NMC, National Exit Test Regulations, 2023

 

[27th June 2023]

In exercise of the overall powers conferred upon the National Medical Commission in general and particularly vide Section 15 read with Section 57 of the National Medical Commission Act, 2019 [Act 30 of 2019], the National Medical Commission hereby make the following Regulations, namely

CHAPTER 1 PRELIMINARY, SHORT-TITLE, DEFINITIONS

Regulation - 1. Short Title and Commencement

(a)      These regulations shall be called the "NMC, National Exit Test Regulations, 2023.

(b)      These Regulations shall come into force at once from the date of their publication in the official Gazette.

2. Definitions

(a)      "Act" shall mean the National Medical Commission Act, 2019 (Act 30 of 2019).

(b)      "Chairperson" shall mean the Chairperson of the National Medical Commission appointed under Section 5 of the Act.

(c)      "Commission" or "NMC" means the National Medical Commission constituted under Section 3 of the Act.

(d)      "Council" or "MAC" means the Medical Advisory Council constituted under section 11 of the Act.

(e)      "Foreign Medical Graduate" shall mean a graduate with a medical degree from any country other than India; and recognized for registration to practice modern system of medicine in India subject to fulfillment of requirements and conditions as may be notified and applicable by the appropriate bodies and the Government of India from time to time.

(f)       "Member" shall mean a Member of the Commission appointed under Section 5 of the Act and shall include the Chairperson thereof.

(g)      "Next": shall be the abbreviated form for National Exit Test as specified in the Act.

(h)     "Notification" means notification published in the Official Gazette of India and the expression "notify" shall be construed accordingly.

(i)       "Prescribed" means prescribed by rules made under this Act.

(j)       "President" means the President of an Autonomous Board appointed under Section 18 of the Act.

(k)      "Recognized medical qualification" means a medical qualification recognized under Sections 35 or 36 or 37or 40, of the Act, as the case may be.

(l)       "Regulations" means the Regulations made by the Commission under this Act.

(m)    "Schedule" means the Schedule of this Act.

Interpretation -

Words and phrases used in these Regulations which are not defined here, but defined in the National Medical Commission Act, 2019 shall have the same meaning assigned to them there.

3. General

(1)     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)     The National Exit Test (Next) shall form the basis of:

(i)       Certifying the eligibility of the medical graduate to register to practice the modern system of medicine in India and therefore serve as a Licentiate Examination.

(ii)      Determining the eligibility and ranking for the purpose of admission of those desirous of pursuing further Postgraduate Medical Education in the country in broad medical specialities and therefore serve as an entrance Examination for admission to courses of Postgraduate Medical Education.

(3)     The following shall undertake the National Exit Test (Next)

(i)       All undergraduate medical students pursuing the degree of MBBS in all Medical Colleges as approved by the National Medical Commission including Institutes of National Importance.

(ii)      All Foreign Medical Graduates fulfilling the requirement of foreign medical graduate Licentiate Regulation by the National Medical Commission for the purpose of obtaining a licence to practice medicine as a registered medical practitioner in India and for enrollment in the State Register or the National Register, as the case may be in such manner as may be specified by regulations.

(iii)     Any other person with a Medical Degree for purposes 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.

(iv)    All those who have been granted a Licence to practice and are Registered in the National MedicalRegister / State Medical Register as the case may as per applicable regulation at that time for such practice &who wish to take admission to Postgraduate courses in broad specialities.

(4)     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.

(5)     It is implied that whenever the Next is in force, the corresponding equivalent existing Examinations shall be phased out/cease to be applicable for the 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, then the existing examinations shall continue for such time as deemed appropriate to the Commission with the understanding that the NEXT shall 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 and when necessary and notified by the Commission.

CHAPTER 2 Broad outline and General Features of the Next

Regulation - 2.

2.1. Next Step 1

(i)       Next Step 1 shall be a Theory Examination.

(ii)      The Questions shall be one or more than one type of Multiple-Choice Type.

(iii)     The Examinations shall be conducted through a Computer Based Online mode.

(iv)    The Commission will specify by regulations and/or by notification the manner of conducting common counselling by the designated authority for admission to the postgraduate broad specialties seats in the medical institutions. The Government of India will decide and notify the agency of counseling of all broad specialties postgraduate seats.

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

Medicine and allied disciplines

Surgery and allied disciplines

Obstetrics and Gynaecology

Paediatrics

Otorhinolaryngology

Ophthalmology

(Applied aspects of all subjects covered under I MBBS and II MBBS & 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 approved/recognized by the Commission shall be eligible to appear in the examination.

(vii)   There shall be regular Next Step 1 Examinations held twice a year in the months of May and November or any other time as may be notified by the Commission.

(viii)  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.

(ix)    There is no restriction to the number of attempts to appear in the Next Step 1 Examination to improve scores provided these examinations for improvement of scores are taken after completion of Next Step 2. Candidate is not entitled to appear in Next step I for improvement of score till completion of Next 2.

(x)      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.

2.2. Next Step 2

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

Medicine and allied disciplines

Surgery and allied disciplines

Obstetrics and Gynaecology

Paediatrics

Otorhinolaryngology

Ophthalmology

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.

(iii)     The examination shall be held in person 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.

(iv)    There shall be a Regular Next Step 2 Examination twice a year.

(v)      A Next Step 2 Supplementary Examination shall be held twice a year and is restricted to only those candidates who have failed in one or more of the seven subjects and are required to repeat subjects.

If a candidate fails in more than three subjects, she/He must appear in all the seven subjects afresh in supplementary examination.

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

2.3. Next Score

(1)     Nature of Scoring

(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 of appropriate competence that is being evaluated.

