Ensuring medical students are “fit for purpose”

It is time for the UK to consider a national licensing process

“The intent to develop liberally educated graduates, rather than competent technicians, is what makes a university a university.”1

This statement stands to be challenged. Postgraduate medical training in the United Kingdom is undergoing profound change as the Modernising Medical Careers project introduces a generic competency based curriculum for all newly graduated (foundation) doctors. A new culture of assessment is developing which increasingly focuses on testing clinical skills in the workplace.2 Licensing processes will be quality assured by the Postgraduate Medical Education Training Board (PMETB). The principles formulated for this encourage reliable, well designed assessments mapped against the requirements of the General Medical Council's (GMC) Good Medical Practice guidance (www.gmc-uk.org/med_ed/default.htm), appropriate standard setting, lay involvement, and transparency of process for candidates (http://www.pmetb.org.uk/). Royal colleges are reviewing their accreditation processes to meet these requirements.

Against this background it is time to reconsider undergraduate examinations for UK medical students. In contrast to the United States and Canada, where national licensing examinations are held, the …