Material

One obvious loophole of my discussion yesterday is: Why don't we make good use of the years in medical school to ensure the graduates to be capable of ordering sound investigations and prescribing effective treatment ?

Well, there are many practical and political difficulties (excuses). Nonetheless, on major question is: How could we ensure a student learn a particular thing ?

By putting it in the examination, of course. (Alas, that's what our educationalists call Outcome-Oriented Teaching.)

There comes the problem: How could we examine those practical aspects ?

No, don't be silly. It's not as easy as you imagine to test how a student order investigation and prescribe treatment in a real-life manner. "Which one of the following five treatment options would you choose ?" Have you ever seen a patient giving you options ?

With some grey hairs and wrinkles, we know very well whether a treatment order is reasonable or potentially lethal - but it is almost impossible to fit it in a (well-defined 10-point) marking scheme.

But we need to be fair ! We should therefore confine ourselves to reproducible scenarios and rigid marking schemes ...

... Things that could be counted, not those that count.