The Indian Medical Association (IMA) recently approached the National Medical Commission (NMC) expressing concerns regarding the proposed National Exit Test (NExT). The NExT aims to be an all-encompassing examination for MBBS students in India, serving as both a licentiate and post-graduate selection exam.
The proposed examination is intended to determine the competency of medical graduates who have gained their degrees from NMC approved medical institutions. This would also apply to overseas students wishing to register for medical practice in India. The NMC plans to introduce the autonomous ‘Board of Examinations in Medical Sciences,’ which will replace tests like FMGE and NEET PG with the NExT. Students would need to successfully pass this examination within 10 years of starting their MBBS to secure a professional license.
Concerns Raised by the IMA
While the NExT is seen as a step towards improving the standardization of medical education in India, the IMA has raised concerns about its implementation. They argue that the recent establishment of almost 50% of India’s medical colleges could disadvantage new entrants in comparison to those from older, more established institutions.
The IMA suggests an alternative approach, advocating for a minimum passing mark of no more than 30%. They argue that the licensing exam’s focus should be on assessing minimum standards rather than presenting challenging questions. Additionally, they believe the post-graduate medical entrance exam should remain separate from the NExT to effectively evaluate the most deserving students.
Current Medical Education Standards in India
In India, the admission process to undergraduate medical courses, including MBBS, in all medical institutions requires students to clear the NEET conducted by the National Testing Agency. Following this, the National Board of Examinations in Medical Sciences (NBEMS) is tasked with holding exams for Post Graduation (NEET PG).
As of 2023, the number of available medical seats in India has significantly increased from 60,000 to 1,04,333. Of these, 54,278 are allocated to Government Medical Colleges, while the remaining 50,315 go to Private Medical Colleges.
Despite these measures, concerns remain about the quality of medical education due to instances of colleges failing to meet accreditation requirements set by the NMC.
Challenges in The Indian Medical Education System
However, various systemic issues continue to plague medical education in India. Top of the list is the serious mismatch between demand and supply of medical seats relative to population norms. Adding to this problem is the high cost of education in private colleges, a byproduct of scarce resources.
The rapid establishment of new medical institutes has resulted in a significant faculty crunch. In an effort to address this, the government enacted requirements for publications in order to promote academic rigor amongst faculty. However, dubious quality journals sprouting up as a result has raised concerns over academic integrity.
Other key issues include the commercialisation of medical education following law changes in the 1990s, allowing private entities to establish medical schools. This, coupled with prevalent fraudulent practices such as fake degrees and bribes, signifies deep-rooted corruption in the medical education system.
Looking Forward
In response to these challenges, the NMC’s efforts to regulate college fees face resistance from medical colleges. As a solution, there are calls for the government to consider subsidising medical education or finding alternative financing methods for disadvantaged students.
Regular quality assessments of medical colleges, with public availability of the findings, could help improve transparency. The NMC’s proposal to implement a common exit exam is seen as a step towards quality control and raising the standards of medical professionals. However, alongside these improvements, the system needs to innovate to address the shortage of health professionals, especially given the increasing demands of an aging populace and the rise of lifestyle-related ailments.
