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Whether we like it or not (and I suspect most of us don’t!) knowledge testing trainees as part of their assessment of competence is here to stay.
There is an understandable need to demonstrate that any doctor completing their training has sufficient knowledge of their speciality to be able to practice safely and competently.
There is also a likelihood that knowledge testing may be extended to consultants/specialists in future, as part of the revalidation process.
In 2006 Geriatric Medicine was one of five medical specialties (the others were cardiology, dermatology, neurology and gastroenterology) which piloted a knowledge test for specialist registrars (and some consultant volunteers). These pilots have recently been fully evaluated and deemed to be very successful. As a result the Federation of the Royal Colleges of Physicians of the United Kingdom are recommending that knowledge tests are adopted and implemented by all 13 medical specialties from 2008.
The Geriatric Medicine Pilot Examination 2006
A project board capably chaired by Prof Steve Allen consisting of members of the SAC and British Geriatrics Society was established, and a small group of question setters from the specialty recruited and trained.
The same examination was held twice on 11th (Northern Ireland and Scotland) and 18th (England and Wales) May 2006.
The paper consisted of 100 best-of-five questions, was closed book (candidates had no access to books or other reading material) and had to be completed in a time of 3 hours.
Four-hundred-and-forty-eight candidates sat the examination (411 SpRs and 37 consultants). The turnout was excellent 77% of SpRs registered with the JCHMT sat it and all 5 years of SpR training were well represented.
There was a progressive rise (albeit modest!) in the mean score over the 5 years of training and to consultant level, one consultant achieved an amazing score of over 80% (if he/she makes himself/ herself known to me I shall personally buy them a bottle of good wine!)
The feedback received from candidates was excellent and will help shape future exams. In particular, questions must be applicable to all countries in the UK not just England and Wales as the law differs between countries and has a major bearing on some aspects of the specialty.
The Future And How You Can Help?
STOP PRESS Dear Colleague, |
The Federation of the Royal College of Physicians are introducing knowledge testing for trainees (specialist examinations) in all 13 medical specialties from 2008. There will be twice yearly diets (exams), using best-of-five questions with clinical scenarios. It is anticipated examinations will consist of 200 questions divided into two papers consisting of 100 questions each.
The five pilot specialties (geriatric medicine, neurology, cardiology, gastroenterology, dermatology) will hold the first exams in Spring 2008 and all 13 specialties in Autumn 2008.
UK trainees must have passed their MRCP (UK) before they can sit their specialist examination and must pass this before their Penultimate Year Assessment (PYA)
Our specialty needs to recruit at least 25 question writers with each writing 30 questions a year to meet our targets. You will need to attend a one day training session (next dates are March 28th and 18th April) travel expenses will be paid by the College.
Previous experience in question writing e.g. for MRCP, DGM or MBBS/MBChB is valuable but not essential. Above all I am looking for individuals who are keen, well motivated and will deliver!
I have been approached by some senior SpRs who are very keen to be involved, however regrettably the RCP requires that all question setters are post-CCT
Why Should You Volunteer?
Quite simply it is excellent CPD, you will be able to claim up to 12 external CPD credits per year, have the fun and stimulation of discussing (and at times defending!) your questions with your peers, and it is enormously satisfying knowing that a question you have devised has been included in an exam and “performed well” (the performance of questions used in exams is analysed by the RCP).
Your specialty needs you!
If you are interested in being a question setter please email me through the editor.
Oliver J Corrado
Chair Specialist Examining Board in
Geriatric Medicine