Achieving equal standards in medical student education: is a national exit examination the answer?

Abstract

Although it is commonly assumed that the quality of medical school education in Australia is uniformly high, there is no national process for assessing its outcomes. There is substantial variability in the content of medical school curricula, and the process of curriculum change is becoming more challenging because of intense competition for time and space in the course. A national exit examination could provide a uniform standard of assessment for all medical school graduates in Australia, as well as foreign graduates applying to work in Australia. Such an examination could assess medical school outcomes, monitor the effects of curriculum change, and provide a benchmark for new medical schools that would help medical curricula evolve to better meet society's needs.

Designing and implementing a skills program using a clinically integrated, multi-professional approach: using evaluation to drive curriculum change

“…The idea of a national exit examination has been raised,26 an element that would drive such a development.…”

Managing tensions in assessment: moving beyond either–or thinking

“…For example, using findings from assessment research as well as careful analysis of the US medical education context, Hanson and colleagues wrote a powerful plea for replacing numbers (grades) with words (narratives) to enable the achievement of education and assessment goals . Similarly, assessment experts argue that different information management strategies are to be used depending on assessment purposes and rationale, that we should refrain from grading if we use assessment for formative purposes, that we should focus on standardised assessments and criteria‐based grading in the assessment of learning in order to ensure that our graduates are equivalent and fit for practice, and that we should favour qualitative over quantitative assessment approaches if we want to capture professional competence . Proposed solutions then typically include measures to ‘overcome’ barriers to the successful implementation of the assessment ideal or to provide arguments to illustrate the fallibility of others’ views and thinking.…”

What do undergraduate doctors really need to know about radiation oncology?

“…Universities are under no pressure to improve medical education because the demand for places far outstrips the number of places which is capped by the Australian Government. There are no national standards for the content that is taught in any medical course in Australia . The Australian Medical Council accredits process not content and there is no common exit assessment to assure consumers that their doctor has been trained to a minimum standard or to guide students in the performance of universities.…”

“…Undergraduate medical education needs to be subjected to realistic competition to drive it to a common standard that includes adequate teaching about cancer and radiation oncology. A common exit assessment would provide a benchmark of the quality of medical teaching in Australia and assure patients of the standard of training that their doctors have received . More radically one could envisage a market‐driven payment system where universities all received the same amount for each student regardless of the number of years they took to train a student to pass a common exit assessment.…”