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November 02, 2008

Reflections on Assessment

As part of my MSc here in  Warwick I have been asked to reflect on assessment that I have experienced and my own reflections on these.

I surprised myself by really considering only those assessments that were formative, as these were the only assessments that seemed to stick in my mind. True I've been subject to a number of summative assessments in the past through my medical training, but although they were some of the interactions that mattered most to me as a clinician, in terms of my career and future prospects they are also those that in hard tangible terms mattered the least.

Take the praise from a Vascular surgeon, putting my position opr my ranking as "one of the best", and my pride in this. The indignation of being asked to justify continuing as a trainee in the very hospital I had excelled in, worked for and committed so much time to: outrage at being penalised for success in my previous summative examinations.

"you might go and get an SPR job" before I had even sat the most important assessment of all in my career to date, the MRCP examination.

Yes the MRCP, the exam that I passed, so clearly and held so much pride and belief in, only to see it pass by the wayside as candidates that I felt were "not fit" seemed to walk through the exam with lacklustre knowledge. The same exam that I cherished became less of a trophy and more of a disappointment at times.

What about the people I have assessed?  The DOPS Mini CEX, CBD, 360 degree appraisal of my own trainees. My own trainees whose flaws and shining examples of innovation and commitment were so much more important than a piece of paper regarding urethral catherisation. The unfair selection of marks, some given out freely, others so cautiously that there is no real standard.

Assessment is improving, but unfortunately the people who "know" who the  failing and shining trainees are are still not being asked. There are some things that can't be measured with a tick box.

The very priorities that drive junior doctors towards these assessments can sometimes count against them. I feel more inclined to support a doctor who puts his patients first and his assessment forms second.

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