Doctors at Crossroads: The Delayed NEXT and India’s Search for a Fair Medical Future
When the time comes for the NEXT exam to finally take shape, it should not be remembered as a policy imposed from above, but as a vision built together by doctors, educators, regulators, and the very students who breathe life into India’s healthcare system.
When a group of determined young doctors from the Federation of All India Medical Association (FAIMA) walked into the National Medical Commission (NMC) headquarters in New Delhi this week, they carried the voice of an entire generation of Indian medical students. Their purpose was not confrontation but collaboration. They came armed with data, concerns, and recommendations for reform. A rare moment when grassroots realities met the nation’s medical policymaking table. What unfolded after that meeting was something that resonated deeply across India’s healthcare community.
The NMC Chairman, Dr. Abhijat Sheth, announced that the much-debated National Exit Test (NEXT) i.e. an exam meant to be the gateway for MBBS graduates to practice medicine and enter postgraduate programs would not be implemented immediately. The Commission, he said, would first conduct mock tests over the next three to four years. These trials, fully funded by NMC, would allow students and institutions to experience the process, test its feasibility, and offer feedback. Only after evaluating these outcomes would a decision be made about the final rollout of the exam. It was a pause signaling a recognition that reform, especially in something as critical as medical education, cannot be rushed.
The announcement brought a mix of relief and reflection across the medical community. For months, anxiety had been mounting among MBBS students who felt unprepared for the sudden shift that NEXT promised to bring. Designed as a single national test to replace the existing MBBS final exam, the Foreign Medical Graduate Exam (FMGE), and the NEET-PG entrance, NEXT was envisioned as a unifying framework that would assess both competence and knowledge. On paper, it appeared to be a solution to streamline evaluation and ensure uniform quality. But in reality, its sudden implementation raised valid concerns about infrastructure, training disparities, and fairness especially for students from government and private institutions with varying resources.
FAIMA’s survey results echoed these apprehensions. The federation gathered inputs from thousands of medical students and young doctors across India. Their responses painted a detailed picture of the current medical education ecosystem its strengths, its gaps, and its struggles. Many students voiced that while a unified test like NEXT could eventually standardize competence, India was not yet ready for it. The disparity in teaching quality, patient exposure, and institutional infrastructure was too wide. Without addressing these foundational inequalities, imposing a high-stakes national exam could have led to chaos rather than reform.
Dr. Sheth’s response showed an openness rarely seen in regulatory bodies. By deciding to test the waters first, the NMC has acknowledged the need for gradual transformation instead of abrupt policy shifts. It has also validated FAIMA’s evidence-based advocacy, a reminder that policymaking should listen to those who live through its consequences. Dr. Sheth appreciated the data-driven approach of FAIMA and assured that their recommendations would be reviewed for inclusion in upcoming discussions. For India’s young medical professionals, this gesture of acknowledgement is a signal that dialogue is finally replacing one-sided directives.
The delay in implementing NEXT opens a vital window for introspection about the deeper issues plaguing medical education in India. Beyond the exam lies a more pressing question, is the medical training system itself ready to produce confident, competent, and compassionate doctors in a changing world? Every year, thousands of students graduate with theoretical knowledge but limited hands-on experience. Many struggle with burnout, mental health challenges, and the pressures of an education system that often prioritizes grades over growth. The problem is not with the ambition of the doctors, but with the structure that molds them.
FAIMA’s meeting with NMC also addressed this broader context. Their discussions extended to four key areas including the review of medical education and infrastructure, integration of research into learning, improvement of the physical and mental well-being of students, and the overall quality of medical education. These may sound like administrative goals, but they cut to the heart of what it means to be a doctor in India today.
Take infrastructure, for instance. While India has dramatically increased the number of medical colleges, quantity has sometimes outpaced quality. In several newly established institutions, students face inadequate patient inflow, insufficient faculty, and outdated equipment. Such gaps leave many graduates theoretically sound but practically underprepared. Introducing an exam like NEXT without addressing these structural issues would have been unfair it would measure performance without ensuring equal opportunity to learn.
