The new licencing examination for human medicine: from concept to implementation

Abstract

A new Swiss federal licencing examination for human medicine (FLE) was developed and released in 2011. This paper describes the process from concept design to the first results obtained on implementation of the new examination. The development process was based on the Federal Act on University Medical Professions and involved all national stakeholders in this venture. During this process questions relating to the assessment aims, the assessment formats, the assessment dimensions, the examination content and necessary trade-offs were clarified. The aims were to create a feasible, fair, valid and psychometrically sound examination in accordance with international standards, thereby indicating the expected knowledge and skills level at the end of undergraduate medical education. Finally, a centrally managed and locally administered examination comprising a written multiple-choice element and a practical “clinical skills” test in the objective structured clinical examination (OSCE) format was developed. The first two administrations of the new FLE show that the examination concept could be implemented as intended. The anticipated psychometric indices were achieved and the results support the validity of the examination. Possible changes to the format or content in the future are discussed.

Examiner effect on the objective structured clinical exam – a study at five medical schools

“…Countries like the United States of America, Canada, and Switzerland have already introduced standardized OSCE into their exams in order to evaluate clinical and practical competencies [3, 4], whereas in Germany, the organization, content, and grading of an OSCE is completely regulated by each medical faculty. Thus, there are difficulties when trying to compare outcomes or standards of medical students from different faculties.…”

Medisinsk grunnutdanning – hvordan har universitetene forholdt seg til signaler om nye kompetansekrav?

“…(Chenot, 2009). I Sveits gjennomførte man første gang i 2011 en nasjonal eksamen for medisinstudiet (Guttormsen et al, 2013). Et fellestrekk ved initiativene er at de drives frem av utdanningsinstitusjonene og ikke av statlige myndigheter.…”

Mot en nasjonal delprøve i medisinstudiet

“…Det tar dessuten lang tid å besvare slike oppgaver, noe som gjør at kun en relativt liten del av pensum testes (6). Med unntak av Canada benytter ingen av de mest kjente etablerte nasjonale eksamenene slike oppgaver (5,7,8).…”