The National Exit Test (NEXT), proposed by the National Medical Commission (NMC) in June 2023, represents a landmark reform in Indian medical education. It is designed to function as a common final-year undergraduate examination for medical students and aims to standardize the assessment of medical graduates across the country [1]. The NEXT examination will serve multiple purposes, including acting as a licensure examination for medical practice, a screening test for foreign medical graduates, and a ranking examination for admission into postgraduate medical courses [1,2].

This unified approach replaces traditional systems such as NEET-PG and FMGE, with the objective of ensuring uniformity, transparency, and improved quality in medical training and evaluation [2,3]. Such reforms are expected to align Indian medical education with global standards and promote competency-based learning.

However, the introduction of a high-stakes, multi-purpose examination like NEXT may significantly influence students’ academic preparation, mental well-being, and career planning. Studies conducted in similar contexts have shown that major examination reforms often lead to increased anxiety, uncertainty, and reliance on coaching systems among students [4,5].

Previous research has also demonstrated variability in awareness and mixed perceptions among undergraduate medical students regarding national-level licensing examinations [5,6]. Understanding these perceptions is essential for identifying gaps in knowledge and addressing concerns related to implementation.

Therefore, the present study was conducted to assess the knowledge and perception regarding the National Exit Test (NEXT) among medical students in Rewa city.

MATERIALS AND METHODS

This cross-sectional study was conducted among undergraduate medical students at Shyam Shah Medical College, Rewa, Madhya Pradesh. The study population included MBBS students from first year to internship. A total of 400 students were included in the study using a convenient sampling technique.

Data were collected using a pre-tested and pre-validated structured questionnaire, which was administered online through Google Forms. The questionnaire consisted of sections assessing socio-demographic characteristics, knowledge regarding the National Exit Test (NEXT), and students’ perceptions and attitudes toward the examination.

The study variables included socio-demographic details such as age, gender, and family income, along with variables assessing knowledge and perception regarding NEXT. Data obtained were compiled and analyzed using descriptive statistical methods. Frequencies and percentages were calculated for categorical variables, while mean and standard deviation were used for continuous variables.

RESULTS

A total of 400 medical students participated in the study. The mean age of the participants was 20.32 ± 2.81 years, with the majority belonging to the 19–20-year age group. Among the participants, 55.5% were males and 44.5% were females, as shown in Table 1.

Regarding knowledge about NEXT, 52.3% of the students correctly identified the primary objective of the examination as ensuring uniform standards in medical education. However, a considerable proportion (43.3%) were unaware of the detailed pattern of NEXT Step 1. Most participants (89%) knew that the examination consists of two steps, while 35.5% were not aware of the number of attempts allowed (Table 2).

In terms of perception, 45.5% of students agreed that NEXT should replace the existing NEET-PG/FMGE examination, whereas 30% disagreed. A majority (63.2%) believed that NEXT would improve conceptual understanding, and 51.5% felt that it would enhance the overall quality of healthcare (Table 3).

With respect to preparedness, only 12.5% of students felt adequately prepared for the NEXT Step 2 practical examination. About 32.5% expressed the need for more training or practice time, and 56.5% were uncertain about how their performance in NEXT would compare with NEET-PG (Table 4).

The perceived impact of NEXT revealed that 56.5% of students believed it would increase dependence on coaching classes, while 47.5% felt it might reduce attendance in clinical postings and academic sessions. Additionally, 44.8% agreed that the new examination pattern would increase the academic burden on students. A significant proportion of students reported experiencing stress related to NEXT, with 38.3% reporting definite stress and 44.3% experiencing occasional stress (Table 5).

Regarding academic implications, 18.3% of students believed that NEXT might negatively influence their choice of specialization. Nearly half of the participants (47.5%) supported the idea that pre-clinical and para-clinical subjects should be given equal emphasis in the NEXT examination (Table 6).

Table 1: Socio-demographic Characteristics of Study Participants (N = 400)

Table 2: Knowledge Regarding NEXT Examination

Table 3: Perception Regarding NEXT

Table 4: Preparedness and Performance

Table 5: Perceived Impact of NEXT

Table 6: Academic Implications of NEXT

DISCUSSION

The present study highlights that medical students possess moderate awareness but exhibit mixed perceptions regarding the National Exit Test (NEXT). A majority of participants correctly identified the primary objective of NEXT as standardizing medical education, indicating an acceptable baseline level of awareness. Similar findings have been reported in previous studies where students demonstrated general awareness but lacked detailed understanding of examination structure and policies [5,6].

Despite this, significant gaps were observed in specific knowledge areas such as the examination pattern and the number of attempts allowed. This suggests the need for structured orientation programs and curriculum integration to improve awareness, as also emphasized in earlier studies [6,7].

Students in the present study expressed several concerns, including increased dependence on coaching classes, higher academic burden, and stress related to the new examination system. These findings are consistent with prior research indicating that high-stakes examinations often drive students toward private coaching and contribute to academic stress and burnout [4,8]. The perception that NEXT may reduce focus on clinical learning further raises concerns regarding its potential impact on competency-based education.

A considerable proportion of students reported experiencing stress or anxiety related to NEXT. This aligns with existing literature suggesting that uncertainty surrounding new examination systems can adversely affect students’ mental health and academic performance [8,9].

Despite these concerns, a positive outlook was observed among students regarding the potential benefits of NEXT. Many participants believed that the examination could improve conceptual understanding and contribute to the standardization of medical education. Similar positive perceptions have been documented in studies evaluating competency-based medical education reforms [7,10].

This dual perception—acknowledging both benefits and challenges—indicates that while students are receptive to the idea of reform, there are significant concerns regarding its implementation. Addressing these concerns through proper guidance, transparent communication, and curriculum alignment will be crucial for the successful adoption of NEXT.

CONCLUSION

The present study reveals that the knowledge regarding the National Exit Test (NEXT) among medical students is moderate but not comprehensive. While students demonstrated a generally positive attitude toward the objective of standardizing medical education, several important concerns were identified. A significant proportion of students expressed apprehension regarding increased stress levels, growing dependence on coaching classes, and inadequate preparedness for the examination. These findings highlight the need for better awareness and academic support to facilitate a smoother transition toward the NEXT system.

Recommendations

Based on the findings of the study, it is recommended that structured orientation programs on NEXT be conducted for undergraduate medical students to enhance their understanding of the examination pattern and objectives. Integration of the NEXT framework into the existing MBBS curriculum is essential to ensure alignment between teaching and assessment. Furthermore, greater emphasis should be placed on strengthening clinical and practical training to improve students’ confidence and competence, particularly for the practical components of the examination. Additionally, providing mental health support and counselling services is crucial to help students cope with stress and anxiety associated with the new examination system.

Limitations

The study has certain limitations that should be considered while interpreting the results. Being a single-centre study conducted at one medical college, the findings may not be generalizable to all medical students across India.

REFERENCES

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