NExT Exam 2026 Complete Guide for Italy MBBS Graduates: What Has Changed from FMGE
The NExT exam for Italy MBBS graduates represents the most significant change to India’s medical licensing system in decades. The National Exit Test (NExT) is replacing FMGE as the single gateway for all foreign medical graduates — including those who studied at Italian universities — to practice medicine in India. This guide covers exactly what NExT is, how it differs from FMGE, the current 2026 implementation status, and what Italy graduates must prepare for.
If you are currently studying MBBS in Italy or planning to apply through the IMAT exam, understanding NExT is critical to your career planning. For those who have already graduated, our FMGE complete guide remains the current reference until NExT is fully implemented.
What Is NExT and Why Every Italy MBBS Student Must Know It
The National Exit Test (NExT) was introduced under the National Medical Commission (NMC) Act 2019. It is designed to create a single, unified exit examination for all medical graduates in India — whether from Indian or foreign universities. NMC India (nmc.org.in) is the authoritative source for all NExT updates.
NExT affects every student currently studying MBBS at NMC-recognised Italian universities including Naples Federico II, Turin, Pavia, and Tor Vergata Rome. Your career pathway to India goes through this exam.
NExT vs FMGE — Key Differences
| Factor | FMGE (Old System) | NExT (New System) | Impact on Italy Graduates |
|---|---|---|---|
| Who takes it | Foreign medical graduates only | ALL medical graduates (Indian + foreign) | Equal footing with Indian graduates |
| Format | 300 MCQ, single day | Part 1 (MCQ theory) + Part 2 (clinical OSCE) | Clinical skills assessed separately — Italy’s training helps |
| Timing | After graduation + internship | Integrated into final year (for Indian) / post-graduation (for foreign) | Foreign graduates take both parts after returning to India |
| PG eligibility | Separate NEET PG needed | NExT score determines PG rank directly | One exam unlocks both practice and PG access |
| Attempts | Multiple, no limit | Limited attempts proposed (details pending confirmation) | Preparation becomes more critical |
| Internship | 1 year in India after passing | 1 year in India (same) | No change |
Current 2026 Status of NExT — What Is Confirmed
As of May 2026, the NMC Act mandate for NExT is law, but full implementation for foreign graduates is still in a transitional phase. Check the National Board of Examinations (natboard.edu.in) for the latest schedule.
- Currently enrolled students (2022–2026 batch): likely to face a transitional arrangement — some may still sit FMGE. Confirm directly with NMC.
- Students enrolling from 2024–25 onwards: expected to sit NExT in its full form
- Those who already graduated: check whether you are in the FMGE window or NExT regime based on your graduation year
For current exam context, our FMGE complete guide covers the existing system fully. The NEET PG eligibility guide explains how NExT scores will eventually replace NEET PG rankings. Also see the salary comparison guide to understand what Indian practice actually pays.
NExT Part 1 — Theory Examination
Format and Subjects
NExT Part 1 is a comprehensive MCQ-based theory examination covering all pre-clinical and para-clinical subjects. The subject list aligns closely with what Italy MBBS students study in Years 1–4:
- Pre-clinical: Anatomy, Physiology, Biochemistry
- Para-clinical: Pathology, Pharmacology, Microbiology, Community Medicine, Forensic Medicine
- Clinical: Medicine, Surgery, Ob-Gyn, Paediatrics, Orthopaedics, Psychiatry, ENT, Ophthalmology, Dermatology, Radiology
Italy’s clinical training at hospitals affiliated with Naples Federico II, Turin, and Pavia covers all these clinical subjects in depth. The FMGE pass rates at these universities provide a useful benchmark — see Naples FMGE rates, Turin FMGE rates, and Pavia FMGE rates.
NExT Part 2 — Clinical and Practical Examination
Part 2 is what makes NExT genuinely different from FMGE. It is an OSCE (Objective Structured Clinical Examination) format — 18 clinical stations, approximately 8 minutes each.
What Part 2 Tests
- Clinical history taking and examination
- Procedural skills (suturing, IV cannulation, catheterisation)
- Communication with patients and families
- Data interpretation (ECG, X-rays, blood reports)
Italy’s Clinical Training Advantage for Part 2
This is where Italy MBBS graduates have a genuine structural advantage over graduates from Russia, China, or Ukraine. Bedside teaching at Italian teaching hospitals, oral examination culture, and direct patient contact during clinical rotations build exactly the skills NExT Part 2 tests. Students at universities like Naples, Pavia, Tor Vergata, and those who follow the Padua or Tor Vergata pathways are especially well-prepared.
