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FORMAT OF NEB EXAMINATION FOR PAKISTANI NATIONALS HAVING

FOREIGN MEDICAL & DENTAL BASIC OUALlFlCATIONS NOT INCLUDED IN
THE SCHEDULES OFTHE PM&DC ORDINANCE 1962.

NATIONAL EXAMINATION BOARD FOR FOREIGN MEDICAL GRADUATES

WILL CONSIST OF THE FOLLOWING THREE STEPS:

STEP-I (Basic Science Subjects Examination)

STEP-l! (Clinical Science Subjects Examination)

STEP-III (OSCEIVIV A Examination)

STEP-I (Basic Science Subjects Examination)

Basic Science Subjects examination will have following two papers:

Papers Type of Questions Duration Marks

Paper-I 150 MCQ's 3 hours 150

Paper-l! 150 MCQ's 3 hours 150

Total Marks 300

Note: Both papers will be held on same day. Candidate who succeed in Step-I(Basic Subjects
exam) will be eligible to sit in Step-II (Clinical Science Subjects exam).

STEP-II (Clinical Science Subjects - Theory Examination)

Clinical Science Subjects - theory examination will have following two papers:

Papers Type of Questions Duration Marks

Paper-I 150 MCQ's 3 hours 150

Paper-l! 150 MCQ's 3 hours 150

Total Marks 300

Note: Both papers ofPart-l! will be held on same day and candidate who passes Step-l! will
be eligible to sit in Step-IJI Examination.
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FORMAT OF NEB STEP-III (OSCENIVA) EXAMINATION

Consist of fifteen short cases/Assessment stations

15 Stations

(10 Minutes each Station)

5 minutes for examination and 5 minutes for

Presen tationNiva/ Assessment.

07 St ations
07 Station s
Surgery and Allied
Medicine and A Hied

01 Station

Diagnostics

Note: Each station will have 10 marks (5 marks for examination & 5 marks for
PresentationlVivai Assessment and 10 minutes each station (5 minutes for examination and 5
minutes for PresentationlVivai Assessment.

STEP-I (Basic Science Subjects Examination)

Papers Type of Questions Duration Total Marks

Paper-I 150MCQ's 3 hours 150

Each question will carry one mark.

Subjects
I. Applied Anatomy
2. Applied Physiology
3. Applied Biochemistry
4. Pathology
5. Clinical Pharmacology
6. Forensic Medicine
7. Community Medicine

Note: Total 150 MCQ's (At least 10 from each of above mentioned seven subjects).
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Paper Type of Questions Duration Total Marks

Paper-II 150 MCQ's 3 hours 150

Each question will carry one mark.

Subjects
I. Applied Anatomy
2. Applied Physiology
3. Applied Biochemistry
4. Pathology
5. Clinical Pharmacology
6. Forensic Medicine
7. Community Medicine

Note: Total 150 MCQ's (At least 10 from each of above mentioned seven subjects).

STEP-II (Clinical Science Subjects - Theory Examination)

Papers Type of Questions Duration Marks

Paper-I 150 MCQ's 3 hours 150

Each question will carry one mark.

Subjects
I. Medicine
2. Behavioural Sciences.
3. Surgery
4. Obst & Gynnae
5. Paeds
6. E.N.T
7. Ophthalmology
8. Psychiatry
9. Dermatology

Note: Total 150 MCQ's (At least 10 from each of above mentioned nine subjects).

Paper Type of Questions Duration Marks

Paper-II 150 MCQ's 3 hours 150

Each question will carry one mark.

Subjects
I. Medicine
2. Behavioural Sciences.
3. Surgery
4. Obst & Gynnae
5. Paeds
6. E.N.T
7. Ophtl13lmology
8. Psychiatry
9. Dermatology
Note: Total 150 MCQ's (At least 10 from each of above mentioned nine subjects).
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TABLE OF SPECIFICATION FOR STEP-I BASIC SCIENCE SUBJECTS

EXAMINATION

I. Applied Anatomy
Histology
Embryology
Neuroanatomy
Gross anatomy

2. Applied Physiology
Blood RBCs+ WBCs+ Immunity
Hemostasis+ Blood Group
CVS
Renal/ body fluids IEndo
NS (Sensory systemIMotor System)

