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The Differential

What Are We Testing?

AbraarKaran, Medical Student, 09:13PM Dec 19, 2013

After recently finishing my GI block exam, I began thinking more about the types of questions that were asked on the test. Generally, there are a few broad categories, some which require reasoning skills, and others which are rote memorization. It's the latter ones that I find myself getting stuck on, largely because I frankly dislike having to memorize minute details. Don't get me wrong--some things you just need to know, especially for emergency situations that require quick decision-making. However, with the advancement of technology, I am not convinced that the way we educate and test medical students has evolved as it needs to. We are far past the days when not remembering a detail, such as a disease's specific receptor mutation, required one to physically go to a library and search through a massive textbook.

I much prefer the questions that present cases where one must reason through the data and propose an educated treatment plan. These seem to test the intellectual acuity that I would think is at the heart of diagnostics and patient care from a technical standpoint. However, to push this idea further, what if we didn't have paper based testing? Or, in addition to a short, multiple-choice exam, we also had an oral portion in which medical students are presented cases by a group of physicians and they are judged on how they think. While this already exists for the 3rd and 4th year during rounds, I believe introducing this type of testing during the preclinical years in a gradual manner could be particularly beneficial for medical education.

The way that people access and process information is so drastically different than it was in the pre-internet era, yet the way we evaluate students and their ability to utilize knowledge has changed very little. In medical education particularly, we would benefit from moving away from rote memorization and testing of disconnected facts. We need to be aspiring toward a system in which medical students are tested in an environment where they can easily access minutiae from their ipad or iphone, just like they might in real life. Testing through this lens is not only practical, but will also challenge us to be more creative thinkers earlier on in our careers.


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  • Amanda Xi

    Oakland University William Beaumont School of Medicine, Rochester, Michigan

  • Alexa Mieses

    Icahn School of Medicine at Mount Sinai, New York, New York

  • Casey Sharpe

    University of Texas Medical Branch at Austin, Texas

  • Carl Streed Jr

    Johns Hopkins University School of Medicine, Baltimore, Maryland

  • Matt Wiepking

    University College Cork, Cork, Ireland

  • Rick Pescatore

    Philadelphia College of Osteopathic Medicine

  • Sara Teichholtz

    Medical School for International Health, Be'er Sheva, Israel

Olaseni Ajibade

Mercer University School of Medicine, Macon, Georgia

Bryce Krishna Cragg

Texas Tech University Health Sciences Center, Lubbock, Texas

Zoyah Thawer

McMaster University School of Medicine, Hamilton, Ontario, Canada

Abraar Karan

David Geffen School of Medicine at UCLA, Los Angeles, California

Annie Chiu

Albany Medical College, Albany, New York

Felix Lee

University of Kentucky College of Medicine, Lexington, Kentucky


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