Make medical education more transparent

Why is it that important information-important enough to appear on an examination-is often withheld from medical students? As a student having just completed the two year didactic component of medical education, I have accrued countless examples of this absurdity.

At the end of the year, our practical skills in medicine are assessed by an objective structured clinical examination, an observed examination of clinical skills. We have to interview a patient, ask all the relevant questions about the presenting problem, and perform a physical exam. Examiners have a list and check off the questions as they are asked, and the physical exam manoeuvres as they are performed. The examination is worth half of our mark for the entire year, but lasts for only two and a half hours. These precious checklists, the criteria by which we are evaluated, are heavily guarded, tightly held secrets. If it were up to the faculty that runs the course, we would never see a checklist throughout all of our time at medical school. How useful would the lists be, however, if they were integrated into our lessons, and the importance of their questions and physical exam manoeuvres were emphasised? To me, the lack of transparency is an injustice and a disservice to our education.

Understanding medical students can help shed some light on a possible reason behind this practice. Applicants to medical school are already intelligent, hardworking, resourceful, and well rounded individuals. The application process further selects from these already highly competent people using various criteria, such as scores in the medical college admission test; essays; …