3. Applied Biochemistry
Carbohydrate, Lipid and Protein Metabolism
Enzymes
Vitamins
Molecular Biology

4. Applied Pathologv

Gen pathology
Parasitology
Microbiology (General I, Clinical 2)
Virology
CVS, Resp, GIT and Iiver/GU
Chemical Path
Hematology
General Pathology and Microbiology including Virology, Mycology
Parasitology
Haematology, Chemical Pathology, Immunology, Clinical
Microbiology
Special Pathology

IMPORTANT TOPICS
General Pathology
Basic concepts and application of knowledge of the following:
Cell injury, intracellular accumulations, fatty change and pathologic calcification
Acute and chronic inflammations and chemical mediators
Transudates and exudates
Wound healing by I" intention and secondary intention
Thromboembolism an dDVT
Genetics
Neoplasia
General Microbiology
Structure of bacterial cell, bacterial reproduction, classification and important
infections caused by bacteria.
Classification and structure of viruses, and important diseases caused by virus.
Classification and structure of fungi and important diseases caused by fungi
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Plasm ids and bacterial resistance

Sterilization and disinfection

lIaematology
Etiology, pathogenesis and lab diagnosis of the following
(ron deficiency
Megaloblastic anaemia
Thalassaemia major and minor
Sickle Cell Disease
Glucose-6-Phosphate Dehydroginase Deficiency
Hereditary Spherocytosis
Acute Leukemias
Immune Thrombocytopenic Purpura
Disseminated Intravascular Coagulation
Von Willebrand Disease
Haemophilia
Important human blood groups
Safe blood transfusion

Chemirull'athology
Etiology, Pathogenesis and lab diagnosis of:
Diabetes Mellitus
Ischaemic heart disease
Thyroid disease
Menstrual irregularities
Acidosis
Renal failure
Liver disease
Bone disorders

Special pathology
Etiology, pathogenesis and lab diagnosis of the following:
Atheroselerosis, hypertension and IHD
COPD, pneumonias, pneumoconiosis
Acid peptic disease
Hepatitis
Carcinoma cervix
Carcinoma breast
Osteogenic sarcoma
Hodgkin;s disease
Non-hodgkin Lymphoma

Clinical Microbiolog)':
The etiology, pathogenesis and lab diagnosis of the microbial diseases involving the
following:
Skin, soft tissue, bones, joints, GIT, Respiratory system, CVS,CNS and genitourinary
system.
Obstetric, congenital & neonatal infections.
Infections in immunocompromised hosts
Etiology pathogenesis & Lab diagnosis of diseases prevalent in Pakistan,like
Tuberculosis, Malaria, Typhoid, Viral hepatitis, Dengue fever, Tetanus, Viral
hemorrhagic fevers, Diphtheria, Diarrheas, Dysenteries, Cutaneous leishmaniasis,
Giardiasis, Influenza
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Specimen MCQs
(One best pattern from within four or five given options)

General/Clinical Microbiology
Q.No.\ Culture and sensitivity report of pus from infected surgical wound of
abdomen reveals isolation of Escherichia coli resistant to a number of
antibiotics. The following component of bacteria plays an important role in
the development of antibiotic resistance in some bacteria.
a) Cell Wall
b) Lipopoly saccharides
c) Ribosomes
d) Plasmids
e) Teichoic acid

Pathology (Histopathology - Diseases of Organs system)

Q.No .2 A 28- year old woman goes to her physician for a routine examination. 11le
cytopathology report of pap smear indicates the presence of severely
dysplastic cells ( high grade squamous intraepitheliallesion, or HSIL.). A
biopsy of the cervix is perfonned, and on microscopic examination shows
cervical intraepithelial neoplasia IIl( CIN Ill). Infection with which of the
following organisms is most likely to cause her disease?
a) Candida albicans
b) Epstein- Barr Virus
c) Gardnerella Vaginalis
d) Human Papillomavirus
e) Trichomonas Vagiatix

Q. No 3 A 30 years old man complains of a urethral discharge. You perform a Gram stain
on a specimen of the discharge and see neutrophils but no bacteria of the
organisms listed, the one most likely to cause the discharge is
a) Treponema Pallidum
b) Chlamydia trachomatis
c) Candida albieans
d) Coxiella bumetil
e) Legionella pneumophila

