The NExT dilemma weighs patient safety against system readiness

The NExT dilemma weighs patient safety against system readiness

 Divyansh.Kumar@timesofindia.com 20.04.2026

TIMES OF INDIA EDUCATION TIMES BENGALURU

The National Medical Commission (NMC) has postponed the National Exit Test (NExT) for 2028-29, which has once again intensified the debate over the risks to the healthcare system when medical graduates enter practice without clearing a uniform competency test. 

After deferring its execution for five years in 2019, the NMC has again extended the dates of NExT implementation to ensure the system is adequately prepared for a nationwide rollout. NMC officials tell Education Times that NExT has been deferred as it is being redesigned. 

“NExT will help the NMC to bring standardised clinical training across the country by replacing final MBBS exams, NEET-PG and FMGE. The modalities are being worked out for the implementation, either immediately or phase-wise. The feedback from students, resident doctors, and faculty about having a common exam is good, but apprehensions exist about the final format,” said the source. 

To understand why this transition is critical, a MoHFW official explains that NExT is designed to serve a triple purpose: replacing the final-year university exams, substituting the NEET-PG entrance, and acting as a mandatory licentiate exam. “There are two lines of thought under discussion regarding the medical license. The first option is to separate the exam from the licensing process, where a student could pass the exam, obtain their degree, and pursue nonclinical careers without practising medicine. 

The second, more robust option links the license directly to the exam, you must pass it to practice. Ideally, it should be a unified, mandatory system for everyone,” the official says. The introduction of NExT will also lead to the scrapping of the Foreign Medical Graduate Examination (FMGE). “Whether it is an Indian medical graduate or those who studied in medical colleges in Russia, China, Iran or Philippines, everyone will ha-ve equal opportunity to take same exam,” the official adds. 

Currently, final-year MBBS exams are conducted independently by universities. NExT will replace this fragmented system, putting an en d to uneven university evaluations and addressing  the widespread issue of extortion in private institutions. “Because universities and colleges conduct their own practical exams, we receive complaints of private colleges demanding money from students, threatening to fail them in practicals,” the official says, adding, 

“A single, centralised exam will ensure absolute transparency. It will act as an automated quality control mechanism. Right now, we monitor ‘entry’ quality through NEET UG but lack a standardised way to check the quality of students ‘exiting’ the s ystem. A college that consistently produces students who pass NExT, proves it has good faculty.” Dr Rohan Krishnan, patron, FAIMA, says, “A high-stakes national exam cannot be fairly imposed on a country where clinical exposure and infrastructure vary across colleges.” FAIMA suggests initially using NExT as a formative assessment with no impact on licensure, follo-wed by full integration only after a nationwide audit of infrastructure and faculty. Kadwin Pillai, managing director, Trans world Educare, terms the rescheduling of NExT as a ‘pragmatic recalibration’ of India’s medical assessment strategy. 

“Rather than a simple delay, this period serves as an important buffer to move the system away from rote learning toward genuine clinical competence, ” Pillai says.