Licensing examinations in Southeast Asia: Lesson learnt from exploring changes in education policy

Abstract

Southeast Asian region has been experiencing significant challenges to their health care systems, driving some countries establishing policies to ensure the quality of the medical workforce through the introduction of national licensing examinations. This paper examines the experiences of Southeast Asian countries in implementing licensing examinations, highlighting the changes and development of the education policy and its impact on medical education. The lesson learnt from the high-stakes assessment policy offers a new perspective on how medical licensing examinations could represent a potential regional approach for a better health care.

A commentary on the National Medical Licensing Examination in Vietnam: why, what, who and how

“…Members of this agreement were required to establish regulations for the migration of healthcare professionals. As a result, five out of 10 ASEAN countries have organized NMLEs, including Thailand, Philippines, Indonesia, Malaysia, and Laos ( Kittrakulrat et al , 2014 ; Nur Hidayah et al ., 2020 ; Sonoda et al ., 2017 ). Experiences and practices gained from neighboring countries differed greatly.…”

“…Several concerns about the NMLE system were identified including the targeted populations (foreign doctors versus domestic graduates); language variation (local language versus partial English); which poses challenges to the free flow of medical professionals to practice medicine in any of the region's countries ( Kittrakulrat et al ., 2014 ). It is, however, believed to be the first step towards achieving comparable standards of patient care and medical education in ASEAN, in accordance with the World Health Organization (WHO) strategy for universal health coverage ( Nur Hidayah et al ., 2020 ). The employability for highly skilled physicians across the region will be significantly improved if the MRA goal is achieved.…”

“…A number of institutions are embracing a reformative shift towards competency-based medical education, while others still face substantial deficiencies, lacking the necessary literature, evidence, or motivation to adopt such a change ( Tran et al ., 2022 ). Although there are numerous challenges associated with the NMLE, such as resource consumption, insufficient validity, and reliability, and a lack of direct connection between the NMLE and patient care, the benefits still outweigh the risks ( Nur Hidayah et al ., 2020 ) ( Wang, 2022 ). According to recent experiences from neighboring countries, NMLEs have had positive impacts, such as motivating policy changes, revisiting curriculums and assessment practices, enhancing learning resources and facilities, and strengthening collaboration between educational networks in order to improve physician competence ( Nur Hidayah et al ., 2020 ).…”

The Impact of Indonesian Medical Doctors National Competency Examination (Imdnce) Towards Learning and Clinical Practices: A Qualitative Study on the Internship Doctors’ Perspectives

“…This licensing examination is a high-stakes assessment that has a broad impact on students and institutions, as well as a broader impact, including in terms of educational policy, and might potentially affect the quality of health services and patient safety. [1][2][3] Hidayah 1 saw that NLE in Indonesia impacts changes and improvements in curriculum, assessment, facilities, and faculty development in medical education. The NLE also positively affects the development of self-determination (i.e., being ready to take on professional tasks), confidence, a sense of readiness, pride, and equality in students who have successfully passed the exam.…”