National Exit Test for MBBS Graduates: Substance or Rhetoric?

A couple of days back my mind happened to prevent at a topic that’s been brewing briskly for quite some time now. I decided to provide some thought and it seemed really worth a post.

Somewhere around 2010 the particular union ministry of health and the particular MCI had unifiedly churned out a proposal regarding a common, universal ‘national exit exam’ for Indian MBBS graduates before they were let free to run their hands and minds in medical practice. The suggestion allegedly met some opposition till recently, when it garnered limelight and some enthusiastically backing voices. The nationwide exit exam aims to ensure adequate competence amongst graduates, and also a level of uniformity in competence owing to the varying standard of medical training across institutions, before handing them a permanent registration to practice medicine freely. The academic council of the MCI propounds five pertinent changes within it’s report:

Every graduate has to clear an ‘exit test’ prior to being able to practice independently across India.
Duration of MBBS to be decreased from 4. 5 to 3 or more. 5 years.
Right in the beginning of their academic journey, the student will be offered a choice to choose an area of specialization and learn only related subjects.
The academic council of the MCI will be entrusted with the power to make any academic course in medicine.
The MCI will have it’s personal mechanism for accreditation of healthcare coleges.
We’ll zoom into the initial proposal for the rest of this discussion.

To become fairly simple, the idea of an examination is based on the premise that you test something when you want it to meet a certain standard. And when you want something to meet a certain regular, you need to be sure enough of a delivery system that delivers such a standard. Certainly, before thinking of an exit exam that tests the adequacy associated with competence, we need to be confident enough that our system of medical instruction just isn’t flawed at creating adequately capable MBBS doctors. I reiterate once again, and it has been reverberating across community forums for long, that graduate MBBS training today doesn’t impart adequate practical approach and competence to get practice, and requires additional time associated with training under supervision. The MBBS curriculum is in a great need associated with modernisation. To summarize things, the theory element of study has received more preponderance than it rightly should. Search through medical colleges and you find an undue amount of time devoted to develop strategies to clear the theory exams.

Our exams are predictable and archetypal : they often call for more of tactics and less of understanding. The standards of our practical instruction vary mainly across institutions and often, there is little stringency, little quality control plus little enforcement of order in practical training. Practical training and evaluation is often left at the vagaries of the student, the staff as well as the examiners. Furthermore, the year of compulsory rotating internship, which is the time of developing a world vision in medicine, is variably consumed by trivial routine work, mindless activities and frequently a tumultuous environment of small order that assures little studying. With all that as the backdrop, the idea that simply another exam will guarantee us of uniformly and sufficiently competent MBBS graduates seems hardly credible to be worthwhile. Why isn’t going to the MCI address these imperfections that create a competence inadequacy before chalking out a test that examines competence?
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Isn’t that paradoxical?

We are able to stretch a similar talk over the additional objective of this exit test. The particular academic council of the MCI promises that the exit test would function to uniformize the quality of competence among doctors, but it tells little about the ways to dissolve this standard discrepancy in the first place, and to assure that every organization, irrespective of any administrative or social division, delivers a defined, exalted regular of medical instruction. How can such a standardising test be fruitful enough before levelling the field between advantage based govt. colleges and the personal colleges that auction seats regarding crores?

In a sense, we can say that the national exit test taking place such an askew setting will do almost everything to highlight the problems we face but nothing to solve them. And then, there are concerns over the nature of the examination. Is it going to be another unoriginal MCQ test? Or a familiar detailed test like the university theory exams? Can preparing for and passing this type of test be equated with the proficiency gained through months of dedicated, methodical medical training. Without doubt, it will take little time for such a test to become ‘just another exam’ of dubious value. It will menacingly shroud the deep gorge of incompetence caused by a sloppy training. And if we all somehow put up a near perfect exit test that actually backs it can claims, a good chunk of our MBBS graduates might flunk owing to the loopholes in our system of instruction, and that’s certain to raise mayhem across the healthcare community.

The only way to bring meaning towards the picture of the national exit test is to first address the basic issues in our medical training. Once we bring it out of disrepair, such a single, nationwide exam would prove an essential tool to ensure a defined standard of competence among doctors with varying person skill levels- something we desperately need. A single test scrutinising both Indian and foreign graduates is going to be enchanting and satisfying to international trained indian doctors too. Comparable tests are in effect in the US, North america, Australia etc and are performing prolifically to their satisfaction.

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