Hematologv

Q.No4 A 25 years old female,prime gravid, presented for antenatal check-up Her
blood counts revealed hemoglobin 9.5 gldl.MCV 58 fl and MCH 22 pg .
Blood film examination showed a few target cells. What investigation would
you order to exclude diagnosis of Beta Thalassaemia Trait.
a) Serum Ferritin
b) Serum Iron concentration
c) Serum Transferrin levels
d) Haemoglobin A2 concentration
e) Haemoglobin F concentration.
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Chemical Pathologv
Q.No.5 A 35 year old female presented with a nodular swelling in front of lower
neck. On examination the swelling was determined to be located in lower part
of right lobe of thyroid gland. Which of the following laboratory tests will
effectively exclude hyperthyroidism?
a) Thyroid stimulating hormone
b) Serum Total T4 level
c) Thyroid hormone binding globulin
d) Serum T3 level
e) Serum Iodine levels

5. Clinical I'harmacology
Antibacterial
Antifungal. Antiviral, antiparacytic agents
CYS
GIT
CNS
Resp
Endocrines and Diabetes

6. Forensic Medicine
Medical Law
Traumatology
Poisoning

7. Community Medicine
Topics
J. a Concept of health & diseases, natural history of disease and levels of prevention,
control, elimination and eradiation of diseases.
b. Epidemiology I Biostatisticsl Research Methodology
c. General epidemiology and dynamics of infection disease transmission

2. Introduction to publ ic health and health system,

3. Preventive aspects of immunology
4. Food & Nutrition
5. Environment ( Air, Water, Climate, Noise, Housing Waste disposal) I Entomology I
Parasitology
6. MCHIReproductive HealthiSTI
7. Heaith educationlHMIS/Mental heaith
8. Injuries I Accidents IDisasterslSnake bitelDogibite Hospital waste management.
9. Demography and population control
10. Control and prevention of communicable diseases
I I. Control and Prevention of non-communicable diseasesl cancer
12. Occupational heaith I Radiation
13.Food & Nutrition
14.Control and prevention of non-communicable and communicable diseases
15.MCH/Reproductive HeaithiSTI

Specimen MCQs
(One best pattern from wilhin four or five given oplions)

Epidemiologv I Biostatislics
I. The head circumference of new born babies in a nursery were 48 cm, 48.5 Col, 49
cm, 49.\ Col, 49.2 cm, 47 cm , 47.54,48.7 cm. What is the mean head
circumference of these babies?
a) 48.1 Col
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b) 48.2 cm
c) 48.3 cm
d) 48.4 cm
e) 48.5 cm
Key:c
2. The incidence of respiratory tract infections is more in winter whereas it is less in
summers. This type of time trend or fluctuation in disease occurrence is termed as
a) Epidemic
b) Cyclical
c) Seasonal
d) Secular
e) Pandemic
Key:C

Primary Health Care

I. In order to improve the MCH services Government of Pakistan has started a
program of training of lady health workers and trained birth attendants. They are
selected by local committee and trained locally. By overcoming cultural and
communication barriers, they provide primary health care in ways that are
acceptable to the community. It shows.
a) Equality
b) Equity
c) Efficiency
d) Community participation
e) Intersectoral coordination
Key:d

Immunology
I. A mother brought her 6 weeks old child to the EPI centre for the first
time. The recommended vaccines for this child would be:
a) BCG + Polio
b) BCG + Pentavaient + Polio
c) Pentavalent + polio
d) BCG+ Measles+Polio
e) BCG + Pentavalent + Measles+Polio
Key:b

food & Nutrition

I. A 3 year old female child presented in hospital from a tribal area of
Balochistan with complaints of unsteady gait and pot belly, Clinical examination
showed widening of both the wrist joints which vitamin is likely to be deficient in
this child?
a) Vitamin A
b) Vitamin B
c) Vitamin E
d) Vitamin D
e) Vitamin k
key:d

Environment
I. A husband and wife belonging to low socioeconomic status of a village were
brought to the hospital with history of mental confusion, loss of memory and
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labored breathing eventually leading to coma. Coal fire was being used in
the house for heating purpose Which gas is to be blamed for their condition?
a) Carbon dioxide
b) Carbon Monoxide
c) Hydrogen Sulphide
d) Sulphur dioxide
e) Nitrogen dioxide
Key: b

