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National Exit Test (NExT) improve the quality of doctors

by Vijay Garg
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To implement a standardised national medical examination in the country for PG medical admissions, plans are on to start the National Exit Test (NExT), though its implementation in 2023 is yet to be confirmed. NExT will be the qualifying examination not just for final year MBBS students and for postgraduate seats in broad specialities, but will also apply to institutes of national importance. The exam will also be the qualifying criteria for foreign medical graduates (FMGs) seeking validation to practice medicine in the country.
“While there is no official information on the pattern or scheme of examination, NExT will possibly replace final year MBBS and NEET PG, if not FMGE,” says , director professor, Department of Surgery, Lady Hardinge Medical College, New Delhi. Dismissing the need for a single standardised exam, he,claims not every medical college has AIIMS-like infrastructure, so to put students through the same grilling process seems unfair. “Considering there is no uniform medical education in India, it would not hurt to maintain the status quo,” he adds.
“The National Medical Commission (NMC) had proposed the idea of a common exit test for all medical graduates through an act of parliament, the National Medical Commission Act, 2019. NExT is expected to be conducted within three years since then and should ideally be implemented from 2023.”
Stressing at the need for “quality clinicians” and a common yardstick to assess students, he cites the case of the USMLE (United States Medical Licensing Examination) that medical practitioners need to clear before they can practice medicine in the US. “NExT too should be given similar weightage –with a theoretical and practical component to test the proficiency of doctors both in India or from overseas.”
The exam will be based on the conceptual knowledge of the first, second and final year syllabus. “This will put an end to the culture of rote learning, unlike NEET PG which is MCQ based and focuses mostly on the final year syllabus. The exam is likely to be far more robust to assess the critical skills of doctors; consequently, it would compel the foreign medical institutions to upgrade the quality of training and education they impart to foreign medical graduates. The exam would also be a wake-up call for private medical colleges in our own country to improve their standards of teaching-learning,” the professor adds.
NExT may be conducted prior to the internship period of final year MBBS students which would help them get an idea about the kind of specialisation they need to pursue, as the allocation of seats for PG will be merit-based. “Currently, some of the medical interns may lack due diligence, and are busy cramming for their NEET PG, attending coaching classes – NExT may end that for good,” he says.
Talking about the importance of quality medical education in the country and the importance that needs to be attached to human lives, Dr , professor & head, Department of Medical Education, JIPMER, Puducherry, says, “NEXT aims to be at par with global standards which will allow the medical education system to set quality benchmarks and achieve the stated outcomes.”
The difficulty level of the exam will not increase the shortage of doctors post-Covid; what remains to be seen is whether these doctors (foreign returned or home-grown) are effectively utilised, as most of them gravitate towards the larger cities, he says. “Unless efforts are made to improve medical infrastructure and civic amenities in the small towns, such disparities will continue to exist since the problem lies not in the numbers, but lack of proper distribution of doctors.”

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