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Nepal Medical Council Licensing Examination (NMCLE)

Purpose of the NMCLE Exam

The NMCLE is a licensure exam required by the Nepal Medical Council for anyone wishing to practice medicine in Nepal. It serves as a way to ensure that medical professionals possess the necessary knowledge and skills to provide high-quality healthcare in the country.

The primary objective of the NMCLE is to maintain the quality and standards of healthcare in Nepal. As per NMC laws and regulations, all medical graduates (MBBS, MD, and MS) must pass this examination to demonstrate their competency and readiness to practice medicine.

 

Frequency of the Examination


The Nepal Medical Council Licensing Examination (NMCLE) is conducted every four months by the Nepal Medical Council (NMC). This ensures regular opportunities for medical graduates to obtain their license to practice.

Eligibility Criteria


To sit for the NMCLE, candidates must hold an MBBS degree from an NMC-recognized medical college. Additionally, they must complete a 6-month rotatory internship at an NMC-recognized medical center, ensuring practical exposure and readiness for professional practice.

Exam Format and Duration


The NMCLE is a computer-based test with a duration of 3 hours. The exam comprises a total of 180 marks, testing a candidate’s knowledge across the entire MBBS curriculum.


Licensing and Professional Practice


Successfully passing the NMCLE grants candidates the license to practice as medical doctors in Nepal. For those specializing in specific medical fields, the Nepal Medical Council Licensed Special Examination must also be cleared. This additional step ensures that specialized professionals meet the required standards for advanced medical practice.

The NMCLE plays a pivotal role in upholding the integrity of Nepal’s healthcare system, ensuring that only qualified and competent doctors are entrusted with patient care.

 

Eligibility Requirements

  • MBBS Qualification: Candidates must have successfully completed the MBBS program from a recognized medical college.
  • Internship: Candidates must complete a six-month internship following their MBBS degree. The internship provides practical training, helping medical graduates integrate their academic learning into clinical practice.

Exam Structure

The NMCLE is a computer-based test required for medical graduates to practice medicine in Nepal. It assesses the complete MBBS syllabus and includes both multiple-choice questions (MCQs) and clinically-based short answer questions (CSQs).

Key Details of the NMCLE

Aspect

Details

Purpose

To obtain a medical practice license in Nepal.

Eligibility

Must have completed the MBBS program and a 6-month internship.

Exam Frequency

Offered every 4 months.

Exam Duration

3 hours.

Total Questions

140 questions (130 MCQs and 10 clinically-based short answer questions).

Scoring

MCQs: 1 mark each.

CSQs: 5 marks each.

Minimum Passing Marks

90 out of 180 marks.

No Negative Marking

All questions should be attempted.

Recommended Preparation

– “NMCLE in a Nutshell”

– “First Aid Step 1”

– “Stepping out of NMCLE”

– “Sharad Chandra Quick Review of PGMEE”

Preparation Tips

– Start preparation early, ideally during internship.

– Consistent daily study is important.

– Skip unsure questions and return to them later.

Exam Nature

Tests the entire MBBS syllabus.



NMCLE Exam Syllabus Breakdown

The Nepal Medical Council Licensing Examination (NMCLE) tests the complete MBBS syllabus, meaning questions can come from any subject. While a detailed syllabus is not explicitly provided, the following breakdown highlights key topics and the exam structure:

Exam Structure:

  • Type of Exam: Computer-Based Test (CBT)
  • Duration: 3 hours
  • Total Questions: 140
    • MCQs: 130 multiple-choice questions (1 mark each)
    • CSQs: 10 clinically-based short answer questions (5 marks each)
  • Total Marks: 180
  • Passing Score: Minimum of 90 out of 180

Key Features:

  • No Negative Marking: You are encouraged to attempt all questions.
  • Random Question Arrangement: The questions are mixed between MCQs and CSQs, which requires adaptability during the exam.

 

MCQ Breakdown:

  • Anatomy: 5 questions
  • Physiology: 5 questions
  • Pharmacology: 4 questions
  • Biochemistry: 5 questions
  • Pathology: 7 questions
  • Microbiology: 4 questions
  • Forensic Medicine: 6 questions
  • Community Medicine: 13 questions
  • Medicine: 13-14 questions
  • Surgery: 13 questions
  • Gynecology and Obstetrics: 12-13 questions
  • Pediatrics: 10 questions
  • Anesthesia: 8 questions
  • Orthopedics: 6 questions
  • Ophthalmology: 6 questions
  • ENT: 6 questions
  • Dermatology: 3 questions
  • Psychiatry: 2 questions

CSQ Breakdown:

  • Basic Science: 1 question
  • Orthopedics: 1 question
  • Surgery: 2 questions
  • Medicine: 2 questions
  • Pediatrics: 2 questions
  • Obstetrics and Gynecology: 2 questions

Key Focus Areas

  • Practical Knowledge and Clinical Skills:
    • Identifying disease symptoms
    • Conducting radiological findings
    • Making diagnoses

Selected Skills to be Tested During NMCLE

Basic Clinical Examination and Vital Signs

  1. Demonstrates BP, pulse, and SpO₂ measurement.
  2. Performs auscultation of the heart and identifies murmurs.
  3. Performs auscultation of the lungs and identifies abnormal breath sounds.
  4. Performs abdominal examination.