(2)     Minimum scores to Pass:

(i)       The minimum marks for passing shall be 50% [50out of 100] OR half of the maximum possible Raw scores 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 should be scored to pass the examination.

For calculations of above candidate score across Next-Step-1 examination cycle will be considered.

Explanation 1: Candidate A has scored minimum passing marks in 2 subjects and failed in 4 subjects. He/ She can appear in Next exam cycle of Next Step-1 and if She/He has scored the minimum passing marks in rest 4 subject then He/ She will be considered to have fulfilled the above criteria.

Explanation 2: Candidate A has scored minimum passing mark in 2 subjects and failed in 4 subjects. He/ She can appear in Next exam cycle of Next Step-1 and if She/He has scored the minimum passing marks in 2 subjects then She/ He can appear in Next exam cycle of Next Step-1 and if She/he has scored the minimum passing marks in remaining 2 subjects then She/he will be considered to have fulfilled the above criteria.

(3)     Calculation of Next Step 1 scores for determining merit for the purpose of admission to Postgraduate courses in broad specialties

(i)       for the purpose of determining merit for admission to broad specialty Postgraduate Course shall be calculated from the sum of raw scores obtained in each paper /subject in single Next step-1 examination only.

(ii)      For determining merit for admission to broad -specialty Postgraduate Course the NEXT Step-1 scores shall remain valid for five years. However, if candidate is appeared in Nextexam cycle ofNext step-1 then previous Next step-1 score would be invalid for determination of rank for admission into Postgraduate courses in broad specialties and only last attempt Next step-1 score would be considered for determination of the rank.

(iii)     To determine rank for admission into Postgraduate courses in broad specialties in an academic year, the candidate need to apply generation of a rank in a manner as prescribed by the Commission time to time. Only those candidates who have applied for generation of rank will be entitled for admission in that academic year cycle.

(iv)    Tie breaker rule for generation of rank:

(a)      The Normalized sum of raw scores obtained in each paper /subject in single Next step-1 examination. Method of Normalization of sum of raw scores for across Next Step-I examination cycle will be notified as and when necessary, by the commission.

(b)      Candidate with Lower attempts of Next step-1 will be given higher rank.

(c)      Candidate with Higher marks in following order of preference will be given higher rank:

(1)     Medicine and allied disciplines

(2)     Surgery and allied disciplines

(3)     Obstetrics and Gynaecology

(4)     Paediatrics

(5)     Otorhinolaryngology

(6)     Ophthalmology

(4)     Utility of Next Scores

(i)       Eligibility of an Indian Medical Graduate for Provisional registration to pursue Internship as governed by the Compulsory Rotating Medical Internship Regulations 2021of the National Medical Commission

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 2.3 (2) 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 of a Foreign Medical Graduate for Provisional Registration to pursue Internship as governed by the Compulsory Rotating Medical Internship Regulations2021 of the National Medical Commission

A medical student who has completed undergraduate medical education overseas 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 2.3 (2) as indicated above.

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

Indian Medical graduate or foreign medical graduate shall be eligible to be registered in the National Medical Register / State Medical Register as the case may be andlicence to practice modern system of medicine in India provided all of the following are met with:

(a)      Has completed the appropriate duration of Internship as applicable, having fulfilled the requirements provided in Section 2.3 (4) (i) Subsection (a) and (b) or Section 2.3 (4) (ii) as may be applicable.

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

(c)      Fulfillment of requirements as per Registration of Medical Practitioners and Licence to Practice Medicine Regulations, of the National Medical Commission.

(d)      Any other requirements may be considered appropriate by the Commission as notified from time to 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 National Medical Register / State Medical Register for such practice having fulfilled the requirements in Section 2.3 (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 modern system of medicine in India having fulfilled the requirements provided under Section 2.3 (4) Subsection (iii) above.

(b)      Has participated in the manner of common counselling as prescribed by the Commission through designated authority approved by the Commission for thepurpose.

Explanation:- All those who have been granted a Licence to practice and are Registered in the National Medical Register / State Medical Register before the commencement of this regulation & who wish to take admission to Postgraduate courses in broad specialities need to appear in Next Step-I Only.

(v)      *Utilization of Next Scores for purposes other than above [Section 2.3 (4) Subsections (i) to (iv)]

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 1 scores for purpose such as employment, scholarship, fellowship etc.

*MBBS degree will be awarded after passing of Final MBBS and successful completion of one-year internship.

CHAPTER 3 GENERAL INFORMATION

Regulation - 3.

3.1. Information regarding Next Step 1

(1)     The objective of Next Step 1

The Next Step 1 will be a comprehensive computer-based examination based on high-quality Multiple- Choice Questions (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 is intended to discourage rote learning by 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 skill types 60-70%

* Comprehension type 20-30%

* Recall type 05-15%

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 approximately 10% items will pertain to applied aspects of related subjects.

(iv)    The following Table 1 provides the subjects in each paper with respective number of items and time allotted.

 

Table 1

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

The above schedule is only indicative subject to feasibility and logistics.

3.2. 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 examination and clinical decisionmaking, 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 Examination (OSCE)

* Simulations if possible

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

(3)     Distribution of Subjects

The following subjects shall be evaluated during Next Step 2:

(i)       Medicine and allied subjects

(ii)      Surgery and allied subjects

(iii)     Obstetrics and Gynaecology

(iv)    Paediatrics

(v)      Otorhinolaryngology

(vi)    Ophthalmology

(vii)   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 prior 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.

Note: -There shall again be a counselling in the month of December for the seats which remain vacant after earlier counselling held in May-June.