Members of the Resident Doctors Association and the Student Association of AIIMS Delhi, along with faculty from AIIMS Delhi, Nagpur, Patna and RML, have sought the implementation of the National Exit Test (NExT) for MBBS students. They said it addresses shortcomings in existing university and postgraduate entrance examinations and offers a streamlined, competency-based assessment system.
In an editorial published last month in the Journal of Family Medicine and Primary Care, titled “Immediate NExT rollout is vital for MBBS students and the medical education ecosystem of India”, the doctors said current undergraduate medical assessments are inconsistent and fragmented.
They added that these exams are often poorly aligned with competency-based training. The authors said NExT aims to introduce a uniform, transparent and clinically relevant evaluation framework.
NExT, introduced through the National Medical Commission Act, 2019, and further elaborated in the 2023 Gazette notification, was envisaged as a singular qualifying examination to replace three existing exams in the field of medicine-the final MBBS exams, the National Eligibility-cum-Entrance Test for post-graduate seats (NEET-PG), and the Foreign Medical Graduate Examination (FMGE) for foreign medical graduates to practice medicine in India.
However, the test has been postponed multiple times, creating uncertainty and delaying reforms, the authors said. The editorial explains why immediate implementation is essential.
It said NExT can improve the validity and reliability of assessments, support student learning, and increase institutional transparency. It also aimed to help build a more competent medical workforce.
The authors noted that university-based MBBS final exams vary widely in quality and fairness. Theory papers are often subjective. Content does not always align with national competencies, and evaluation standards differ across institutions.
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“This creates inconsistency in determining whether a graduate is ready to practise medicine,” they said. They also pointed out that current PG entrance tests rely on a relatively small pool of about 200 Multiple Choice Questions (MCQs) to assess the entire MBBS curriculum.
This limited sampling reduces reliability and increases the role of chance. The focus on recall-based questions also promotes coaching-driven preparation over clinical learning. Currently, students must prepare for two very different exams.
The university final exam is theory-heavy and long-answer-based, while the PG entrance test is entirely MCQ-based. “This mismatch forces students to adopt different strategies and adds to stress,” the authors said. The NExT aims to unify both into a single standardised exam.
“A national exit examination is not just a format change. It is a shift towards clinically oriented assessment with a larger and uniform question pool,” they said. This, they added, will improve learning outcomes and raise standards. The authors said NExT Step 1 includes a larger MCQ pool based on clinical vignettes and applied reasoning.
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This reflects real-life decision-making. NExT Step 2 aims to assess practical skills, communication and clinical competence through structured clinical exams, though details are still awaited.
They added that NExT applies to all students, including those from government and private colleges, as well as foreign medical graduates.
“By assessing all candidates through the same national standard, it strengthens public confidence in medical training and ensures that every licensed doctor demonstrates a uniform threshold of competence, regardless of where they received their education,” the authors said.
The editorial said a unified test will reduce the burden of preparing for multiple exams with different formats. The NExT Step 1 scores may be used not only for postgraduate admissions but also for government service positions, and various fellowships or scholarship opportunities. A single score, it said, will improve transparency and reduce arbitrary selection processes.
The editorial highlighted that a uniform national benchmark will allow colleges, especially new and private institutions, to demonstrate their training quality through measurable student outcomes.
“Experiences from engineering, management, and dental education over the past two decades illustrate how rapid expansion without strong evaluation mechanisms can compromise quality.
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Many institutions in these sectors lacked rigorous student assessment processes and gradually became degree-granting centres rather than fostering meaningful learning. The closure of several such colleges highlights the long-term risks associated with expansion in the absence of credible quality assurance,” the editorial stated.
“In medicine, poor training can lead to serious harm. NExT will set a national minimum standard that every graduate must achieve before independent practice, thereby protecting public health and ensuring trust in the profession,” the editorial stressed. To ensure a smooth rollout, the authors recommended preparatory support, including multiple mock tests, sample questions, workbooks, and detailed syllabus material.
