The use of three-option MCQs in a health professions examination resulted in a time saving equivalent to the completion of 16% more MCQs per 1-hour testing period, which may increase content validity and test score reliability, and minimise construct under-representation. The higher cut scores may result in higher failure rates if an absolute standard setting method, such as the TLA method, is used. The results from this study provide a cautious indication to health professions educators that using three-option MCQs does not threaten validity and may strengthen it by allowing additional MCQs to be tested in a fixed amount of testing time with no deleterious effect on the reliability of the test scores.

The implementation of a new curriculum with more small group educational activities including academic communities enhanced connectedness between students and faculty and resulted in an increased sense of community.

While most medical students generally perform well on examinations and pass their courses during the first year, we do not know how much basic science content they retain at the start of their second year and how that relates to minimal competency set by the faculty. In the fall of 2014, before starting their second-year courses, 27 medical students volunteered to participate in a study of long-term retention of the basic sciences by taking a "retention exam" after a delay of 5-11 months. The overall mean performance when the students initially answered the 60 multiple choice questions (MCQs) was 82.8% [standard deviation (SD) = 7.4%], which fell to 50.1% (SD = 12.1%) on the retention exam. This gave a mean retention of 60.4% (SD = 12.8%) with the retention for individual students ranging from 37 to 81%. The majority of students (23/27; 85%) fell below the minimal level of competency to start their second year. Medical educators should be more aware of the significant amount of forgetting that occurs during training and make better use of instructional strategies that promote long-term learning such as retrieval practice, interleaving, and spacing.