What Is the Pattern of Viva and Practicals in MBBS in Bangladesh?

Medical education in Bangladesh has earned an impressive reputation over the past few decades. Every year, thousands of students from Bangladesh and other countries—especially India, Nepal, Bhutan, Sri Lanka, and various African nations—choose to pursue their MBBS degree in Bangladeshi medical colleges. The education system is structured, affordable, and globally recognized by organizations such as the World Health Organization and the National Medical Commission of India.

A crucial part of this medical training is assessment. Unlike many academic fields that rely heavily on written examinations, MBBS in Bangladesh emphasizes a balanced evaluation system combining theory, viva voce (oral examinations), and practical exams. These assessment components are designed to test not just memorization but also comprehension, clinical reasoning, and hands-on skills.

Understanding the pattern of viva and practicals in the MBBS program of Bangladesh is essential for students who wish to prepare effectively. This article provides a comprehensive overview of how these assessments are structured, what students can expect, and how they can excel in them.

Structure of MBBS in Bangladesh

Before exploring the details of viva and practical examinations, it is important to understand how the MBBS course itself is organized.

In Bangladesh, the MBBS program is usually five years of academic study followed by a one-year internship in an affiliated hospital. The course is divided into four professional phases, each concluding with a professional examination conducted under the authority of the Bangladesh Medical and Dental Council (BMDC) and respective universities.

The Four Professional Phases

  1. First Professional Phase:

    • Duration: 1.5 years

    • Major subjects: Anatomy, Physiology, Biochemistry

  2. Second Professional Phase:

    • Duration: 1 year

    • Major subjects: Community Medicine, Forensic Medicine

  3. Third Professional Phase:

    • Duration: 1 year

    • Major subjects: Pathology, Microbiology, Pharmacology

  4. Final Professional Phase:

    • Duration: 1.5 years

    • Major subjects: Medicine, Surgery, Obstetrics and Gynecology

Each phase includes theory classes, laboratory work, ward duties, and tutorials. At the end of each phase, students must pass professional exams that consist of three components:

  1. Written (theory)

  2. Viva (oral)

  3. Practical or clinical examination

Understanding Viva and Practical Exams in MBBS

In medical education, both viva voce and practical examinations are crucial because they test a student’s application of knowledge rather than mere recall of textbook material.

  • Viva (Oral Examination):
    It evaluates a student’s understanding, reasoning ability, and clarity of medical concepts. Professors ask questions directly, often linked to clinical cases or specimens.

  • Practical Examination:
    This component assesses hands-on skills. Students are asked to perform laboratory tests, demonstrate clinical procedures, identify specimens, interpret findings, or examine patients under supervision.

Together, these assessments simulate real-life medical situations and ensure that future doctors can apply theory to practice.

Pattern of Viva and Practicals in Each Phase of MBBS in Bangladesh

The nature of viva and practical examinations evolves throughout the MBBS course. Let us explore how these assessments are conducted in each professional phase.

First Professional Phase

Subjects:

  • Anatomy

  • Physiology

  • Biochemistry

1. Anatomy Viva and Practical Pattern

Anatomy is the study of the structure of the human body, and its practical assessment focuses on visual and descriptive identification.

Practical Components:

  • Identification of bones, muscles, and organs from cadaveric specimens.

  • Drawing labeled diagrams of anatomical structures.

  • Surface marking exercises on human models.

  • Spotting tests: identifying structures on bones, specimens, or histological slides.

Viva Pattern:
Students face oral questioning on:

  • Human skeleton and muscle attachments

  • Internal organs and blood supply

  • Embryology and histology

  • Radiographic anatomy

The examiner may point to a specimen and ask questions like “What is this muscle’s origin and insertion?” or “Which artery supplies this region?”

2. Physiology Viva and Practical Pattern

Physiology deals with body functions, so practical exams involve functional experiments.

Practical Components:

  • Recording blood pressure and pulse.

  • Determining respiratory rate and vital capacity.

  • Examining reflexes and basic neurological functions.

  • Performing simple experiments on hematology (counting RBCs, WBCs, estimating hemoglobin).

Viva Pattern:
During viva, examiners test understanding of physiological processes such as:

  • Mechanisms of respiration and circulation

  • Functions of the nervous and endocrine systems

  • Clinical significance of experimental findings

Students are expected to explain the rationale behind each test rather than merely demonstrating procedures.

