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Monday, April 6, 2026
NEW DELHI — In a direct challenge to the National Medical Commission’s (NMC) repeated delays, a coalition of senior doctors and faculty from the country’s premier medical institutions is calling for the immediate implementation of the National Exit Test (NExT). Led by representatives from AIIMS Delhi, the group argues that India’s medical education system remains “fragmented and inconsistent,” posing a long-term risk to public health. In a landmark editorial published in the Journal of Family Medicine and Primary Care in March 2026, the experts warned that without a uniform competency-based assessment, the rapid expansion of medical colleges across the country could lead to a surge in subpar clinical training.
A System in “Survival Mode”
The push for NExT comes at a time when India’s medical education is undergoing an unprecedented boom. While the number of medical seats has grown to meet the country’s rising demand, the quality of training remains uneven. Currently, MBBS students face a disjointed evaluation process: subjective university-level theory exams that vary by state, followed by the NEET-PG—a high-stakes, 200-question multiple-choice marathon that many experts argue rewards rote memorization over bedside manner and clinical reasoning.
“This creates a fundamental mismatch,” says the editorial, co-authored by Dr. Sarthak and Dr. Piyush Ranjan of AIIMS Delhi, along with faculty from AIIMS Nagpur, Patna, and RML Hospital. “Students are forced to juggle two entirely different preparation strategies. One for their university finals, and another for the PG entrance. This not only adds immense stress but fails to determine if a graduate is truly ready to practice medicine safely.”
What is NExT? The Proposed Two-Step Revolution
The National Exit Test was designed to be a “one-stop-shop” for medical licensing and postgraduate admission. As detailed in the National Medical Commission Act of 2019, NExT is structured into two distinct phases:
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Step 1: A nationwide, computer-based examination consisting of high-quality Multiple Choice Questions (MCQs). Unlike current formats, these focus on “clinical vignettes”—real-world medical scenarios that require applied reasoning to solve.
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Step 2: A practical and viva-voce examination focusing on clinical skills, communication, and patient interaction. This step ensures that a doctor isn’t just “book smart” but can actually perform a physical exam and talk to a grieving family.
By replacing the final MBBS exams, the NEET-PG, and the Foreign Medical Graduate Examination (FMGE), NExT aims to establish a single “minimum competence” threshold for every doctor in India, regardless of whether they studied at a government college, a private institution, or abroad.
The Quality Control Crisis
The urgency voiced by AIIMS doctors is rooted in a sobering comparison to other fields. The editorial points to the engineering and dental sectors, where rapid institutional expansion without rigorous quality checks led to a surplus of graduates with “subpar training.” In medicine, the authors warn, the stakes are significantly higher.
“Medicine is not a field where we can afford ‘suboptimal’ graduates,” the authors note. With India’s doctor-to-population ratio recently improving to approximately 1:811 (surpassing the WHO’s 1:1,000 benchmark), the focus must now shift from quantity to quality. A standardized exam like NExT provides a measurable benchmark, essentially “grading” the medical colleges themselves. If a college’s students consistently fail NExT, it signals a systemic failure in that institution’s teaching standards.
Friction and Fear: Why the Delay?
Despite its perceived benefits, NExT has faced a rocky road. Initially slated for a 2025 rollout, the exam has been pushed back, with some estimates now suggesting a 2028–2029 implementation. This delay is fueled by significant pushback from student bodies and organizations like the Federation of All India Medical Association (FAIMA).
Dr. Rohan Krishnan, Chief Patron of FAIMA, has been a vocal critic of the current transition plan. “While the idea of standardization is good, the infrastructure across India’s 700+ medical colleges is not uniform,” Dr. Krishnan has previously stated. Critics argue that NExT might unfairly penalize students from colleges with fewer resources or faculty, effectively making it a test of “which student had the better coaching center” rather than their medical school’s training.
Additionally, many students fear that adding a licensing layer on top of their final year will only extend an already grueling degree. “Aspirants are familiar with the NEET-PG format. Changing the goalposts now creates immense psychological pressure,” says a representative from a prominent medical student union.
Expert Commentary: Shifting the Paradigm
Independent medical educators suggest that the “coaching culture” in India is one of the biggest hurdles. “A national exit examination is not just a format change. It is a shift toward clinically oriented assessment,” emphasizes the AIIMS editorial.
The goal is to force a change in how students learn. If the exam rewards clinical reasoning (NExT) over fact-recall (NEET-PG), students will spend more time in the wards and less time in front of MCQ apps. However, experts not involved in the editorial caution that for NExT to succeed, the NMC must provide:
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Clear Blueprints: Detailed syllabi for Step 1 and Step 2.
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Mock Tests: Robust, national-level practice runs to familiarize students with the new software and question style.
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Equity Measures: Ensuring that Step 2 (the practical) is graded objectively and fairly across different states.
The Public Health Bottom Line
For the average patient in India, the implementation of NExT could mean greater peace of mind. It ensures that any doctor carrying an “MBBS” title has passed the same rigorous national standard, whether they are in a metropolitan hospital or a rural clinic.
As the NMC continues to deliberate, the message from the AIIMS-led coalition is clear: The “survival mode” of Indian medical education must end. Standardizing the exit process is the first step toward a healthcare system built on verified competence rather than just credentials.
References
https://health.economictimes.indiatimes.com/news/education/doctors-seek-implementation-of-next-for-mbbs-students/130035044?utm_source=top_story&utm_medium=homepage
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
