NeXT

The National Exit Exam (NExT)

 A Comprehensive Guide for MBBS Students in India

The landscape of medical education and practice in India is undergoing a significant
transformation with the introduction of the National Exit Exam (NExT). This examination is
set to become a pivotal milestone for all MBBS students, serving as a dual gateway for both
obtaining a license to practice medicine in India and securing admission to postgraduate
medical courses. This article provides a comprehensive overview of NExT, including the
National Medical Commission (NMC)’s plan, its implementation, the subject-wise
distribution of questions, the exam pattern, and effective preparation strategies for both
NExT 1 and NExT 2.

NMC CBME Guidelines 2024 and NExT Implementation
The National Medical Commission (NMC) has released the Competency-Based Medical
Education (CBME) Curriculum Guidelines 2024, which are integral to the implementation of
NExT. These guidelines aim to equip medical students with the necessary skills for
healthcare practice. The Regulations on Graduate Medical Education (GMER) 1997 were
updated in 2023, and these new guidelines adapt to the evolving demographics and socio
economic contexts of the nation. A key addition is the longitudinal program called ‘AETCOM’
(Attitude, Ethics, and Communication), designed to foster essential professional attributes
in future medical practitioners.

Eligibility Criteria for Professional Examinations
To be eligible for professional examinations, including NExT, students must meet specific
attendance criteria:

Attendance:
Theory: A minimum of 75% attendance is required.

Practical/Clinical: At least 80% attendance is necessary in practical and clinical
sessions.
Subjects with multiple phases: For subjects spanning multiple phases, a minimum of
75% attendance in theory and 80% in practicals is required for each phase.

AETCOM: Students must maintain at least 75% attendance in AETCOM sessions and 80%
attendance in family visits as part of the Family Adoption Program.
It is crucial to note that students failing to meet the 75% attendance criteria in electives will
be barred from appearing for the third Professional – Part II examination or NExT.
Marks Distribution (as per CBME 2024)
The CBME 2024 guidelines also outline the phase-wise marks distribution for various
subjects:

Passing Criteria: Students are required to achieve a cumulative score of 50% in university
conducted exams (combining theory and practical), with a minimum of 40% marks secured
separately in both theory and practical.

NExT Exam (National Exit Test) Process
The National Exit Test will be conducted in two distinct steps: NExT 1 and NExT 2.

 NExT 1 is designed as a theoretical examination, while NExT 2 will focus on practical and clinical skills   Successful qualification in NExT 1 is a prerequisite for eligibility for an internship, which then precedes the NExT 2 practical examination. The NMC is expected to release a detailed information brochure outlining the application process and other critical details for the NExT PG exam.

NExT Step 1
NExT Step 1 will be a computer-based examination comprising a total of 540 multiple-choice
questions (MCQs). The exam will be divided into six papers, covering subjects from the third
year/final MBBS course, Part 1 and Part 2. Candidates who have successfully completed the
third year/Final MBBS course from a recognized medical college are eligible to appear for
this examination. 

NExT MBBS Step 1 will be conducted once a year, prior to the University
Practical Examination for the III MBBS (Part 2)/Final MBBS, which precedes the Compulsory
Rotating Internship. Supplementary examinations for NExT Step 1 will also be held once a
year, allowing candidates who fail in one or more of the six subjects to re-appear. There are
no restrictions on the number of attempts for the NExT exam; however, candidates must
pass NExT Step 1 within 10 years of joining MBBS.

NExT Step 2
NExT Step 2 is a Practical/Clinical and Viva-based examination. This part of the National Exit
Test will be conducted in person/live by the respective state Health Universities/Institutions.
Paper 2 will encompass seven clinical subjects/disciplines. The NExT Paper 2 will feature
clinical case-based and simulated cases/patients, designed to evaluate practical/clinical
skills, clinical decision-making abilities, and communication skills essential for medical
practice.
NExT Syllabus: Step 1 and Step 2

NExT Step 1 Syllabus
The NExT Step 1 syllabus covers subjects from the III MBBS/Final MBBS, Part 1 and Part 2.
The six papers will assess applied aspects of all subjects taught throughout the MBBS
course. 

