One major reason for the down-grading of the college examination - and to a large extent examinations in (our) medical school - is the obsessive passion for fairness.
"Why do I have a long case who speaks this funny dialect while my friend had one who volunteers to regurgitate the whole history in five minutes ?" Well, let's have a few standard scenarios for history taking.
"Why do I see three short cases in 20 minutes but the other candidate sees seven ?" OK, let's fix the number of case and the time for each.
"Why does the examiner give me such a vague instruction - I don't even know which system to examine." Oh, our apology. We shall specify the system and standardize the instruction.
But, nothing would happen exactly the same twice. The same patient could behave differently. Even the mood of the examiners may change. And, after all, most patients in real life could not tell you which system do they have the problem.
At the end of the day, we change a smart test that picks up bright candidates to a dense examination for dumb doctors.
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