Medical education in Nepal has gained significant recognition in South Asia and among international students due to its well-structured curriculum, affordable tuition fees, and high-quality training modeled on international standards. With a growing number of students from India, Bangladesh, Sri Lanka, and beyond choosing Nepal for MBBS studies, one of the most common queries is about the examination pattern.
The MBBS program in Nepal spans five and a half years, which includes four and a half years of academic study followed by a one-year compulsory internship. The crucial question that arises for many students is whether the MBBS examinations in Nepal follow a yearly system or a semester-based evaluation system.
The answer is that the Nepal MBBS curriculum primarily follows a yearly examination pattern, though the academic calendar is structured into semesters for teaching and internal assessments. This article provides a comprehensive overview of how exams are conducted, the differences between yearly and semester approaches, and their impact on medical education in Nepal.
The MBBS curriculum in Nepal is governed by bodies like the Nepal Medical Council (NMC), the Institute of Medicine (IOM) under Tribhuvan University, Kathmandu University, and B.P. Koirala Institute of Health Sciences. Though the teaching-learning method may slightly vary between universities, the broad framework remains consistent.
Duration: 5 years of academics + 1 year internship
Phases of Study:
Pre-clinical phase: 2 years
Para-clinical and clinical phase: 2.5 years
Internship: 1 year
Examinations: Conducted on a yearly basis, with continuous internal assessments through semester-based classes
The MBBS exams in Nepal are yearly professional examinations, which means students appear for major board examinations once every academic year. These exams are designed to assess knowledge, clinical reasoning, and practical skills.
Comprehensive Assessments
Students are tested on all subjects studied during the year.
Exams include theory papers, practicals, viva-voce, and clinical case presentations.
Professional Examinations
Named as First, Second, Third, and Final Professional Exams.
These are university-conducted, standardized assessments.
Weightage
Greater emphasis is placed on the professional exams compared to internal assessments.
However, internal performance is often required for exam eligibility.
Progression
Passing each yearly professional exam is mandatory to move to the next phase.
Students failing in one subject may have supplementary exams but cannot progress without clearing them.
Although exams are yearly, the teaching calendar is divided into semesters. Typically, one academic year is split into two semesters.
To structure the teaching-learning process.
To allow better pacing of subjects.
To facilitate internal evaluations.
Students undergo class tests, tutorials, viva-voce, practical demonstrations, and internal exams every semester.
These assessments contribute to building knowledge gradually and prepare students for yearly exams.
Some universities also set a minimum internal score requirement to qualify for the yearly professional exam.
Thus, while Nepal follows a yearly examination pattern, the semester system ensures continuous learning and evaluation.
Subjects: Anatomy, Physiology, Biochemistry
Components:
Written theory papers
Practical/lab exams
Oral viva
Subjects: Pathology, Microbiology, Pharmacology, Forensic Medicine
Components:
Theory examinations
Practical assessments (lab-based, specimen identification)
Viva sessions
Subjects: Community Medicine, Ophthalmology, ENT
Assessment:
Written exams
Fieldwork/clinical case studies
Viva
Subjects: Medicine, Surgery, Pediatrics, Gynecology & Obstetrics, Psychiatry, Orthopedics, Dermatology, Radiology
Assessment:
Written theory exams
Long and short clinical cases
Practical skills demonstration
Viva-voce with multiple examiners
Duration: 1 year
No separate university exam, but performance is continuously evaluated.
Completion is mandatory for MBBS degree recognition.
| Aspect | Yearly Exam Pattern | Semester-Based Assessment |
|---|---|---|
| Frequency | Major exams once a year | Internal tests every semester |
| Nature | Summative (final evaluation of knowledge) | Formative (continuous progress tracking) |
| Stress Level | High-pressure exams due to vast syllabus | Lower pressure per test but more frequent |
| Eligibility | Passing yearly exams is compulsory to progress | Internal marks required for eligibility |
| Global Comparison | More traditional, similar to India’s older system | Semester approach is closer to Western models |
Comprehensive Knowledge – Students develop a holistic understanding of the subjects.
Strong Academic Foundation – In-depth preparation ensures mastery.
Resemblance to Indian MBBS – Helps Indian students adapt easily, especially those preparing for NEXT/FMGE.
High Stress and Pressure – Vast syllabus covered in one exam.
Risk of Year Loss – Failure in yearly exams may delay academic progression.
Continuous Learning – Prevents last-minute cramming.
Better Teacher-Student Interaction – Regular tests encourage consistent performance.
Practical Skill Building – Frequent assessments enhance clinical competence.
Frequent Tests – May create academic fatigue.
Lower Stakes – Some students may not take internal assessments seriously since final progression depends on yearly exams.
India: Earlier followed yearly exams; now, under NMC, many colleges use competency-based curriculum with more frequent assessments.
Bangladesh: Follows professional exams yearly, similar to Nepal.
Russia & Ukraine: Predominantly semester-based systems with exams every term.
Western Countries (USA/UK): Use semester or modular systems with continuous assessment rather than yearly professional exams.
Thus, Nepal maintains a traditional yearly model, making it familiar for South Asian students.
Many students feel that the yearly exam system is challenging due to the large syllabus but also rewarding as it builds strong medical fundamentals. The semester-based internal tests help them stay on track, though they add to the workload.
International students from countries with semester-based systems may take time to adjust but ultimately benefit from the rigorous preparation Nepal provides.
There are discussions about integrating more frequent assessments in line with global trends.
Some universities are experimenting with Objective Structured Clinical Examinations (OSCEs) and OSPEs for skill-based evaluation.
The balance between yearly summative exams and semester-based formative assessments is likely to improve in coming years.
The MBBS exam pattern in Nepal is primarily yearly, with professional exams conducted at the end of each academic year. However, the academic structure is divided into semesters for teaching and internal assessments, ensuring students are evaluated continuously throughout their studies.
This combination provides the benefits of both systems—comprehensive yearly evaluations for academic progression and semester-based assessments for consistent learning. For students, this means facing high-stakes yearly exams while also engaging in regular semester tests that prepare them gradually.
Ultimately, Nepal’s MBBS exam structure ensures that graduates are not only knowledgeable in medical sciences but also competent in practical and clinical skills, making them well-prepared for both national and international medical careers.