Then comes the question of research. India’s medical education system has long been criticized for treating research as an afterthought. Most students view dissertations as formalities rather than opportunities for discovery. Integrating meaningful research into medical training can change that. When future doctors learn to question, investigate, and innovate early in their careers, they contribute not only to patient care but to medical science itself. FAIMA’s suggestion to make research an integral part of learning is a step towards creating a generation of doctors who are thinkers as much as practitioners.
Equally important is the well-being of medical students. Behind the white coats and stethoscopes are young individuals navigating immense pressure. The path to becoming a doctor in India is long, competitive, and emotionally draining. The system, in its current form, often overlooks the mental toll it takes on students. Depression, anxiety, and burnout are not rare in medical campuses; they are quietly pervasive. Recognizing this, FAIMA emphasized that reforms should also include provisions for counseling, mentorship, and mental health support. A doctor’s ability to care for others begins with the system’s ability to care for them.
The discussion on quality improvement was perhaps the most encompassing of all. FAIMA’s report highlighted how the variance in teaching standards between different institutions affects students readiness for national-level examinations. Some colleges have access to advanced simulation labs and well-equipped hospitals, while others struggle with basic clinical material. In such a landscape, a single exam cannot be the equalizer unless the system first becomes equitable. The NMC’s decision to delay NEXT acknowledges this uncomfortable truth that before testing students, India must first test its own readiness.
Beyond these policy matters, the meeting carried emotional weight. For many doctors, the word “NEXT” had become synonymous with uncertainty. Students feared being part of the first batch subjected to an untested evaluation system. They questioned how the exam would be structured, how results would affect their postgraduate admissions, and whether it would recognize the diversity of medical training across states. The lack of clarity had created an atmosphere of anxiety and distrust. The NMC’s latest assurance to conduct mock tests, gather feedback, and evolve based on experience restores a measure of faith. It tells students that reform can be collaborative, not coercive.
However, this pause must not become an excuse for complacency. The delay in NEXT’s implementation should be used wisely to strengthen curriculam, upgrade hospital infrastructure, and train faculty for the modern age of medicine. The goal is not to postpone change indefinitely, but to prepare for it responsibly. When NEXT does arrive, it should stand on a foundation of fairness, inclusivity, and readiness.
This episode also highlights an evolving relationship between doctors and regulators. For decades, India’s medical community has often felt unheard governed by policies made in closed rooms, far from hospital corridors. But the dialogue between FAIMA and NMC marks a new possibility. It suggests that India’s healthcare system can move from confrontation to collaboration. If this spirit continues, future reforms could emerge not as impositions but as shared visions shaped by those on the ground.
The road ahead is long, but the direction feels promising. The NMC’s willingness to engage with data, listen to practitioners, and adapt policies is a welcome shift from the rigidity of the past. Medical education in India is at a crossroads, torn between the need for standardization and the demand for inclusivity. Balancing these two forces requires wisdom, empathy, and courage. The NEXT exam, when eventually implemented, could redefine how India assesses its doctors. But before that happens, the system must ensure that every student, regardless of geography or privilege, gets a fair chance to succeed.
In the end, the story is not about an exam. It is about restoring faith in medical governance, rebuilding trust between students and institutions, and redefining what progress truly means in the realm of healthcare. The decision to delay NEXT is not a setback; it is a moment of clarity and acknowledgment that haste can harm, and thoughtful reform can heal.
As the nation continues to produce thousands of young doctors each year, it owes them more than degrees, it owes them a system that respects their effort, supports their growth, and prepares them for the realities of modern medicine. The doctors of tomorrow deserve a medical education that is rigorous yet compassionate, standardized yet adaptable, ambitious yet humane.
When the time comes for the NEXT exam to finally take shape, it should not be remembered as a policy imposed from above, but as a vision built together by doctors, educators, regulators, and the very students who breathe life into India’s healthcare system every single day. Until then, this delay is not a pause in progress, it is progress in its most thoughtful form.
Sunny Parayan
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