This Part 2 advantage also applies to the PLAB 2 OSCE if you choose the UK route. For those planning alternative pathways, the USMLE Step 2 CK also tests clinical reasoning in a similar MCQ format.
NExT Eligibility for Italy Graduates
| Requirement | Details | Italy Graduate Status |
|---|---|---|
| Medical degree | From NMC-recognised university | ✓ All major Italian public universities qualify |
| Registration | NBE registration after graduation | Apply at natboard.edu.in after degree |
| Internship | 1-year rotating internship in India | Must complete at NMC-registered hospital |
| State Medical Council | Registration for practice licence | After NExT + internship completion |
Year-by-Year NExT Preparation Plan for Italy Students
| Year | NExT Preparation Action | Key Resources |
|---|---|---|
| Year 1–2 | Build strong foundation in Anatomy, Physiology, Biochemistry | University notes + First Aid basics |
| Year 3 | Begin subject-wise MCQ practice alongside para-clinical subjects | Marrow, DAMS app |
| Year 4 | Clinical subject MCQ banks; begin OSCE skill practice | PrepLadder, clinical skill videos |
| Year 5 | Full subject revision; 2 mock tests per month | Grand tests on Marrow + DAMS |
| Year 6 | Intensive prep: 3 mock tests per week; Part 2 OSCE practice | Clinical OSCE course (AIIMS/private) |
Integrate this preparation into your broader Italy study timeline and 6-year financial plan. Students who deferred admission (see our deferral guide) or transferred universities should recalculate their preparation timeline accordingly.
NExT and NEET PG — How They Connect
Under the NExT regime, your NExT Part 1 score will directly determine your PG specialisation ranking — replacing NEET PG entirely. This means a strong NExT score serves double duty: it both licenses you to practice and ranks you for postgraduate specialisation. Our NEET PG eligibility guide covers the transitional rules in detail.
For International Students (Non-Indian)
NExT is India-specific. Students from Pakistan, Nepal, the UAE, Africa, or other countries who complete MBBS in Italy and want to return to their home country should check their home country’s medical licensing authority. Alternatives to NExT include the USMLE for USA, PLAB for UK, DHA/DOH for UAE, and European specialisation. The salary comparison guide helps you choose the most financially rewarding pathway.
Frequently Asked Questions
- Is NExT the same as FMGE?
- No. NExT is a two-part exam (theory MCQ + clinical OSCE) that replaces FMGE. It applies to all graduates including Indian MBBS students, not just foreign graduates. Our FMGE complete guide covers the current system until NExT is fully implemented.
- When will NExT fully replace FMGE for Italy graduates?
- The transition is ongoing. NMC and NBE publish updates on their official sites. Students graduating in 2024–25 onwards are most likely to sit NExT in its complete form. Check natboard.edu.in for the latest schedule.
- Does NExT Part 2 require clinical training in India?
- No — you can prepare for Part 2 based on your Italian clinical training. However, attending a dedicated OSCE preparation course in India (available at major medical coaching centres) is strongly recommended.
- Will Italy MBBS graduates be disadvantaged in NExT compared to Indian graduates?
- Italy’s English-medium curriculum and strong clinical training actually creates advantages, particularly for Part 2. The oral examination culture in Italian medical schools builds clinical communication skills directly assessed in OSCE format.
- Can I appear for NExT and USMLE simultaneously?
- Yes — the exams are not mutually exclusive. Many Italy graduates prepare for NExT Part 1 and USMLE Step 1/2 CK simultaneously since the subject content overlaps significantly.
- What is the passing score for NExT?
- NMC has proposed a minimum 50% qualifying score for Part 1 and a separate clinical competency standard for Part 2. Final thresholds are confirmed at nmc.org.in.
Get NExT Preparation Guidance from Italy Study Centre
Understanding how NExT affects your MBBS in Italy journey is essential from Day 1. Italy Study Centre can help you choose the right university based on clinical training quality, map your year-by-year preparation strategy, and plan your post-graduation career. Book your free consultation today.
