In-Training Exam

Exams never end; luckily, those in medical training are no stranger to standardized tests. We recently had our annual in-training exam, given nation-wide so we can see how we do relative to anesthesia residents elsewhere. I wrote about this last year, and upon rereading the blog, I realize how much I've grown. Having done the subspecialty rotations (pediatrics, obstetrics, cardiac), I found fewer topics obscure, though there were still questions of basic pharmacology that challenged my memory.

Exams are a simple, tried-and-true way of testing knowledge base. But we find ourselves more and more in a world where knowledge is not the be-all and end-all of things. What is known about science and medicine is changing so rapidly that much of what I know now will become obsolete, irrelevant, or disproven in a decade. Indeed, the test reflects this; there are many questions on drugs that are no longer used because better alternatives and replacements have been discovered. Furthermore, we have much improved access to knowledge. Perhaps a generation ago, a physician would have to flip pages through a large reference book or hunt for papers in a dark library to find something out. But now, our computers in the operating room or phones on the wards can give us real-time information. It turns out finding knowledge isn't hard, but filtering it, interpreting it, and utilizing it appropriately is the challenge.

Tests will never go away; I'm resigned to that fact. But I think they need to adapt to the changing world of medicine, science, and knowledge today. The traditional knowledge-based standardized test - with questions vetted years and years ago assessing recall of obscure facts - is an obsolete dinosaur, and we need instead to formulate examinations that engage those faculties physicians today need - critical thinking and interpretation of data, experiments, and conclusions.