How is NExT 2023 being taken by medical candidates and experts? What are its positives and drawbacks, we discuss

While few candidates think NExT is a good move for the benefit of candidates, another lot criticises it for the duration and pattern of the exam
NExT guidelines: What does the medical community think about it? | (Pic: EdexLive)
NExT guidelines: What does the medical community think about it? | (Pic: EdexLive)

The National Medical Commission (NMC) released the draft guidelines for the National Exit Test (NExT) for feedback and comments from the public. The exam has two steps: Step 1, an objective Computer Based Test (CBT) and Step 2, a practical one.

Here's the breakdown of when the test will be held:
December second week: NExT Step 1
January second week: Step 1 results
February 2023'24: Compulsory internship period will then last for a year
March: NExT Step 2
April: Step 2 results
May: Admission process into PG courses begins
June: Admission process ends
July: PG courses will begin

Until the guidelines were released, candidates had no clarity about NExT 2023. Now, even after these new guidelines have been released, a few students and experts feel that the guidelines are still not clear. Overall, these new guidelines have received mixed responses from experts and candidates.

Positive takeaways
President of Federation of Resident Doctors’ Association (FORDA) Aviral Mathur said, "NMC is trying to make the exam more holistic and is trying to do away with the rote-learning practice." Further, he added, "Current exams were only based on theory but now, in this exam, they are trying to inculcate both practical and theory," he added.

Commenting on NMC's decision to invite public comments, he said, "This is a landmark decision." Additionally, "NMC is trying to revise the MBBS students' studying patterns by testing their clinical knowledge. We are happy that NMC has pushed for this move," he opined.
When asked to choose between NEET PG or NExT, a NExT aspirant Dr Soumyo Sundar Haldar said, "I would like to give NExT as it is more on the clinical side with more chance of improving score as it will be a six days exam as compared to NEET PG which is one-day three-hour exam with fewer chances of improvement."

Otherside of the draft
On the contrary, a NExT aspirant, who wishes to stay anonymous, said the student would prefer NEET PG over NExT "anytime because it is straightforward with the MCQ exam for three hours and an established pattern." Explaining further, the student said, "NExT will just add more hours only to an already gruelling examination during the MBBS course itself with no proof that it will actually improve the quality of medical education in India."

Moreover, "NExT-1 was proposed with the sole purpose for MBBS students to focus more on practical skills and not rote-learning. But with an examination pattern like this, it does not just encourage rote-learning but it also increases it," the student added.

President of the Federation of All India Medical Association (FAIMA), Dr Rohan Krishnan said that the draft has many major drawbacks. Listing these out, he said:

1. The major problem is that even though the syllabus has been released, the government is not yet clear about who is going to conduct the exam, the NBE (National Board of Examination) or the NTA (National Testing Agency). It is playing in a blind field.

2. The general conditions include entry to persons with a medical degree. However, it is not advisable that anyone without a four-year medical degree be allowed to practice medicine.

"Any other person with a medical degree for purpose 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," the draft read. 

Krishnan stressed, "Government should fasten the appointment of authority/body to conduct the exam within a month or two as this gives eight to nine months for the candidates to prepare for the exam." Meanwhile, the anonymous student points out, "The infrastructure and teaching in many medical institutions (mostly private, newly opened government and semi-government) is still way behind to match the knowledge acumen required to crack exams like these."

Challenges being faced

First-year Junior Resident (JR1) in MD Psychiatry at the Institute of Mental Health and Hospital, Agra, Dr Sarthak Vats opines, "The difference in the UG and PG seats is very huge and to put the UG students through NExT seems problematic at the moment."

"Government should introduce the steps and parts of the NExT in phases, so as to make it seamless. Such huge and sudden changes will definitely add to the anxiety and uncertainty in the lives of PG aspirants," he laments. 

Having said that, one more challenge is score evaluation. President of Telangana Junior Doctors Association (JUDA), Dr Karthik Nagula, points out, "The score evaluation process can be a disadvantage to the candidates." Sailing in the same boat of the same thoughts, Haldar said, "Now this is very unrealistic because one candidate if, by chance, had one bad exam and he/she wants to improve then the improvement exam score is taken as an average of the last three consecutive scores. What is the point of giving the exam to improve?" he questioned.

"The Total Marks Percentage of those candidates who have appeared in NExT Step Examination to improve their scores shall be calculated from the average /mean of last three consecutive scores," the draft read. 

Additionally, Karthik opines that it will be too early for doctors to decide whether they want to pursue PG or not. Because most of them will get clarity on which subject they are interested in only after several internships, he added.

Stepping up with Step 2?
Amidst the above-mentioned concerns, there is also a deep analysis of the Step 2 of the NExT exam, that is, a practical test. FAIMA's Krishnan feels, "The government has to think about it. Because I don't think PG should be anything less than an objective type." Adding to what he said, he highlighted that there may be changes in the pass percentage with this step.

Adding to this, the anonymous student said, "Step-2 Practical also has several flaws: one, it will not be taken by a common examination board like NExT-1 but will vary from state to state and from one medical institution to another."
"It might also give a monopoly to already corrupted private institutions to charge hefty amounts for passing the practical test," the student added.
Following western pattern?
Sharing his views on the exam pattern, Mathur said, "They are trying to borrow from what is happening in the US, UK, Australia and so on. The concept is derived from these countries and it is established successfully as well." Further, "This exam will supplement students' knowledge and broaden their vision," he affirmed. 

With regards to following exam patterns from other countries, the anonymous student opines, "If NMC does want to impose an examination pattern which is copied from similar patterns of the USA and UK medical system, it should first make the medical infrastructure and teaching at par with the USA and the UK."

Are NEET PG and NExT the same?
Well, Rohan Krishnan from FAIMA opined that students have to revise all 19 subjects which were studied in all four years.
While NEET PG is prepared solely based on the scores in a three-hour exam, for NExT-1 the scores will be an average of three different years' exams. Pointing this out with regards to NExT, the student questions, "Score of 3 different years of NExT-1 exam with three different sets of questions will be given a single rank list. How is that fair?"

Suggestions and solutions
Mathur suggested including a clinical skill test either in Step 2 or coming up with another step. Adding to this, Haldar suggests that, "For those who want to improve their scores, average marks should not be taken. The NMC can consider taking the best scores of the attempts," he adds.

Pointing out that there are many concerns to be looked at, including how to conduct the rounds of the exam, the anonymous student said, "Since all these valid concerns required thorough examination which will consume a lot of time and by the time they come up with a final pattern it will be too late for existing 2018 batch students to have sufficient time to prepare for a completely new pattern. Striking a solution to this, the student suggests that "they should shift NExT till at least 2024 i.e. applicable for 2019 & 2020 batch onwards."

One of the largest learning platforms Prepladder's CEO and Co-Founder Deepanshu Goyal opines that "With a new exam pattern emerging, it will be a bit challenging for Learners who were preparing for NEET for some time to embrace the learning techniques required for NExT. It is imperative to provide aspirants with simpler solution modules which can help them with this transition seamlessly."

Although many EdTech and learning platforms are already coming up with ways to help students facilitate quality preparation for NExT, Prepladder curated the latest edition of Question Bank which has more clinical scenario-based questions. And the team feels "we are NExT-ready with our best-in-class study resources and learners will benefit from them significantly," adds the CEO.

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