FMGE vs NExT: What Foreign Medical Graduates Need to Know

Medical education in India is undergoing a historic transformation. For years, the “Foreign Medical Graduate Examination (FMGE)“ has been the final destination for Indian citizens who studied medicine (MBBS) abroad and wished to practice back home in India. Now, with the “National Exit Test (NExT)” set to be introduced soon, the medical licensing system is about to transform—creating one unified exam for both Indian and foreign medical graduates.

But what exactly is the difference between FMGE and NExT? And how does one secure an internship in India after passing these exams? Let’s check it out.

What is FMGE?

The “Foreign Medical Graduate Examination (FMGE)” is a evaluation test assessment conducted by the National Board of Examinations (NBE). It is meant completely and entirely for “Indian citizens or Overseas Citizens of India (OCIs) who completed their MBBS (or equivalent) abroad”.

• Grants “provisional registration” with NMC/State Medical Council.
• Requires completion of a “12-month Compulsory Rotating Medical Internship (CRMI)” in India before permanent registration.
• Conducted “twice a year (June & December)”.
• “MCQ-based” exam that tests basic knowledge.

What is NExT?

The “National Exit Test (NExT)” is a much broader reform introduced under the “NMC Act”. Unlike FMGE, it applies to “all MBBS graduates in India and abroad”.

• Serves three purposes:

            1. “Final MBBS exit exam”

            2. “Licensing exam” for practice in India

            3. “Entrance test for postgraduate (PG) courses” (replacing NEET-PG)

• Will be held “once a year”.
• Includes “two parts”:

       1. NExT Part I – theory (MCQs + clinical/case-based questions)

       2. NExT Part II – practical/clinical skills evaluation after internship

• Provides “direct license and PG eligibility” after internship + clearing both parts.

FMGE vs NExT: The Core Differences

To make the contrast clear, let’s look at the two systems side by side:

Table 1: Eligibility and Structure

Feature	FMGE	NExT
eligibility	Only (Indians) foreign medical graduates(MBBS)	All MBBS graduates (Indian & foreign)
Scedule	Twice a year (June & December)	Once a year
Format	Purely theoretical, MCQ-based assessment	Theory + clinical/practical assessments (Part I & II)

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Table 2: Purpose and Outcomes

Feature	FMGE	NExT
Focus	Only Licensing/screening test  for FMGs	Exit exam, licensing exam, PG entrance test (all-in-one)
Outcome	Pass → provisional registration → 12-month internship → permanent registration	Pass Part I & II + internship → full registration + PG eligibility

Quick Points

• “FMGE“ → Only for FMGs, twice a year, MCQ-only, leads to provisional registration + internship.
• “NExT” → For all MBBS graduates, once a year, includes theory + practical, doubles as licensure + PG entrance.
• In short: “FMGE is a filter, NExT is a comprehensive gateway.”

Internship Rules After FMGE

Clearing FMGE does not mean immediate licensure—you must complete a “12-month internship (CRMI)” in India. The process typically looks like this:

1. “Pass FMGE” and obtain the certificate from NBE.

2. “Apply for provisional registration” with NMC/State Medical Council.

3. Get a “No Objection Certificate (NOC)” from the Directorate of Medical Education (in some states).

4. Begin your “internship in an NMC-approved medical college or hospital”.

• Duration: 12 months
• Rotations: Medicine, Surgery, Pediatrics, Obstetrics & Gynecology, etc.

5. Receive “stipend” as per state rules (though often delayed).

6. Collect your “internship completion certificate”.

7. Apply for “permanent registration” to practice independently.

Internship Under NExT

With NExT, the structure will be slightly different:

• Clear “NExT Part I” (theory exam).
• Complete the “12-month internship” in an approved hospital.
• Sit for “NExT Part II” (practical/clinical exam) after internship.
• Obtain “full registration” with NMC/State Council.
• Use “NExT Part I score” for PG admissions as well.

How to Secure an Internship in India (Step by Step)

Whether under FMGE (current) or NExT (future), here’s the roadmap

 For FMGs:

1. “Verify your degree” – Ensure your MBBS is from an NMC-recognized college (World Directory of Medical Schools listing).

2. “Clear the exam” – FMGE (now) or NExT (future).

3. “Apply for provisional registration” – Submit documents to NMC/State Medical Council.

4. “Obtain NOC” – Some states require approval from the Directorate of Medical Education.

5. “Get internship allotment” – States assign candidates to NMC-approved hospitals.

6. “Complete 12 months of internship” – Mandatory with departmental rotations.

7. “Apply for permanent registration” – After internship, secure your full license.

Roadmap for NExT Exam(For Indian & Foreign MBBS Graduates)

1. “Validate your eligibility” – Ensure your MBBS is from an NMC-recognized medical college in India (for Indian graduates) or a listed foreign university (for FMGs).
2. “Appear for NExT Step 1” – A computer-based MCQ exam directed nationally, testing practical knowledge in Medicine, Surgery, Paediatrics, OBGYN, ENT, Ophthalmology, etc.
3. “Undergo Internship/CRMI” –
   1. Indian MBBS graduates: Do compulsory 12-month internship in India after Step 1.
   1. FMGs: Apply for provisional registration with NMC/State Medical Council, then complete the Compulsory Rotating Medical Internship (CRMI) in an NMC-approved hospital.
4. “Appear for NExT Step 2” – A practical/clinical and viva-based exam testing real-life skills, communication, and patient management at the end of internship.
5. “Secure Passing Certificate” – Passing both Step 1 & Step 2 makes you eligible for full registration.
6. “Apply for Permanent Registration” – Submit internship completion + NExT clearance proof to the NMC/State Medical Council. You will now receive your license to practice medicine anywhere in India.
7. “Pursue Higher Studies” – The NExT Step 1 score (not just pass/fail) will also act as the rank/merit list for PG admissions (MD/MS/DNB). High scores = better PG seats.
8. “Career Advancement” – With permanent registration, doctors can:
   1. Start clinical practice (private/government hospitals).
   1. Appear for PG entrance through the same NExT score.
   1. Apply for government jobs (Medical Officer, UPSC CMS, Armed Forces Medical Services)
   1. Explore public health, research, academics, or healthcare management.

In brief:
NExT = One Exam for Two Goals – Certifying for MBBS practice + Ranking for PG admissions.

Key Information and Challenges

• “FMGE will be phased out” once NExT is fully functional.
• “Internship seat shortages” remain a challenge in some states.
• “Stipend disparities” persist, despite entitlement rules.
• “COVID-19 disruptions” led to additional internship requirements for some FMGs.

✅ In Summary:
After clearing FMGE, MBBS graduates are not limited to just clinical practice. They can grow in multiple domains — clinical, academic, research, administrative, public health, pharma, or even global opportunities. The choice depends on individual interests and further qualifications.

Final Takeaway

• “FMGE“ is the currently licensing examination: foreign graduates needs to pass an evaluation assessment exam, do a one-year internship, and then get permanent registration.
• “NExT” is set to become the new future licensing pathway: a unified exam for all MBBS graduates that serves as final assessment, licensing exam, and PG entrance test, all in one test.
• “Internship remains compulsory” under both, forming the bridge between academic study and professional practice.

For foreign graduates planning to work in India:

✔️ Choose an NMC approved recognized university abroad.

✔️ Track official NMC and NBE updates.

✔️ Prepare for both exam theory and clinical assessments.

✔️ Plan your internship application early to avoid delays.

India’s move from FMGE to NExT marks a shift toward a “more standardized, transparent, and skill-focused licensing system”—ensuring doctors are better prepared for both independent practice and postgraduate training.