MCH
I. .A primigravida with 16 weeks ofgestationreported to a Hospital for her first
antenatal checkup. She gave history of consuming two points of alcohol daily which
specific complication is likely to occur?
a) Spontaneous abortion
b) Pregnancy induced hypertension
c) Obstructed labor
d) Ante partum hemorrhage
e) Puerperal psychosis
Key: a
2. A nursing mother came to the MCH centre after one month of delivery with
complaints of easy fatigability and lethargy. She was worried about her child too,
who was not gaining Weight. The additional caloric intake in this state to ensure
proper weight gaining of the baby should be:
a) 500 Cal
b) 550 Cal
c) 800 Cal
d) 1000 Cal
e) 2000 Cal
Key:b

Mental Health
1: A drug abuser describes his drug of abuse as mood elevator, alerter and energizer.
which grug ihe taking?
a) Amphetamine
b) Barbiturate
c) Cannabis
d) Heroin
e) LSD
Key:a

Accident ISnake Bile

I. A 30 year old lady is binen by a snake. She complaints of giddiness, Lethargy,
Muscular weakness and spreading paralysis. The type of snake involved is:

a) Sea Snake
b) Elapid snake
c) Green pit viper
d) Bamboo snake
e) Russell's viper
Key:b

Demogn.phy & Population Control

1. A 30 year old lady delivered her 5'h girl child in the hospital. She was breast feeding
her child. Despite the established role of lactation in contraceptive, obstetrician still
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advised additional contraception owing to decreased frequency offeeding. The best

choice would be:
a) Combined pills
b) Sub-dermal implant
c) Injectable estrogen
d) Post coital pills
e) Prog estogen only pill
Key:e
Communicable Disease
I. A woman brought her child with congenital anomalies of heart and cataract. She gave
history of mild fever and rash in the first trimester of pregnancy, which senled with
mild antipyretics. The possible gestational condition that resulted in these anomalies
was:
a) Measles
b) Herpes
c) Rubella
d) Drugs Taken in pregnancy
e) Streptococcal scarlet fever
Key:C
2. A woman brings her seven year old boy in the OPD with history of intense headache,
vomiting and stiffness of neck. Within a few hours, despite treatment progresses into
coma.
The boy is probably suffering from:
a) Tetanus
b) Cerebral Malaria
c) Meningococcal Meningitis
d) Non paralytic polio
e) Sleeping sickness

Key:c
Non-Communicable Disease
I. A 10 year old boy presented with complaints of fever accompanied by profuse
sweating for the last I week. He also complained of multiple joint pains. Serum ASO
titre was increased. The likely diagnosis is:
a) Malaria
b) Hepatitis B
c) Dengue
d) Rheumatic fever
e) Rickets
Key:d
Occupational Health
I. A rubber industry worker presents with abdominal colic and serve anemia. His blood
examination reveals basophilic stippling of RBCs and microcytic anemia. What is the
likely diagnosis?
a) Lead poisoning
b) Benzene poisoning
c)Radiation effects
d) Sideroblastic anemia
e)Worm infestation

Key:a
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TABLE OF SPECIFICATION FOR STEP-II THEORY

CLINICAL SUBJECTS

I. Medicine
CVS
Resp System
CNS
Rheumatology
GIT
Liver
And Pancreas
Infection
Hematology &
Oncology
Nephrology
Endocrine System
Diabetes Mellitus
Metabolic diseases
Genetic disorders

2. Behavioral Sciences
use of biopsychosocial Model in Medical & Dental Practice Communication
skills, counseling and informational care in health settings
Psychological growth and development pf personality
Psychological reaction in hospitalization, illness, common health setting such
as emergency, intensive are and cancer units.
Influence of stress and psychosocial factors on common medical,
reproductive health and surgical conditions and chronic pain, sleep
disturbances and their non-pharmacological managements
Common psychiatric and psychosocial morbidities such as depressive and
anxiety reactions, dissociation and sick-role and their management at primary
care level Ethics and ethical dilemmas in the life of a doctor

General surgery
Topics
Wound healing
Nutrition
Fluid and electrolyte balance
Haemostasis and transfusion therapy
Post-operative care of surgical patients
Skin and soft tissues tumors
• Melanoma
• squamous cell carcinoma
• basal cell carcinoma
Tetanus
Anesthesia & Critical care

