Updates for Medicine & Surgery Exams in Year 5

Curriculum Retreat 2007

Comparing Outcomes from New and Old Curricula

8 September 2007

Paul B. S. LaiHBP Surgery, CUHK

Med 5 Exam:

students from old curriculum vs.first batch of new curriculum graduatesvs. second batch of new curriculum graduates

Exam format for med 5

Medicine

Final MB examination in Medicine

History

Short case 1Short case 2

Format

• Three sessions of 20 minutes A: History (in Cantonese)

B: Short case I– CNS– CVS– Endo OR Joints OR ECG OR CT/MRI

C: Short case II– Abdo– RS– Fundi OR Skin OR X-ray/CT scan

Clinical score Written score

2005-2006 54.3% 54.1%

2006-2007 53.7% 55.7%

P = 0.043 P < 0.001

Comparison of Scores in Medicine(Class 2006 vs. 2007)

Exam format for med 5

Surgery

Change in Final Surgery Exam

2005/2006• Written papers

- paper 1 (MCQs) [4 hrs]- paper 2 (R-type MCQs +

MEQs) [3 hrs]

• OSCE – 2 hrs & 10 mins for 21

effective stations and 5 rest stations

– total 21 stations and 20 of them carrying marks

2006/2007• Written (50%) & OSCE

(50%)– paper 1 (MCQs) [3 hrs]– paper 2 (R-type MCQs +

MEQs) [3 hrs]– OSCE [1 hrs & 35 mins for 13

effective stations and 3 rest stations]

• Clinical examination– Two pairs of examiners, 20

minutes each (i.e. total of 40 minutes of short to intermediate cases)

Since examination format changed, cannot compare performance by their marks like last year.

Exam results for med 5

Medicine & Surgery

Linear Regression

0 50 100 150

rank_m

0

50

100

150

ran

k_s

rank_s = 32.47 + 0.57 * rank_mR-Square = 0.32

Correlation between marks in medicine and marks in surgery at final MB 2007

If we use the ranking in the class to correlate, the R-Square was 0.32 (but still significant).[Pearson correlation of 0.57 if we use simple correlation for ranking in the class]

Model Summaryb

.654a .428 .424 1.71579 .428 110.752 1 148 .000Model1

R R SquareAdjustedR Square

Std. Error ofthe Estimate

R SquareChange F Change df1 df2 Sig. F Change

Change Statistics

Predictors: (Constant), MARK_Sa.

Dependent Variable: MARK_Mb.

Linear Regression

45.00 50.00 55.00

mark_m

40.00

50.00

60.00

70.00

80.00

mar

k_s

mark_s = -46.05 + 1.97 * mark_mR-Square = 0.43

Correlation between marks in medicine and marks in surgery at final MB 2007

If we use numerical marks in the class to correlate, the R-Square was 0.428 (P <0.001)

Surgery (written + OSCE)

Surgery (clinical exam)

Surgery class rank

Candidate no.

Medicine class rank

Medicine (combined written and clinical)

Remarks for medicine

47.24% 30.0% 149 56 148 48.84% Fail in medicine

42.41% 35.0% 148 104 150 45.00% Fail in medicine

51.39% 25.0% 150 117 144 50.58% Pass in Medicine

51.82% 40.0% 147 124 136 51.86% Pass in Medicine

Students Failing Surgery(Class 2006-2007)

Medicine (combined written and clinical)

Medicine class rank

Candidate no.

Surgery (written + OSCE)

Surgery (clinical exam)

Surgery class rank

Remarks for surgery

48.85% 148 56 47.24% 30% 149 Failed in surgery too

49.16% 147 68 52.57% 50% 143 Pass in surgery

47.74% 149 78 50.89% 55% 136 Pass in surgery

45.00% 150 104 42.41% 35% 148 Failed in surgery too

49.81% 146 132 57.62% 45% 142 Pass in surgery

50.67% 143 134 64.45% 60% 78 Pass in surgery

Students Failing Medicine(Class 2006-2007)

Possible Explanations

• Both medicine and surgery in the final years call for a lot of clinical skills, knowledge of clinical management, as well as basic scientific knowledge

• Examination formats are very similar – written (MCQs, R-type, MEQs), OSCE, clinical examination, etc.

• For those students who were weak in years 1-4 years, they would not have time to catch up as year 5 would be a very tight year for this group of students

Exam results for med 5

Does it matter where the students came from?

Combined Grades of Medicine & Surgery(Class 2006-2007)

Total no. of students

Group A

(good performance)

Group B

(average performance)

Group C

(bad performance)

JUPAS 100 16 (16%) 69 (69%) 15 (15%)

Non-JUPAS 15 1 (7%) 8 (53%) 6 (40%)

EAS 27 9 (33%) 17 (63%) 1 (4%)

Internal Transfer

1 0 1 0

End of day 4 (pull-up and distinction viva) – all the external examiners were shattered

Examiners in Medicine had a good time