Standard

Last week, we held the licentiate examination for the Medical Council. This was an examination for medical graduates from other countries who wished to practise in Hong Kong. In the practical session, candidates were required to obtain history from and perform physical examination on patients. New examiners were often surprised to find how different the candidates could be. British-trained graduates performed examination in a systematic way. Others might jump from one step to another, picking up clues on the way and deciding what to do next as the case unfolded.

Many of us would allow a less systematic approach so far if important signs were not missed. Some examiners were less flexible and would already frown when a candidate pulled out the stethoscope before carefully inspecting a patient. The chief examiner repeatedly complained that Americans relied too much on investigations and did not examine patients properly.

A few examiners asked how we should mark the candidates. Since this was not a specialist examination, we could not expect candidates to get every diagnosis right. But how far should we tolerate?

“Shall we adopt the same standard as our own graduate examination?” suggested one examiner.

“Nope,” another examiner disagreed, “we pass 99% of our students every year. There isn’t a clear-cut standard.”

As usual, Szeto came up with the most useful advice. “Think if you are happy to be treated by the candidate in the future.”

But the room went silent.

What a terrible thought!