3. Biochemistry Viva and Practical Pattern

Biochemistry focuses on chemical processes in the human body.

Practical Components:

  • Qualitative tests for carbohydrates, proteins, and lipids

  • Interpretation of laboratory results (blood sugar, urea, creatinine)

  • Preparation of reagents and understanding biochemical pathways

Viva Pattern:
Questions revolve around:

  • Principles of biochemical tests

  • Interpretation of abnormal lab values

  • Enzyme functions and metabolic pathways

Examiners assess conceptual clarity and correlation with clinical conditions such as diabetes or jaundice.

Second Professional Phase

Subjects:

  • Community Medicine

  • Forensic Medicine

1. Community Medicine Viva and Practical Pattern

This subject focuses on public health, epidemiology, and preventive medicine.

Practical Components:

  • Conducting surveys and collecting public health data

  • Calculating health indices like infant mortality rate and birth rate

  • Preparing charts and interpreting statistical data

  • Demonstrating immunization techniques

Viva Pattern:
Students are questioned about:

  • Disease prevention and control programs

  • Epidemiological methods

  • Principles of health education

  • National health policies

Examiners often ask scenario-based questions, such as how to handle an outbreak or counsel patients about hygiene and vaccination.

2. Forensic Medicine Viva and Practical Pattern

Forensic medicine involves the application of medical knowledge to legal cases.

Practical Components:

  • Identification of medico-legal specimens (weapons, bones, poisons)

  • Demonstration of autopsy findings on models or images

  • Analysis of injury patterns and estimation of time since death

Viva Pattern:
Examiners ask questions related to:

  • Legal responsibilities of doctors

  • Interpretation of postmortem findings

  • Medico-legal documentation

Students must display both medical understanding and legal awareness.

Third Professional Phase

Subjects:

  • Pathology

  • Microbiology

  • Pharmacology

1. Pathology Viva and Practical Pattern

Pathology deals with disease mechanisms and structural changes in tissues.

Practical Components:

  • Identifying histopathological slides of diseased organs

  • Examining gross specimens of organs

  • Performing simple laboratory tests such as ESR or blood grouping

Viva Pattern:
Questions focus on:

  • Pathogenesis of diseases

  • Interpretation of microscopic findings

  • Correlation of clinical symptoms with pathology

Students are often shown a slide and asked to diagnose the condition based on visible features.

2. Microbiology Viva and Practical Pattern

Microbiology explores microorganisms and their role in disease.

Practical Components:

  • Gram staining and identification of bacteria under a microscope

  • Preparation of culture media

  • Performing antimicrobial sensitivity tests

  • Identifying pathogens from given specimens

Viva Pattern:
Students answer questions about:

  • Mechanisms of infection

  • Laboratory diagnosis of diseases

  • Immunology and sterilization techniques

Practical sessions often require interpretation of culture results and stain characteristics.

3. Pharmacology Viva and Practical Pattern

Pharmacology is about drugs and their actions.

Practical Components:

  • Identifying drugs and writing prescriptions

  • Calculating dosages

  • Demonstrating routes of drug administration on models

  • Explaining adverse effects and drug interactions

Viva Pattern:
Examiners assess:

  • Mechanism of action of drugs

  • Therapeutic uses and side effects

  • Rational use of medicines

Students may be given a clinical case and asked to choose an appropriate drug regimen.

Final Professional Phase

Subjects:

  • Medicine

  • Surgery

  • Obstetrics and Gynecology

This is the most crucial phase of MBBS. The practical and viva examinations here are comprehensive and patient-based, integrating all prior learning.

1. Medicine Viva and Clinical Practical Pattern

Medicine encompasses diagnosis and management of internal diseases.

Practical Components:

  • Case presentation: taking patient history, performing examination, and formulating diagnosis.

  • Interpretation of ECG, X-rays, and lab results.

  • Demonstrating clinical skills like measuring blood pressure or performing neurological exams.

Viva Pattern:
Examiners ask questions related to:

  • Differential diagnosis

  • Disease management protocols

  • Pharmacological treatment plans

  • Interpretation of patient findings

Students must demonstrate logical reasoning, clinical judgment, and empathy toward patients.

2. Surgery Viva and Clinical Practical Pattern

Surgery involves operative and non-operative treatment of diseases.

