Practical

I may have diverged myself in the discussion of improving the system of education and examination.

Of course it seems logical to examine our students on practical things. That's how we could drive their interest back to patients and learning genuine clinical medicine. Examination drives learning is our motto.

Soon after the third year exam, however, I woke up one night and some light passed through my mind. (Alas, there was a thunderstorm outside.)

Do we really want to seriously examine our students on practical things ?

Don't laugh. As I talked to TL today during lunch, there is no difficulty what-so-ever to put up practical short case for the final examination. For example:

• This patient is diabetic and comes for routine follow up. Please ask relevant history and examine accordingly.
• This patient was admitted three days ago for heart failure. Please determine if he is still in heart failure.

You think they are easy ? The Royal College is moving along this line in one of the MRCP examination station, and I become abysmal when looking at the result of the test run.

Experienced examiners know just too well: candidates do not fail in difficult and complicated cases; they fail in simple cases with common medical problems - because there is no excuse for not doing well.