Medical education is constantly evolving to match global healthcare demands. For Indian and international students pursuing MBBS in Nepal, one of the most common concerns is the difference between the old Medical Council of India (MCI) curriculum and the new National Medical Commission (NMC) curriculum.
Nepal follows a system closely aligned with Indian standards, as thousands of Indian students choose Nepal for MBBS due to cultural similarities, curriculum structure, and recognized degrees. Over the years, the MCI was the governing body responsible for regulating medical education in India. However, in 2020, it was replaced by the NMC with an aim to modernize the curriculum and bring uniformity.
For MBBS aspirants in Nepal, this transition brings changes not only in the syllabus structure but also in assessment, licensing, and career pathways. This article explains in detail the differences between MCI (old) and NMC (new) in Nepal MBBS curriculum, how they impact students, and why understanding these changes is important.
The MCI was established in 1934 and functioned as the main body to regulate medical education, set standards, and grant recognition to medical colleges. The MBBS curriculum under MCI was more traditional, subject-wise, and exam-oriented.
The NMC came into effect in 2020 with a goal to reform and modernize medical education in India, making it more competency-based. Since Nepal aligns its MBBS program with Indian standards, the NMC guidelines also influence the structure of MBBS in Nepal.
MCI (Old):
The MCI followed a discipline-based curriculum where subjects were taught separately in compartments such as Anatomy, Physiology, Biochemistry, Pathology, Microbiology, Pharmacology, etc. Integration between pre-clinical, para-clinical, and clinical subjects was minimal.
NMC (New):
The NMC promotes a Competency-Based Medical Education (CBME) approach. This means students are expected to learn not only theory but also practical skills, communication abilities, and ethical decision-making from the very beginning. Subjects are more integrated with clinical exposure starting in the first year.
MCI (Old):
The course was spread across 4.5 years of academics plus 1 year of compulsory internship, making a total of 5.5 years.
NMC (New):
The new structure still keeps the 4.5 + 1-year format, but emphasizes continuous clinical exposure throughout the academic years instead of waiting until the final stages.
MCI (Old):
The MBBS program was divided into:
First Year: Anatomy, Physiology, Biochemistry
Second Year: Pathology, Microbiology, Pharmacology, Forensic Medicine
Third Year (Part 1): ENT, Ophthalmology, Community Medicine
Final Year (Part 2): Medicine, Surgery, Pediatrics, Obstetrics & Gynecology
NMC (New):
The NMC has introduced a phase-wise integrated curriculum with early clinical exposure. For example:
From the first year, students are introduced to clinical wards and patient interaction.
Pre-clinical subjects are not taught in isolation but are linked to clinical cases.
Community-based learning is spread throughout the course instead of being restricted to a specific year.
MCI (Old):
Exams were conducted at the end of each professional year.
The system was more theory-focused with less weightage on continuous assessment.
Internal assessment existed but was not strongly emphasized.
NMC (New):
Continuous formative assessments are given greater importance.
Objective Structured Clinical Examination (OSCE) and skill-based assessments are included.
Focus is on competency and performance, not just theoretical memorization.
MCI (Old):
Internship was one year long, usually after the completion of final exams, with rotations across various departments.
NMC (New):
The internship structure remains one year, but now it has a defined competency logbook. Students must demonstrate mastery of specific clinical skills to qualify for degree completion.
MCI (Old):
Indian students studying MBBS abroad had to clear the FMGE (Foreign Medical Graduate Examination) to practice in India.
NMC (New):
The NMC has proposed the NEXT (National Exit Test) which will serve as:
A licensing exam to practice in India.
A common exam for both Indian and foreign MBBS graduates.
A postgraduate entrance exam for further studies.
This change is significant for students studying MBBS in Nepal, as they will now need to prepare for NEXT instead of FMGE.
MCI (Old):
More emphasis on theoretical learning, memorization of facts, and subject-based lectures.
NMC (New):
Greater focus on practical skills, communication, ethics, and problem-solving abilities. The curriculum is designed to produce doctors who are not just knowledgeable but also competent in patient care.
MCI (Old):
Research exposure was minimal. Self-learning was not strongly encouraged.
NMC (New):
Students are required to undertake projects, seminars, and research-based learning during the MBBS course. The aim is to develop critical thinking and innovation.
MCI (Old):
Community medicine was mostly taught in theory and limited to later years.
NMC (New):
Community-based projects and rural health postings are introduced earlier. This ensures students understand healthcare challenges at the grassroots level.
MCI (Old):
Nepal’s MBBS curriculum under MCI was already recognized globally, especially in South Asia.
NMC (New):
The revised curriculum aligns more with international standards such as USMLE and PLAB, giving Nepal MBBS students better opportunities abroad.
Better Prepared for NEXT Exam: Since Nepal MBBS now aligns with the NMC system, students will be better equipped for the licensing exam in India.
Stronger Clinical Exposure: Early clinical postings make students more confident in patient care.
Improved Career Opportunities: Competency-based learning matches global requirements, helping students pursue careers abroad.
Higher Academic Pressure: Continuous assessments and competency logbooks may increase workload compared to the old system.
| Feature | MCI (Old) | NMC (New) |
|---|---|---|
| Curriculum Type | Discipline-based | Competency-based |
| Clinical Exposure | Late (after 2nd year) | Early (from 1st year) |
| Assessment | Annual theory exams | Continuous + OSCE + practical |
| Internship | 1 year, less structured | 1 year, logbook-based |
| Licensing Exam | FMGE (for foreign grads) | NEXT (common exam) |
| Research | Minimal | Mandatory projects |
| Community Medicine | Focused in later years | Integrated throughout |
| Global Alignment | Regional recognition | Closer to USMLE/PLAB |
The shift from MCI to NMC curriculum marks a historic change in medical education for students pursuing MBBS in Nepal. While the MCI system provided a strong theoretical base, it was often criticized for lack of integration, limited clinical exposure, and outdated methods. The NMC’s competency-based approach addresses these gaps by ensuring students gain practical skills, ethical grounding, and global competitiveness.
For MBBS students in Nepal, this transition means they must adapt to a more rigorous but rewarding system that better prepares them for modern healthcare challenges. Understanding these differences helps aspirants make informed choices about studying medicine in Nepal while keeping their future career goals aligned.