LETTERS * CORRESPONDANCE
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New exam politically motivated I commend Dr. Michael Leaker, president of the Canadian. Association of Internes and Residents, for his stance as outlined in "New MCC qualifying exam causing confusion and anxiety, interns and residents say," by Lynne Sears Williams (Can Med Assoc J 1992; 146: 2049-2052). Leaker's point about the redundancy of the new, part 2 qualifying examination is 100% correct. I, too, believe that the expense of the exam is "unconscionable" and suggest that it represents yet another barrier to future physicians. When the number of applications to medical schools is only 10% of that 10 years ago, a
conscientious establishment -
For prescribing information see page 1712
Sears Williams' article the suggestion of Dr. Baumber that we should start paying attention to clinical skills when examining future physicians. I wonder why the clinical portions of the examinations held by the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada are no longer equacies. deemed sufficient for most of the With respect to the comments medical students who take one of of Dr. John Baumber, vice-presi- these two major pathways to lident of the Medical Council of censure. To date neither the MCC nor Canada (MCC), that the exam is an essential tool for evaluating the Federation of Medical Licensclinical competence, I believe that ing Authorities of Canada has if this were so, then all practition- produced any evidence that there ers should be required to take it is a need to further examine the over a 5-year introductory period. clinical skills and attitudes of Why not? Dr. David Popkin states medical students and residents. that "anybody who's out in prac- Somehow there does not seem to tice right now and wrote the ex- be a great outcry by the various amination shouldn't have any authorities that the calibre of totrouble passing the QE2." If this day's physicians is dramatically were true we would owe it to the declining or even less than adeCanadian people to test all prac- quate. Before we start implementing tising physicians and ground those not deemed competent. new examinations that cost over Even though it might gener- $1000 and achieve practically ate some credibility for the exam nothing for the 97% or more of and help reduce the individual fee candidates who pass, should we needed to recapture development not have better reasons than concosts there are two reasons why forming to a new, politically motithis will never happen: first, the vated paradigm? failure rates of the physicians tested during development runs and, Shabbir M.H. Alibhai second (and most important), the Richmond Hill, Ont. political nature of the changes; this means that those who will be [Dr. Baumber responds.] hurt are the ones without a political body empowered to properly Mr. Alibhai raises some basic isnegotiate for them - the future sues that have been recognized and debated in many forums over physicians of Canada. the last 2 years. Any innovation or W. Garnet Warrian III, MD change to the established order is Class of 1991 to be questioned, and the bound University of Manitoba bold step taken by the MCC to Winnipeg, Man. introduce a clinical component to in Ms. the qualifying examination was It is interesting to note
were it not acting in a self-serving manner - would be attempting to make future practice more and not less attractive. It would be addressing and correcting the failures of present medical education rather than arbitrarily extending training programs and using an exit exam as a tool to force training programs to correct their inad-
CAN MED ASSOC J 1992; 147 ( 11)