Commission (NMC) has assigned the All India Institute of Medical Sciences (AIIMS) in New Delhi as the responsible body for overseeing the practical aspects of the National Exit Test (NExT) Step I and the administration of Mock/Practice Tests. The Examination Section at AIIMS in New Delhi, in collaboration with the NMC, will be in charge of organizing and conducting the Mock/Practice Tests and NExT Step I. AIIMS in New Delhi is the exclusive authority responsible for all aspects of the Mock/Practice Tests, including accepting applications, conducting the exams, and announcing the scores.

What is NExT exam?

As per the draft guidelines, the NExT exam aims to replace existing examinations and significantly transform the evaluation process for medical graduates. It will replace the final year MBBS examinations and the NEET PG and FMGE exams and act as a licensing exam.

Until now, the final year examinations are held by the medical colleges; NBE conducts the NEET PG exam for admission to postgraduate courses in India, and the NBE drives the FMGE exam for Foreign Medical Graduates (FMG) who want to practice in India after completing their medical education abroad.

One of the critical purposes of the proposed NExT exam is to certify the eligibility of medical graduates to register and practice modern medicine in India. It serves as a Licentiate Examination, ensuring that individuals possess the necessary knowledge and skills to provide healthcare services in line with the standards of the medical profession.

The NEXT exam also determines the eligibility and ranking of aspiring candidates seeking admission to postgraduate medical education courses in various medical specialities. By serving as an entrance examination, it plays a crucial role in assessing the qualifications and abilities of candidates. It helps in the selection process for postgraduate medical education programs in the country.

The National Medical Commission (NMC) has assigned the All-India Institute of Medical Sciences (AIIMS) in New Delhi as the responsible body for overseeing the practical aspects of the National Exit Test (NExT) Step I and the administration of Mock/Practice Tests. 

Who will give the NExT exam?

The proposed regulations for the NExT exam aim to include the following groups of students:

Undergraduate Medical Students:

The NExT exam will be mandatory for all MBBS students studying in medical colleges approved by the National Medical Commission. It ensures that these students meet the required standards of knowledge and skills before obtaining their medical degree.

Foreign Medical Graduates:

Foreign Medical Graduates who seek to practice medicine in India and obtain a license as a registered medical practitioner will also be required to take the NEXT exam. As the regulations specify, the exam is a prerequisite for enrollment in the State Register or the National Register.

Other Medical Degree Holders:

Individuals with a medical degree who intend to pursue academic courses, observerships, or any other purposes specified and approved by the National Medical Commission will also be subject to the NEXT exam. The regulations will outline the specific criteria and requirements for these individuals.

General features of the NExT exam:

The NExT exam will be divided into two sections:

a. NExT STEP 1

b. NExT STEP 2

How can students give Mock/ Practice Test?

Applicants must ensure that they meet all the necessary eligibility requirements for participating in the Mock/Practice Test.

Eligibility: Final Year students pursuing MBBS courses in Medical Colleges/Institutes in India

Firstly, it is crucial for applicants to carefully fill in all the required information in the application which will be done through an online portal on the NExT AIIMS Exam official website.

The application process has three stages:

Stage 1: Registration and candidate information

The registration and basic candidate information is a single process that applicants need to complete in order to participate in the Mock/Practice Test and NExT. This process involves the initial registration of the applicant in the IT system to generate a unique Registration ID and Password. During this process, the applicant must provide essential personal information and upload images, including a photograph, signature, and left thumb impression.

Stage 2: An exam unique code (EUC) is generated for MOC/ Practice 2023

In order to generate a code, it is necessary for the applicant to have valid and confirmed Registration & Basic Candidate Information, which includes providing images of their photograph, signature, and thumb impression. Once the registration is confirmed, the applicant will receive a confirmation email and will be able to view it by logging into the online portal. To signify their intention to apply for the Mock/Practice Test, the applicant needs to generate an exam code. It's important to note that this code is unique to each examination instance and must be generated again for every NExT-related examination.

Stage 3: Completion of application for Mock / Practice.

Before completing the application for the Mock exam the candidate should have a valid and confirmed registration along with basic candidate information and EUC i.e. Exam unique code. The application form should be filled out on or before the last date and time. The mobile number and email address given should be valid.

After the application fee has been paid and the application form has been submitted, certain information may not be modified. It's important to note that the information provided during this stage may be utilized during the application process for NExT-Step I and Step II.