Practical Components:

  • Case presentations: describing surgical cases such as hernia or appendicitis

  • Demonstration of surgical instruments and suturing techniques

  • Identifying X-rays or specimens related to surgical conditions

Viva Pattern:
Questions include:

  • Principles of asepsis and preoperative care

  • Anatomy of surgical sites

  • Postoperative management and complications

Students may also be asked to describe steps of common operations theoretically.

3. Obstetrics and Gynecology Viva and Practical Pattern

This subject focuses on maternal and reproductive health.

Practical Components:

  • Taking obstetric history and performing antenatal examination

  • Identifying obstetric instruments

  • Demonstrating procedures on mannequins, such as delivery techniques

  • Interpreting investigation reports like ultrasound or lab tests

Viva Pattern:
Examiners question:

  • Physiology of pregnancy and labor

  • Complications and their management

  • Family planning methods

Students are also assessed on their ability to communicate sensitively with patients.

Internal and External Examinations

In Bangladesh, professional examinations are conducted jointly by internal (college) and external (university-appointed) examiners.

  • Internal examiners monitor continuous assessment through class tests and practical sessions.

  • External examiners participate in final professional exams to ensure fairness and standardization.

Viva and practical marks are jointly awarded after both sets of examiners evaluate the student’s performance. The balance between written and practical components ensures a holistic evaluation.

Evaluation Method and Mark Distribution

Although the exact mark distribution varies slightly among universities, the general pattern is as follows:

Component Approximate Weightage
Written (Theory) 50%
Viva 25%
Practical/Clinical 25%

Students must pass both theory and practical sections separately to qualify for the next professional phase. This rule underscores the importance of viva and practical exams in shaping competent doctors.

How Viva and Practicals Are Conducted

During examinations, each subject’s practical and viva components are usually held on the same day or consecutive days.

Typical Procedure:

  1. Roll Call and Orientation:
    Students are briefed about exam rules and assigned to stations.

  2. Practical Stations:
    Students rotate through stations performing experiments, identifying specimens, or conducting patient examinations.

  3. Viva Table:
    After practical work, students face a panel of examiners for oral questioning.

  4. Evaluation:
    Marks are given immediately based on accuracy, confidence, and logical explanation.

The environment, though formal, is designed to assess understanding rather than intimidate.

Importance of Viva and Practical Examinations

1. Application of Knowledge

Medical knowledge is meaningful only when it can be applied to real patients. Viva and practicals ensure that students move beyond rote learning.

2. Development of Clinical Skills

From basic lab tests to complex case presentations, students acquire hands-on experience that forms the foundation of medical practice.

3. Enhancement of Communication

Viva exams encourage clarity in expression and strengthen doctor-patient and doctor-colleague communication skills.

4. Critical Thinking and Problem Solving

Students learn to analyze cases, interpret data, and make decisions — essential skills for any practicing doctor.

Tips for Students to Excel in Viva and Practicals

  1. Understand, Don’t Memorize:
    Examiners look for conceptual understanding rather than word-for-word textbook answers.

  2. Practice Regularly:
    Repetition builds confidence. Regular lab work and patient interactions prepare students for smooth performance.

  3. Be Attentive During Ward Rounds:
    Clinical exposure during ward duties offers invaluable real-life learning.

  4. Keep Notes Handy:
    Maintaining concise notes of practical procedures helps during revision.

  5. Stay Calm During Viva:
    Confidence and politeness impress examiners as much as correct answers.

  6. Work on Presentation:
    Neat diagrams, organized reports, and clear speech reflect professionalism.

How the System Benefits Future Doctors

The balanced structure of viva and practical assessments in Bangladesh ensures that graduates are not only academically sound but also clinically proficient.

By the time they complete the MBBS course and internship, students have undergone extensive exposure to patient care, laboratory work, and problem-solving under real conditions. This holistic training equips them to practice medicine responsibly both within Bangladesh and abroad.

Key Highlights at a Glance

  • Viva and practical examinations are part of every professional phase of MBBS in Bangladesh.

  • The pattern evolves from basic laboratory skills in early years to patient-based assessments in final years.

  • Examinations include oral questioning, specimen identification, laboratory tests, and clinical case presentations.

  • Evaluation involves both internal and external examiners for transparency.

  • Equal emphasis is given to theory, viva, and practical components, ensuring all-round development.

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