BLOG: NEXT Exam-A Medical Students opinion

On 29^th December, 2016, Ministry of Health & Family Welfare (MoHFW) posted on its website the draft of the proposed amendments to Indian Medical Council Act. These proposed amendments call for setting up a National Exit Examination for all MBBS students. This exam is intended to serve three purposes:-

• Currently, students from different universities are evaluated in accordance with their own university standards & rules. So a MBBS graduate from one university may not essentially be as competent as that from another. Person with 70% in final MBBS exam from one university may not be as competent as person with 60% from another university. One of the main objective of this bill is STANDARDIZATION & GRADATION OF STUDENTS ON MERIT at the national level.


• As per the existing rules, admission to Post-Graduate medical courses is done on the basis of National Entrance-cum-Eligibility Test (NEET) conducted at the national level. NEXT intends to replace NEET & henceforth admission to PG Medical courses will be done on the basis of merit in NEXT.


• Also this exam will serve as a recruiting exam for Central Health Service.

The draft amendment bill calls for upto 50% reservation for government medical officers in PG Courses. According to the proposed bill, those candidates who opt for government medical services after clearing NEXT & serve for 3 years, they get 50% quota in PG courses in government medical colleges. Also after completion of their PG course, they may additionally be required to serve in rural/difficult area for a further period of 3 years.

The objective of a standardized evaluation of medical students from different universities is much called for. This assessment of students will indirectly serve as a quality indicator for their respective universities. Government aims to incentive NEXT by providing national permit to practice, for those students who clear NEXT. Also a nationwide entrance exam is an effective way of evaluating students & curbing rampant corruption in admissions.

If we closely examine the years, cost & perseverance put in by medical students then this proposed exam is an outright mockery of those who opt for becoming a doctor. Let's have a brief study about the present medical system in our country. We have a total of 63,835 MBBS seats in our country (1). Constitutional reservations leave only 50% of them for open category students. Of these total MBBS seats, nearly 50% are private seats, whose fees only blessed souls can afford. A medical student completes MBBS along with compulsory-internship at the age of 23. In the present era, MBBS practice is under severe constrain & opting for PG is almost a compulsion for every medical student. So at the age of 24, he/she gets into PG & completes it at the age of 27. And most importantly, aforementioned is based on an assumption that after MBBS, the student gets into PG at his 1^st attempt, which is reasonably difficult to get into in 1^st attempt. Also a medical student from government medical college is expected to serve in rural areas.

Now let's examine the scenario if NEXT becomes a reality. NEXT provides for 50% reservations for medical officers in government service. So the probability of an open category MBBS doctor getting into PG directly after MBBS becomes a rarity. An average MBBS doctor, after clearing NEXT will be required to serve in government medical services for 3 years after MBBS. After completion of government services at the age of 27, he/she stands a chance of getting into PG using the proposed 50% quota system. After completing specialization at the age of 30, he/she may still be required to serve in rural/difficult areas for 3 years additionally. So at the age of 33, finally we have a PG medical doctor who is free from the whims & fancies of the government. In my knowledge, I am not aware of any course where conventionally a person graduates at the age of 33. This proposed NEXT exam, has totally neglected the financial & personal life aspect of a doctor. A PG graduate howsoever brilliant academically, needs at least 5-7 years to establish his/her practice. Parents put in a lion's share of their life savings to make their son/daughter a doctor so isn't it fair on their part to expect a stable income from their wards?

We do need doctors in rural areas. I understand the fact that government needs to incentivise rural postings. NEXT is intended as an incentive for rural posting. But the proposed format of NEXT is almost like arm-twisting a MBBS doctor to opt for rural posting. A doctor is just like any other graduate who has personal dreams & aspirations. In my considerate opinion, correct incentive for rural postings would be monetary benefit or reduction in rural posting from 3 to 1 year. Other set of incentives can be providing cheaper loans to set up hospital/clinic for those who opt for rural postings. And main aversion to rural postings is lack of basic infrastructure & poor quality of standard of life. A doctor will be more than happy to serve in rural areas if he/she gets reasonable quality of life & adequate monetary support in lieu of his services.

Medical education & profession can't be subjected to government's whims & fancies. Doctors form the national talent pool of the country. We are more than ready to serve national interests but at the same time reasonability is an important criteria. I believe that quality of medical education & profession will be much better if non-medico bureaucrats experienced medical students' life only for one week.

Source:(1)http://www.mciindia.org/InformationDesk/ForStudents/ListofCollegesTeachingMBBS.aspx

Article written by

Bhaumik J. Kamdar

Final MBBS student,

1. J. Somaiya Medical College & Research Centre, Mumbai-22

Email:- bhaumik.kamdar@gmail.com