Scheme of the Exam:

The mock exam will be in CBT mode in a single day in cities of India. The exam will follow the following scheme:

	Paper I	Paper II
Duration and Time	3 hours (9:00 am to 12:00 noon)	3 ½ hours (2:30 pm to 6:00 pm)
No. of questions	120	140
Subjects	Medicine and allied subjects, Paediatrics and Ophthalmology (including applied aspects of these subjects covered under I, II and III MBBS course	Surgery and allied subjects, Obstetrics and Gynaecology and Otorhinolaryngology, including applied aspects these subjects covered under I, II and III MBBS course.
Type of Question	Multiple Choice questions with a single correct option	Multiple Choice Questions with a single correct option
Correct Answer	1 mark	1 mark
Incorrect answer	- ¼ marks	- ¼ marks
Marked for review or unanswered	0 marks	0 marks

NExT Exam Pattern:

NExT STEP 1:

• The National Exit Test (NExT) Step 1 will be a comprehensive computer-based examination designed to assess the knowledge and competencies of Indian medical graduates. It aims to promote objectivity, ensure nationwide delivery, and maintain the highest standards of medical education.

• NExT Step 1 will have a theoretical examination delivered computer-based or online.

• Multiple Choice Questions (MCQs): The NExT exam will primarily comprise multiple-choice questions (MCQs) or a combination of different question types.

• Six Papers Covering Multiple Subjects: It will encompass six papers that cover a range of subjects, including Medicine, Surgery, Obstetrics and Gynaecology, Paediatrics, Otorhinolaryngology, Ophthalmology, and the applied aspects of previous course modules.

• Eligibility: Students who have completed the III MBBS/Final MBBS course from a recognized medical college will be eligible to appear for the NExT exam.

• Exam frequency: The exam will be conducted annually, with a regular NExT Step 1 Examination before the university practical examination for the III MBBS/Final MBBS preceding compulsory rotating interInternshipupplementary Examinations and Retakes: A supplementary examination, restricted to specific papers/subjects, will be conducted for candidates who have failed one or more of the six papers. Those who do not pass the regular and supplementary examinations can reappear for the routine examination the following year.

• Allowed attempts: There will be no restriction on the number of attempts to appear in the NExT Step 1, provided the candidate passes both NExT Step 1 and NExT Step 2 within ten years of joining the MBBS course.

Subjects of NExT Step 1:

• Purpose of NExT Step 1: To evaluate doctors' higher-level comprehension, analytical skills, and clinical problem-solving abilities. By discouraging rote learning, the exam will encourage students to develop a deeper understanding of medical concepts and their practical application.

• Clinical Scenarios: The examination will use clinical case scenarios to simulate real-life medical situations. This approach will allow students to demonstrate their ability to apply knowledge in a clinical context. These scenarios will need thoughtful analysis and decision-making, enabling a more holistic evaluation of a candidate's competencies.

• Exam Pattern: The NExT Step 1 will have a balanced distribution of multiple-choice questions (MCQs) across different knowledge levels.

• Approximately 65% of the questions will focus on problem-solving and analytical skills, with clinical cases comprising 15% of the exam duration. 25% of the questions assess comprehension, while 10% test recall.

Distribution of subjects in NExT Step 1:

• The exam will have six subjects.

The six subjects are:

1. Medicine and allied subjects

2. Surgery and allied subjects

3. Obstetrics and Gynaecology

4. Paediatrics

5. Otorhinolaryngology

6. Ophthalmology

• The NExT exam aims to integrate the applied aspects of various subjects from the MBBS curriculum into the relevant clinical issues. To ensure that students understand the practical application of their foundational knowledge in real-life medical scenarios. Specifically, this integration includes the subjects of Forensic Medicine and Toxicology (FMT) and Community Medicine.

• To achieve this integration, each paper of the NExT examination will include 10% of items that focus on the applied aspects of Anatomy, Physiology, Biochemistry, Microbiology, Pathology, Pharmacology, and Forensic Medicine relevant to the subjects being evaluated. This means that students will be tested on their ability to apply their theoretical knowledge of these subjects to clinical situations.

• Additionally, in every paper, another 10% of the items will pertain to the applied aspects of Public Health and Community Medicine relevant to the subjects being evaluated. This emphasizes the importance of understanding medical practice's broader community and public health aspects.

NExT STEP 2: Practical / Clinical and Viva Voce Examination:

• It consists of a practical/clinical and viva voce examination that covers seven clinical subjects/disciplines.

• These subjects include:

1. Medicine and allied disciplines

2. Surgery and allied disciplines

3. Obstetrics and Gynaecology

4. Paediatrics

5. Otorhinolaryngology

6. Ophthalmology

7. Orthopaedics and Physical Medicine and Rehabilitation (PMR)

• Format of the exam: The exam will be objectively structured and will have a simulation of clinical cases/patients. It will assess practical and clinical skills, clinical decision-making, and effective communication skills expected from Indian medical graduates. This approach ensures a comprehensive evaluation of student's abilities to apply their theoretical knowledge in real-life medical scenarios.

• Conducting the Examination: The NExT Step 2 examination will be conducted in person/live by the respective state health universities/institutions. These institutions follow the standards and guidelines provided by the NMC.