NExT Step 1 will be a computer-based examination. NExT MBBS Step 1 will feature 540 multiple-choice questions. The question breakdown is as follows: 65% will focus on problem-solving and analytical skills, 25% will be comprehension-based, and the remaining 10% will be recall-based.

NExT Step 2 Syllabus
NExT Step 2, being a practical examination, will evaluate candidates on their clinical
proficiency. 

 NExT Step 2 will be conducted offline. 

How to Prepare for NExT (National Exit Test)

 Effective preparation for the NExT exam demands a strategic and consistent approach.

Given its role in replacing both the NEET PG and FMGE exams, a well-structured study plan is paramount for MBBS students. Here are key strategies and tips to help you prepare:

1. Understand the Syllabus and Exam Pattern
Familiarize yourself with NExT Step 1 and Step 2: Gain a clear understanding of the
theoretical (MCQ-based) nature of Step 1 and the practical/clinical/viva-voce format of
Step 2.

Subject-wise distribution: Pay close attention to the weightage of each subject in NExT
Step 1, as outlined by the NMC. This will help you prioritize your study efforts and
allocate time accordingly.

Question types: Be aware that NExT Step 1 will include a mix of problem-solving,
analytical, comprehension, and recall-based MCQs. Practice all types of questions to
ensure comprehensive preparation.

2. Create a Realistic Study Schedule

Early start: Begin your preparation well in advance, ideally 6-12 months before the
exam. This provides ample time for thorough syllabus coverage, revision, and practice.

Daily and weekly goals: Break down the extensive syllabus into manageable daily and
weekly study targets. Maintain a consistent study schedule to build momentum.

Allocate time for all subjects: Even if some subjects carry less weightage, ensure you
dedicate sufficient time to cover all topics thoroughly. A holistic approach is crucial for
NExT.

Include revision slots: Regular revision is indispensable for knowledge retention.
Integrate dedicated revision sessions into your study schedule to reinforce learning.

3. Effective Study Techniques

Conceptual understanding: Prioritize understanding concepts over rote memorization.
NExT emphasizes problem-solving and analytical skills, requiring a deep grasp of
medical principles.

Integrate basic sciences with clinical subjects: Since NExT covers applied aspects of
medicine, actively connect your knowledge of basic sciences (anatomy, physiology,
biochemistry, pharmacology, pathology, microbiology) with clinical subjects. This
integrated approach will be highly beneficial.

Active recall and spaced repetition: Regularly test yourself on what you’ve learned.
Employ active recall techniques, such as flashcards or self-quizzing, and spaced
repetition to enhance memory retention and recall speed.

Solve previous year questions (PYQs) and mock tests: Practice extensively with PYQs
from NEET PG and FMGE, as they can offer valuable insights into the types of questions
asked and the exam’s difficulty level. Take mock tests regularly to assess your progress,
identify weak areas, and refine your time management skills.

Clinical case-based learning: For NExT Step 2, focus on engaging in clinical case
discussions, practicing patient examinations, and developing strong clinical decision
making and communication skills. These practical aspects are vital for success in the
viva-voce and clinical components.

4. Utilize Resources Wisely
Standard textbooks and reference materials: Rely on standard MBBS textbooks for in
depth understanding and foundational knowledge.

Online platforms and coaching: Consider leveraging online courses or coaching
institutes that specialize in NExT preparation. These resources often provide structured
content, comprehensive mock tests, and expert guidance tailored to the exam.

Discussion with peers and mentors: Engage in constructive discussions with fellow
students to clarify doubts and share insights. Seek guidance from experienced
professors or doctors who have a strong understanding of the exam and its
requirements.

5. Maintain Well-being
Balanced lifestyle: Ensure you prioritize adequate sleep, maintain a healthy and
nutritious diet, and incorporate regular physical activity into your routine. A balanced
lifestyle is crucial for preventing burnout and sustaining focus during intensive
preparation.

Stress management: Practice effective stress management techniques, such as
mindfulness, meditation, or short breaks during study sessions. Managing stress will
help you maintain a positive mindset and optimize your learning capacity.
By diligently following these strategies, MBBS students can build a strong foundation,
enhance their preparedness, and approach the NExT exam with confidence, ultimately
paving their way to a successful medical career in India.