Airway and Emergency Management

  1. Demonstrates airway maneuvers.
  2. Demonstrates bag-and-mask ventilation.
  3. Demonstrates chest compressions.
  4. Demonstrates cervical collar application.
  5. Demonstrates neonatal resuscitation.

Newborn and Maternal Care

  1. Demonstrates essential newborn care.
  2. Demonstrates kangaroo mother care.
  3. Demonstrates normal labor and delivery along with a partogram.
  4. Performs manual removal of the placenta.
  5. Performs obstetric examination.
  6. Demonstrates per speculum and per vaginal examination.
  7. Demonstrates pap smear collection and interpretation.
  8. Performs episiotomy.

Ophthalmology and ENT Skills

  1. Demonstrates ophthalmoscopy (technique only).
  2. Identifies papilledema on ophthalmoscopy.
  3. Removes foreign bodies from the eye, ear, or nose.
  4. Demonstrates otoscopy (technique only).
  5. Demonstrates tuning fork tests and differentiates between sensorineural and conductive hearing loss.

Neurological Assessment

  1. Performs cranial nerve examination.
  2. Demonstrates deep tendon reflexes.
  3. Performs a mini mental state examination (MMSE).
  4. Assesses brain stem function.
  5. Evaluates the Glasgow Coma Scale (GCS).
  6. Detects signs of raised intracranial pressure.

Procedural Skills

  1. Performs intramuscular, intravenous, and subcutaneous injections.
  2. Performs venipuncture.
  3. Performs urinary catheterization.
  4. Performs anterior nasal packing.
  5. Performs incision and drainage of superficial abscesses.
  6. Performs pleural tapping.
  7. Performs ascitic tapping.
  8. Performs chest tube insertion and drainage.
  9. Performs lumbar puncture.
  10. Performs nasogastric tube insertion.

Surgical and Wound Care Skills

  1. Demonstrates basic suturing.
  2. Demonstrates wound care and basic bandaging.
  3. Applies basic splints and slings.
  4. Performs compression bandaging.
  5. Demonstrates eye irrigation and ocular bandaging.

Counseling and Communication Skills

  1. Provides immunization schedule counseling.
  2. Counsels for family planning, breastfeeding, lifestyle modifications, chronic diseases, alcohol, smoking, consenting for surgery, and breaking bad news.
  3. Takes informed consent for surgical procedures from standardized patients.

Pharmacology and Prescription Writing

  1. Calculates drug dosages and prescribes medications accurately.
  2. Writes prescriptions in a professional format.

Life Support and Trauma Management

  1. Demonstrates defibrillation and cardioversion.
  2. Demonstrates trauma life support and early trauma management.

Pediatrics and IV Infusions

  1. Sets up pediatric IV infusions and calculates drip rates.

Legal and Reporting Skills

  1. Writes medico-legal reports (e.g., injury, sexual assault, suicide/homicide, postmortem).

Lab and Imaging Interpretation

  1. Interprets basic laboratory investigations.
  2. Interprets ECGs and X-rays.

NMCLE Preparation Tips

  • Comprehensive Study: Study all subjects thoroughly as the exam covers the entire MBBS curriculum.
  • Balanced Preparation: Do not neglect any subject, as the exam is unpredictable, and questions can come from any area.
  • Start Early: Begin your preparation during your internship, as it allows you to integrate theoretical learning with practical experience.
  • Consistent Study: Consistency is crucial. Even short daily study sessions help with long-term retention.
  • Recommended Resources:
    • Books: “NMCLE in a Nutshell,” “NMCLE Easy Entry,” “Stepping out of NMCLE,” etc.

During the Exam

  • Time Management: Allocate time wisely, especially for CSQs. If a question seems challenging, move on and come back to it later.
  • Focus on CSQs: Read clinically-based short-answer questions carefully, as understanding the full context is key to answering them correctly.

 

Why Passing the NMCLE is Important

  • Passing the NMCLE demonstrates your competency and readiness to provide quality medical care in Nepal. It is a crucial step for licensing and ensures that candidates meet the standards necessary for practicing medicine in Nepal.
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