Neck
Topics
Goitre
• Specific thyroid disorders
• Hypothroidiism {Thyrotoxicosis
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• Thyroid Neoplasms
• Complications of thyroid surgery
Parotid gland tumors
Lymphadenopathy
• Tuberculous lymphadenitis
• Lymphoma
Parathyroids
• Hperparathroidism
• Prathyroid careinoma
• Parathyroid surgery
Chest including Breast
Topics
Benign breast disease
Breast infections
Nipple discharge
Gynaecomastia
Carcinoma of Breast
Pleural infusion! Pneumpthorax
Bronchongenic carcinoma

Upper Gastrointestinal Tract

Topics
Carcinoma of Oesophagus
Peptic ulcer disease
Hiatus Hernia & GERO
Carcinoma Stomach

Hepatopanereatobiliary Svstem
Topics
Gallstones
• Acute/chronic cholelithalsis
• Cholidocholithiais
• Carclinoma of gall baldder
Acute & Chronic Pancreatitis
Carcinma of Pancreas
Hydatid cyst of liver

Clonic, Rectal and Anal disorders

Topics
Appendicitis
Large bowel obstruction
Bleeding per rectum
• Haenorrholds
• Anal fissure
• Rectal polyes
• Rectal carcinoma
Pilanidal sinus
Inflammatory bowel disease
Meckel's diverticulum

Venous, Arterial & Lvmphatic Systems

Topics
Varicose veins
Lymphoedema
Chronic limb ischaemia
Aortic aneurysm
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Trauma & Recuscitation

Topics
Primary & Secondary survey of trauma victims
General Managements of Fractures
Head injury

Acute Abdomen
Topic
Acute intestinal obstruction

Spleen
Topics
Haemaotological disorders
Splenectomy

Hernia
Topics
Inguinal hernia
Femoral hernia
Abdominal wall hernia

Urological Disorders
Topics
Urinary stones
Benign prostatic hyperplasia
Testicular disorders
• Testicular torsion
• Testicular tumours
• Undescended testis
Carcinoma of urinary bladder

4.0bsl &Gynae
Antenatal Care
Prenatal diagnosis
Abnormal Presentation
Medical disorder in Pregnancy
Normal labour, preterm labour
Ante partum haomorrage
Post panum haomorrage
Ultera sound in obstetrics and Gynae
Menstraual disorder / DUB (Dysfunictional Uterine Bleeding)
Infection of the genital tract
Ectopic Pregnancy
Miscarriages
Displacement of Uterus
Tumors of the genital tract

S.Paeds
Neonatal problems Diarrhoes ,ARL ,Malnutrition Tropical Paediatrics
Growth and Develoment in infancy and childhood
Paediatric GastroenterologyfHepatology
Genetics Metabolic Problems
Paediatric Nephrology
Paediatric Haematolagy fOncology
Paediatric Cardiology
Paediatic Endocrinology/ Immune deficiency disorders
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Paediatric Pulmonology
Paediatric CNS /Neuromuscular disorders
Paediatric Emergencies/Paediatric Surgery
6.E.N.T
Ear (Deafness Vertigo Ac Som Ch Som,
Complication of Otitis media Secretosy OM
Nose ( Rhinibs Trauma Nose
Throat ( Dysphagia, Infection of Phospix Larynx,
Hoarseness Obsturcted airway Foreign boies/Air
Food Passage
Head and Neck tumours ( acoustic Neuroma, Nasphomgcal
Fibroma CA Laynx
7. Ophthalmology
Cataract (Classification Senile cataract Congeita\ cataract,
Surgeries and Complications of Cataract surgery
Glaucoma ( Classification, Prinery Open Angle Glaueoma
Acute Angle Closure Glaucoma. Management and
Glaucoma Drugs)
Retina (Diabetic Retinopathy Rential Detachment
Age related macular Degeneration
Ocular Trauma (Classification Emergency Management)
Squint (Classification Management
Refractive Errors (Myopia Hypermeropia ,Presbiopia)
Red Eye (Corneal Ulcer Uveities)
Tumors (Retinoblastoma)

8.Psyehiatry

From Detection and Primary care management of common psychiatric disorders

Early detection and management of Depression and anxiety related disorders at primary care
level and liaison settings
Management of delirium and epilepsy
Detection, acute management and appropriate referral of patients with psychosis and high
violence and suicide risk.

9. Dermatology
Infections and infestations (bactorial viral),
Fungal, sexually transmitted disease,
Pedicu\sis, leihmaniasis
Ezema, puplosquamous, pityriasis rosea
Acne, collage, vascular disorder (SLE,
Dermatomyoitis, systemic sclerosis .
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