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EXTRAORDINARY
PART III—Section 4
PUBLISHED BY AUTHORITY
No. 447] NEW DELHI, WEDNESDAY, JUNE 28, 2023/ASHADH A 7, 194 5
CG-DL-E-30062023-246874
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िनवरी --------------
NATIONAL MEDICAL COMMISSION
NOTIFICATION
New Delhi, the 27th June, 2023
F. No. CDN-19012/15/2022/Coord. -NMC .—In exercise of the overal l power s 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
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 th e 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 N ational 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 a ny 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 bod ies 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 i n 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) "Recognize d medical qualification" means a medical qualification recognized under Section s 35 or 36 or
37or 40, of the Act, as the case may be .
l) "Regulations" means the Regulations made by the Commissi on 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 Ex it Test ( NExT) shall form the basis of :
i. Certifying the eligibility of the medical graduate to register to practice the modern system o f
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 pur suing
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 G raduates fulfilling the requirement of foreign medical graduate Licentiate
Regulation by the National Medical Commission for the purpose of obtainin g 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 f or purposes such as pursuing an academic course,
observership or any other purposes as may be specified and approved by the National Medical
Commission through due notification or regulations from time to time.
iv. All those who have been granted a Licence to practice an d are Registered in the National Medical
Register / 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 shal l 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 cou nselling 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
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 B ased Online mode.
iv. The Commission will specify by regulations and/or by notification the manner of conducting
common counse lling by the designated authority for admission to the postgraduate broad -
specialt ies seats in the medical institutions. The Gove rnment 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 s tudents 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 a nd
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 MB BS
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 s hall 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
Pract ical/ clinical examinations shall continue to be held conventionally unless otherw ise 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 a llied 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, Simul ated Cases /Patients
aimed at evaluating Practical /Clinical skills, clinical decision -making and communicati on 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 Healt h 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 corres ponding 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 Scor es should be scor ed 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 mark s 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 an d failed i n 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 re maining 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 f or 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 NExT exam cycle of
NExT 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 la st 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 presc ribed 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 highe r 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 2021 of the National
Medical Commission
A Medical student from a college recognized by the Com mission 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 abov e.
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 Rot ating Medical Internship Regulations 2021 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 Compu lsory 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 f or 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 r egistered in the National
Medical Register / State Medical Register as the case may be and licence 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 cri teria are
met with -.
a) Has been eligible and granted Licence to practice modern system of medicin e 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 presc ribed by the
Commission through designated authority approved by the Commission for the
purpose .
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 /institut ion 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
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 b ased 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 h igher 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 domain s of medical learning, a majority of items shall test higher l evel
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 e xamination .
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 o f 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 1 0% items will pertain to applied aspects of related subjects.
iv. The following Table 1 provides the subjects in each paper w ith respective number of items and time
allotted .
Table 1
Papers Subjects No of Items Duration
1. Medicine & allied subjects 120 Items 3.0 hours
2. Surge ry & allied subjects 120 Items 3.0 hours
3. Obstetrics & Gynaecology 120 Items 3.0 hours
4. Paediatrics 60 Items 1.5 hours
5. Otorhinolaryngology 60 Items 1.5 hours
6. Ophthalmology 60 Items 1.5 hours
4. Proposed Time Scheduled of Papers (Table 2)
Day Subject Duration Break Subject Duration
1. Medicine & allied subjects 3.0 hours 2.0 hours Paediatrics 1.5 hours
2. Rest Day No Examination
3. Surgery & allied subjects 3.0 hours 2.0 hours Otorhinolaryngology 1.5 hours
4. Rest Day: No Examination
5. Obstetrics &Gynaecology 3.0 hours 2.0 hours Ophthalmology 1.5 hours
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 practi cal / clinical examination to be conducted after completion
of Internship that evaluated competencies in clinical diagnosis, patient examination and clinical decision -
making, practical and communication skills necessa ry for practice of modern system of med icine 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. Paediatr ics
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 / I nstitutions 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 ad mission 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 ma y be necessary
from time to tim e and duly notified appropriately.
Sl.
No. Event Date of Exam / Commencement Date of Result/ Completion
1. NExT Step I May/ November 1st week June /December
3. III MBBS /FINAL MBBS PART 2
Practical / Clinical University 1st Week June/December 3rd Week June / December
Examination
4 Internship 1stJanuary/July 31st December/30th June
following year
5. NExT Step 2 Regular 3rd Week June/ Dec 4th week of June/Dec
6. NExT Step 2 Supplementary 1st week Sep/March 3rd week Sep/March
7. Post Graduate Admission May-June (Counselling)
30th June
8. Postgraduate Course 1st July/ 1st week January --------------
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.
Dr. PULKESH KUMAR , Secy.
[ADVT. -III/4/Exty./ 228/2023 -24]
Note: These Regulations are being published in English and Hindi, the English version shall prevail in case of any
doubt about the interpretation of these Regulations.
Uploaded by Dte. of Printing at Government of India Press, Ring Road, Mayapuri, New De lhi -110064
and Published by the Controller of Publications, Delhi -110054 .
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