The process runs as an online exercise in defined rounds. Candidates who have qualified in the national medical entrance test register on the board portal, pay the prescribed fee, fill and lock their preferences of colleges and courses, and are then allotted seats strictly in order of state merit and category. Allotment is followed by document verification and reporting to the allotted college within the notified time, after which upgrade rounds, mop up rounds and a stray vacancy round are held for seats that remain unfilled. The courses covered include the bachelor of medicine and bachelor of surgery, the bachelor of dental surgery and, where notified, courses in ayurveda, homoeopathy and other systems handled by the same board. Reservation, domicile and special category rules notified by the Bihar government are applied during allotment.

Only candidates who have qualified in the national eligibility cum entrance test for undergraduate courses in the relevant year may take part, and they must additionally satisfy the residence or domicile conditions laid down by the Bihar government for state quota seats. Candidates must have passed the class 12 or equivalent examination with physics, chemistry, biology or biotechnology and English, in line with the requirements of the national medical regulator. The qualifying percentile in the national test, the minimum marks in the qualifying examination, the minimum age on the prescribed date and the certificates needed for reserved and special categories are stated in the counselling brochure issued each year.