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National Exit Exam to be Merged With Final year MBBS Exam: Rajya Sabha Committee Decision

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The Committee, recommends that the final year MBBS examination be considered as the Licentiate Examination.

New Delhi : Settling the debate of the proposal of a common exit exam after MBBS, the Rajya Sabha Committee has given its recommendations. The committee has recommended certain modifications with which the clause proposing the National Licentiate exam would now be adopted in the modified bill

Simply put these recommendations include

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  • Merging the Exit exam (National Licentiate Exam, NLE) with Final year MBBS Exam and its conduction at the State Level
  • The examination should be a common short-question based examination for all final professional students at a level commensurate with the current final professional theory examination.
  • De-linking PG NEET exam from the NLE as the use of same instruments for merit ranking for post-graduate entrance may not serve the purpose because a qualifying examination and a rating examination should not preferably be equated
  • Doctors passing out of institutions such as AIIMS, JIPMER, and other on which NMC Bill is not applicable, will have to clear the National Licentiate Exam


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It is reported that Clause 15 of the proposed National Medical Commission Bill provides that National Licentiate Examination for students graduating from the medical institutions for granting licence to medical practice, enrolment and admission to postgraduate medical courses.

The clause had become a bone of contention between the medical fraternity and the government, with thousands of young doctors taking to streets opposing an additional exam as a license to practice. The government on the other hand had justified the clause as bringing uniformity in the quality of medical education in the country.

After going through all the view-points given by various stakeholders, the Rajya Sabha Committee,which had been asked by the Lok Sabha to take stakeholders opinion and recommend appropriate changes to the NMC bill has given the following recommendations

Committee’s observations/recommendations

4.15.6 The Committee in its 92nd Report had recommended to introduce a common exit test for MBBS doctors as an instrument of quality assurance, and to ensure that the quality and competencies of a doctor, before one starts practicing, are guaranteed and standardized. The Committee held a detailed discussion on the issue of the National Licentiate Examination in view of the suggestions of the stakeholders. The clause 15 mandates a uniform National Licentiate Examination for students graduating from the medical institutions governed by the proposed NMC Act. A three year grace period has been provided for the NLE to be operational. The Committee has taken note of the concerns expressed by various experts and stakeholders regarding the advisability of introducing the NLE at this stage.

4.15.7 The Licentiate exam is proposed to be compulsory for any MBBS doctor to make him eligible to practice medicine. The Committee, however, observes that unless the NLE is carefully designed, there is apprehension that a sizeable number of MBBS doctors who have passed their university level examinations, may be debarred from practice on disqualifying NLE. This will not only undermines the sanctity of the examinations conducted by various universities but also put an extra pressure on the system when the country is already facing a shortage of doctors. This will create a dichotomy where the university certifies a doctor as fit to practice and the failure to qualify NLE exam renders him unfit to practice. It is obvious that the implementation problem will be huge and the country will, over a period of time, have a population of mismatched unhappy doctors, who have nowhere to go.

4.15.8 The above analysis leads the Committee to the conclusion that the NLE will put undue stress on students, especially those who come from backward sections of the society and States, who cannot afford private guidance/tuitions for NLE and may not be able to crack the Multiple Choice Questions (MCQs).

4.15.9 Taking all the above factors into account, the Committee recommends that the Licentiate examination be integrated with the final year MBBS examination and be conducted at the State Level. The final MBBS examination should be of a common pattern within a particular State, initially due to the logistical constraints, and could be extended across the country as the system streamlines. The Committee also recommends that the final year MBBS exam should be designed in such a way that it takes into consideration not only the cognitive domain but also the assessment of skills by having practical problems/case study types of questions as a major component, with a strong tilt towards primary healthcare requirements.

4.15.10 The Committee further observes that the theoretical examination should be a common short-question based examination for all final professional students at a level commensurate with the current final professional theory examination. The examiners for conducting the practical examinations should be external and to be decided through a lottery from an empanelled list of examiners. The Committee is of the considered view that making provision for the final year MBBS examination as the Licentiate Examination would test both the theoretical and clinical aptitude of the students. The Committee, therefore, recommends that the final year MBBS examination be considered as the Licentiate Examination.

4.15.11 Further, the Committee is of the strong view that if PG entrance and licentiate examination are combined, the students will concentrate only on performing in entrance examination, during their undergraduate days and internship. The Committee, therefore, recommends that the PG NEET for admission to PG courses may continue as of now as an interim management till a mechanism is evolved within three to five years for the conduct of a common final year MBBS examination which has an adequate structure, so that subjectivity in the theoretical examination is replaced by common problem/case study based MCQ type examination. The common final year MBBS examination may be conducted within a particular State by any State University/State Health University or any other suitable agency.

4.15.12 The Committee also observes that the NLE has also been proposed to serve as an instrument for post-graduate entrance. The Committee is of the view that a licentiate exam is a good instrument to maintain a minimum standard across all graduates. The Committee, however, is of the firm view that to use the same instruments for merit ranking for post-graduate entrance may not serve the purpose because a qualifying examination and a rating examination should not preferably be equated. The Committee, accordingly, recommends that necessary modifications may be made in the above clause to address its above mentioned concerns.

