NExT Deferred for 3-4 Years: What is Next?

NExT Deferred for 3-4 Years

The National Exit Test (NExT), envisioned by the National Medical Commission (NMC) as a unified qualifying examination, collectively serves as the final MBBS screening exam, the basis for Postgraduate (PG) entrance (replacing NEET-PG), and the licensing exam for Foreign Medical Graduates (FMGs, replacing FMGE). Following the recent deferral of its implementation, likely until 2028/2029, a critical window for meticulous preparation and systemic refinement opens up.

Strategic Timeline for a feasibility study

The initial target for NExT implementation was 2026. For a smooth and successful rollout, a feasibility study inclusive of pilot tests and refinements should ideally have commenced at least two years prior, around 2024.

With the deferral to 2028/2029, the optimal time to initiate the comprehensive feasibility study and subsequent fine-tuning for NExT to be an efficient outcome-based assessment is now shifted to 2026. This ensures adequate time for addressing the significant logistical and technical challenges inherent in an examination of this unprecedented scale.

An Unprecedented Challenge

The sheer volume of expected applicants poses a monumental logistical challenge. Projected estimates for NExT-1 applicants by 2029 are staggering:

• Undergraduate (UG) Students: Based on approximately 700 medical schools, the total number of final-year MBBS seats available to attempt NExT-1 will be around 100,000.

• PG Aspirants: The anticipated number of aspirants seeking PG seats via NExT-1 is projected to be no less than 250,000.

• Foreign Medical Graduates (FMGs): FMGs available to attempt NExT-1 are estimated to be around 30,000.

This totals an estimated 380,000 NExT-1 applicants within 3-4 years.

This total applicant volume is arguably unprecedented for any medical examination board globally. The NMC/National Board of Examinations (NBE) must therefore take all necessary precautions, primarily through rigorous feasibility studies, to ensure a smooth and successful delivery of NExT in 2028/2029.

Logistical Challenges in NExT-2

Assuming a 50% passing rate in NExT-1 for the estimated 130,000 UGs/FMGs, approximately 65,000 applicants will progress to NExT-2 each year from 2029 onward.

The challenges associated with NExT-2, the practical/clinical component, will be disproportionately higher compared to the computer-based NExT-1.

NExT-2, which is expected to utilize the Objective Structured Clinical Examination (OSCE) format, demands sophisticated logistical management. Key logistical hurdles include:

1. Setup & Infrastructure: Development of extensive OSCE stations and infrastructure, including mandatory IT/CCTV monitoring systems.

2. Workforce: Recruitment of a vast workforce encompassing assessors, patients/simulated patients (SP)/adjuncts, technical staff, and non-academic staff.

3. Assessment Tools: Development of blueprinted, vetted, and validated OSCE items with standardized checklists.

4. Training and Faculty Development: Mandatory Faculty Development Programs (FDP) for assessors and specialized training for SPs/patients/adjuncts.

5. Orchestration and Finance: Complex orchestration of all the above elements and securing adequate financial allotment.

Recommendations for NMC/NBE

To successfully implement NExT-2 by 2029/2030, the NMC/NBE must adopt a proactive, phased approach:

1. Preparation Start: Initiate FDPs and the preparation/validation of OSCE items by 2025.

2. Pilots: Commence pilot testing programs by 2026.

3. Refinement: Implement corrective measures and refinements before 2029/2030.

4. Infrastructure Utilization: Strategically utilize existing OSCE station infrastructure across states with medical and nursing schools, and teaching hospitals (like Apollo).

   • Synchronization: Establish seamless synchronization with state-level medical councils.

Suggestions for Colleges and Students

Without proper sensitization and adaptation, even good students with sound knowledge and skills face a high risk of poor performance, stemming from failure to handle the technicalities of the testing platform. mismanagement of adjusting common mistakes and overstress - if not given time for adaptation through repeated practice / feedback.

• Sensitization: Students must be immediately sensitized and trained in both computer-based objective exams and the OSCEs, simulating a high-stakes examination environment.

• Adaptation: Students must be provided with opportunities for repeated practice (mastery learning) with constructive feedback.

The required sensitization and adaptation time for such complex, high-stakes examinations typically ranges from 1 to 2 years. The sooner this dedicated training begins, the better prepared the cohort will be for this systemic change.