Regulatory Updates
NExT Step 2 and OSCE: What Indian Medical Students Need to Know About Clinical Skills Assessment
Understanding the proposed OSCE component of NExT Step 2 -- what OSCE stations look like, how clinical skills are assessed and how to prepare for practical examinations.
MedNext Editorial Team | 2026-08-01 | 6 min read
NExT Step 2 and OSCE: What Indian Medical Students Need to Know About Clinical Skills Assessment
Understanding the proposed OSCE component of NExT Step 2 -- what OSCE stations look like, how clinical skills are assessed and how to prepare for practical examinations.
Understanding OSCE and Its Role in NExT
The Objective Structured Clinical Examination (OSCE) is a widely used assessment format in medical education worldwide. It is the proposed format for NExT Step 2, the clinical skills component of the National Exit Test. While NExT has not yet been implemented, understanding OSCE is valuable for any medical graduate, as clinical skills assessment is increasingly embedded in medical training globally.
What an OSCE Station Looks Like
A typical OSCE consists of 12-18 stations, each lasting 5-10 minutes. Candidates rotate through stations in sequence. Each station tests a specific competency and is assessed by a trained examiner using a standardised marking scheme.
Station types include history-taking stations (a standardised patient presents symptoms and the candidate must take a focused history), physical examination stations (demonstrate a specific examination on a standardised patient or mannequin), procedural skills stations (perform or describe a clinical procedure such as suturing, catheterisation, or IV cannulation), data interpretation stations (interpret an ECG, X-ray, blood report, or ABG and answer related questions), communication stations (break bad news, obtain informed consent, counsel a patient about a diagnosis), and integrated stations (combine history-taking and examination with a management plan).
Each station has a structured marking checklist that ensures objectivity. The examiner checks off specific behaviours, questions asked, or skills demonstrated.
OSCE in the Indian Context
Several challenges are specific to implementing OSCE at a national scale in India. The number of candidates (over 100,000 MBBS graduates annually) requires massive logistical coordination. Standardised patients must be trained in large numbers across multiple languages. Examiner calibration must ensure consistency across centres. Infrastructure (simulation labs, examination stations) varies widely between medical colleges.
The CBME curriculum introduced by NMC has incorporated OSCE elements into internal assessments at medical colleges. This is building familiarity with the format among current students and faculty, which would ease a future transition to a national OSCE.
How to Prepare for Clinical Skills Assessment
Regardless of whether NExT Step 2 materialises, strong clinical skills are essential for medical practice. Key preparation strategies include maximising hands-on clinical exposure during rotations (volunteer for procedures, attend OPDs and emergency departments), practising systematic clinical examinations (cardiovascular, respiratory, abdominal, neurological) until they are fluent, developing a structured approach to history-taking (presenting complaint, history of presenting illness, past medical/surgical history, drug history, family/social history, review of systems), practising communication skills (explaining diagnoses, obtaining consent, breaking bad news), and learning interpretation of common investigations (ECG, chest X-ray, ABG, basic blood reports).
International Precedents
OSCE is successfully used in several countries for medical licensing. The UK PLAB 2, Canadian MCCQE Part II, Australian AMC Clinical Examination, and US USMLE Step 2 CS (now discontinued and replaced with alternatives) all used or use OSCE-format assessments. India's NExT Step 2 would draw on these international models while adapting to the Indian clinical and linguistic context.
The key lesson from international experience is that OSCE favours candidates with genuine clinical exposure and communication skills over those who rely solely on theoretical knowledge. This alignment between assessment and real-world practice is one of the primary motivations for including OSCE in NExT.
Frequently Asked Questions
What is OSCE?
OSCE (Objective Structured Clinical Examination) is a practical examination format where candidates rotate through a series of stations, each testing a specific clinical competency. Stations may involve standardised patients (actors trained to present specific symptoms), clinical skills (procedures, examinations), data interpretation, or communication tasks.
Is OSCE already used in Indian medical education?
Yes, several Indian medical colleges have implemented OSCE as part of their internal assessment under the CBME curriculum. However, OSCE has not yet been used as a national-level standardised examination in India. NExT Step 2 would be the first such implementation if approved.
How many OSCE stations would NExT Step 2 have?
The exact format has not been finalised. International OSCE exams (such as the UK PLAB 2 or Canadian OSCE) typically have 12-18 stations with 5-10 minutes per station. NExT Step 2 would likely follow a similar structure, adapted to Indian clinical contexts.
Can I prepare for OSCE using question banks?
OSCE preparation requires clinical practice, not just theoretical knowledge. While question banks help with the knowledge base, OSCE competencies (communication, examination technique, procedural skills) are best developed through clinical rotations, simulation labs, and practice with peers or standardised patients.
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