Breaking News: NMC releases Draft gazette on NEXT with details, invites comments; Check out complete Breakdown
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 a gateway entrance Examination for admission to courses Postgraduate Medical Education
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
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
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 | 2nd Week january |
| 2 | NExT Step Supplementary | ||
| 3 | III MBBS /FINAL MBBS PART 2 Practical / Clinical University Examination | 1st Week January | 4th Week January |
4 | Internship | 1St February | 28 February following year |
| 5 | NExT Step 2 Regular | 2" Week March | 1st Week April |
| 6 | NExT Step 2 Supplementary | ||
| 7 | Post Graduate Admission | May-June | 30th June |
8 | Postgraduate Course | 1st July |