4.15.13 Further, the Committee fails to understand as to how the MBBS students passing out from AIIMS, JIPMER and such other institutions on which NMC Act will not be applicable, will be allowed to get registered in the State/National Register or get admission into postgraduate courses in other medical institutions, without qualifying the NLE. In this regard, the Committee notes the views of the Government and recommends for inclusion of other medical institutions established by separate Act of Parliament in clause 15(1). The Committee also recommends suitable changes in the clause 15(5) to incorporate such medical institutions for conducting common counseling for admission to the postgraduate courses.

The committee in its report final stated that Subject to the above recommendations, the clause is adopted.


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53 comment(s) on National Exit Exam to be Merged With Final year MBBS Exam: Rajya Sabha Committee Decision

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  1. user
    Rahul Kasturba July 15, 2019, 9:12 pm

    What is the status of the exam for those students that plan on practicing abroad? From what I understood, it seems like this exam is only for those who plan on practicing in India and it also provides an added advantage for them stating that it is almost an equivalent for PG entrance. By doing well in a country\’s respective entrance exam, it is automatically implying the level of the student. I have seen NEET questions and I have seen USMLE questions among other exam material. The material tested on both exams is day and night. Studying for Indian PG vs USA, UK, Australia, etc. is very much different. I hope to see some exemption for students that have committed to studying abroad and I believe this exam should only be an option for those who know they are practicing in India or just want another degree. That too the fact that they recommended it at the end of 4th year is ridiculous. You think if I ask an engineering student or a veterinary student or a law student minute details from their first year of education they will remember it? It just creates added pressure to an already stress-filled year. I wish to see some true and real change to this redundant proposal.

  2. user
    Shambhu Sharma July 16, 2019, 7:44 pm

    Between NEET & USMLE which one is \’DAY\’ & which one is NIGHT? Which is tougher? What other ways do the two differ?
    Those who go abroad may be exempted. They may be made required to pass if/ when they need to practise in India
    Types & difficulty level of questions may be left to an expert committee.
    The pattern and proportion of weightage to different subjects also mabe as per guidelines of experts
    Relative importence to different domains is a matter of choice of the host country\’s need.

  3. Since neet is there for abroad going students like private institute.
    Common exit should be there .
    It is not difficult to pass for gov college students as they are cream & can easily pass.

  4. These rules are nonsense by government & policy makers…. currently india doesn\’t have much problem with the quality of doctors passing through current system but the problem is with the quantity of doctors. Government should focus on increasing quantity of doctors.
    You take NEET-UG for medical entrance then MBBS Professional exams then NEET-PG , you don\’t even have enough seat for these mbbs graduate to take PG courses.
    Your entrance exams are under both neet ug/pg question. Better improve those first before you talk about another parallel exam. Regulate private college fees, improve infrastructure & setup new colleges. Impose restrictions on govt ug/pg graduate moving abroad. Improve rural healthcare. Have seen your PHC you don\’t have a fan working at 40° temp & you want us to see 75-100 patients daily. Improve those first then talk about these fu***** shit.

  5. First of all this exit exam is stupid idea… suddenly u must not shud be from 1st to final year like preparation for fresher batch as student must be aware of it\’s structure,teachers must teach them in such a way they get trained by the time they reach final year,so that unnecessary fear and coaching classes outside college can be avoided…another reason is what about people who have already did mbbs but after few years preparation want to take pg course…then what exam they will write,as already exit exam has decided ur marks,,if u think final exam marks are used for pg seat to get license..then already pass out having license nd mbbs but want to pursue pg later what exam dey can write…also doctors are humans not machine to test,it\’s a humanity field not engineering field for accuracy as medical facts keeps changing….this is mass killing…so better stop it or modify it …license exam must be periodical test…so who passed license exam are lifelong not to be tested their quality..??.mbbs s lifelong commitment things get changed very fast.. updating knowledge lifelong s key.and the technique and skills change with India must setup more research centers than this stupid exams…exams DNT decide the quality… college,poor infrastructure, standard of teaching , sub-standard equipments, facility and management decides d quality…

  6. user
    Priydarshanie singla June 8, 2018, 4:52 pm

    If the national exit exam is merged with the final mbbs year exam in india then for the doctors who are completing their mbbs abroad how will they be able to give the same exam as the indian students will give, and if they are to give a seperate test i.e, mci screening test which is already well known a prejudiced attempt so that not too much students can clear is not right.Every student whether doing mbbs from india or abroad should go through the same test so that everyone gets an equal chance. I think that everybody should support this without bias and our rajya sabha should also take this into consideration.

  7. Sorry but if you cant get seat in INDIA because of your low mark scores and lack of hard work, don\’t complain to be like those who know more than you or those who worked harder. You\’re not fighting for equality, you\’re fighting to get stuffs without working hard. … And of course, this isn\’t all about India. In other countries, if an Indian Educates doctor wants to practice in the foreign country, say, United Kingdom, you need to give a test. It\’s everywhere dude. Don\’t complain. Every country is doing it . because education in countries are different and they want to make sure.