• Regular and Supplementary Examinations: The NExT Step 2 examination will be held once a year as a regular examination. A supplementary exam will also be conducted for candidates who have failed in one or more subjects (up to three issues) of the seven subjects. The supplementary examination allows students to repeat specific topics to improve their scores and progress in their medical education.

Attempts and Eligibility: There will be no restriction on the number of attempts to appear in the NExT Step 2 examination, provided that candidates have passed both NExT Step 1 and NExT Step 2 within ten years of joining the MBBS course. This flexibility allows students to focus on learning and improvement without unnecessary limitations.

Subjects of NExT Step 2:

• The NExT Step 2 examination will be a comprehensive practical and clinical assessment that will take place after the completion of the InterInternshipwill focuses explicitly on clinical diagnosis, patient and clinical decision-making, practical skills, and effective communication.

• The main aim of this examination will be to ensure that medical graduates are equipped with the necessary skills and knowledge to provide quality healthcare in India.

• Each examination will comprise actual cases, Objective Structured Clinical Examination (OSCE), and, if possible, simulations.

• These evaluation methods will allow candidates to demonstrate their abilities in real-life clinical scenarios and provide a comprehensive assessment of their practical skills.

• The grading system for the examination is straightforward, with two levels of performance: "Competent" or "Pass" for satisfactory performance and "Not Competent" or "Fail" for unsatisfactory performance.

• The evaluation includes the following subjects:

Medicine and allied subjects

Surgery and allied subjects

Obstetrics and Gynaecology

Paediatrics

Otorhinolaryngology

Ophthalmology

Orthopaedics and Physical Medicine & Rehabilitation (PMR).

• By assessing candidates in these critical areas, the NExT Step 2 examination will ensure they possess the necessary competencies to excel in medical fields and deliver comprehensive patient care.

Passing Criteria:

a. NExT Step 1: Raw scores obtained in the theoretical examination will be calculated as whole numbers. Percentages with appropriate decimals may be calculated if required.

b. NExT Step 2: The examination results will be declared a pass or fail based on evaluating the practical/clinical skills and competencies.

Minimum marks for Passing:

NExT Step 1: To pass the exam, students must score at least 50% (50 out of 100) or half of the maximum possible raw scores in each of the six papers.

NExT Step 2: The criteria for passing the practical/clinical examination is the satisfactory demonstration of the evaluated competencies.

How will the marks of NExT Step 1 be calculated for admission to Postgraduate Courses:

• The total marks for determining merit in admission to broad speciality postgraduate courses are calculated by summing up the raw scores obtained in each paper/subject.

• If a candidate fails in one or more subjects, the total marks/percentage for NExT Step 1 will be calculated by considering the total raw scores in each issue from both regular and supplementary examinations in which the candidate has secured passing marks.

• Candidates appearing in the NExT Step Examination to improve their scores will have their total marks/percentage calculated based on the average of the last three consecutive scores.

• NExT Step marks will remain valid for three years to determine the merit in admission to postgraduate courses.

The uses of NExT marks:

For Provisional Registration and Internship:

After completing NExT Step 1 and Step 2, along with meeting other applicable requirements, medical students will be eligible for compulsory rotating interInternshipprovisional registration to practice medicine in India.

License to Practice:

Graduates who have passed NExT Step 2 and completed the required interInternshipwill fulfil other specified requirements and can register in the Indian Medical Register/State Medical Register and obtain a license to practice modern medicine in India.

Admission to Postgraduate Courses:

Candidates with a valid license to practice medicine and NExT Step 1 marks can apply for admission to postgraduate medical courses in broad speciality subjects in approved colleges/institutions.

The government, state governments, and other organizations may use NExT Step 1 marks for employment, scholarships, fellowships, etc., after taking permission from the National Medical Commission or competent authorities.

Schedule of NExT exam:

The National Medical Commission (NMC) and authorized bodies will announce the comprehensive timetable for the NExT Examination, internship, and admission to broad speciality Postgraduate courses. The table below outlines the suggested or anticipated time schedules subject to potential changes. Please refer to the National Medical Commission's official website for any updates.

S.No.	Event	Date of Exam/Commencement	Date of Result/ Completion
1.	NExT Step I Regular	2nd Week December	2nd Week January
2.	NExT Step Supplementary	to be updated	to be updated
3.	III MBBS /FINAL MBBS PART 2 Practical / Clinical University Examination	1st Week January	4th Week January
4.	Internship	1 February	28 February the following year
5.	NExT Step 2 Regular	2nd Week March	1st Week April
6.	NExT Step 2 Supplementary	to be updated	to be updated
7.	Post Graduate Admission	May-June	30 June
8.	Postgraduate Course	1 July	to be updated