Admission to undergraduate and postgraduate medical courses: Looking beyond single entrance examinations

Abstract

In India, a single national level entrance examination for admission to undergraduate and postgraduate medical courses has been introduced. This is largely an effort towards alleviating financial corruption in admission process, improving logistics and ease of examination for students, and resource-efficacy in conduct of examination. Unfortunately, the possible educational impact of such single high-stakes examination has not been overtly discussed. A major handicap in doing so is the lack of documentation and analysis of our own experience with multiple entrance examinations over many years. One adverse aspect of a single high-stakes examination, especially the Postgraduate entrance examination, is that the students’ learning priorities get redefined to being ‘examination-oriented’ rather than ‘competency-development oriented’. Hence, we must draw lessons from admission processes in other countries that have gone through similar course. Two key effective practices in these countries include giving weightage to prior academic performance, and use of a combination of some form of cognitive testing, aptitude testing and non-cognitive assessment, for taking selection decisions. It is prudent to modify our existent examination processes utilizing the same principles. There is a need to improve the formative assessments and the end-of-training certification examinations, and possibly also include them as inputs for the admission process.