The medical course reform will be applicable for the 6th year students from the first year. “It is organized in the context of the desire to change the competition,” explains Carla *, a student at the University of Paris: “So it is easier for students, not in terms of studies, but to live for the well. – Being students. This is the first year of carrying out this reform. »
The principle, on paper, seems clear: instead of a single written exam at the end of the sixth year, the exam consists of a written exam at the beginning of the year and an oral exam at the end. Carla explains, “The idea is to avoid cramming, but the workload is terrible, especially since there is less time to prepare for the competition. Although it is very interesting to set up an oral exam, as if we are evaluated based on our clinical skills and the ability to empathize with patients. But in reality it is a disaster. »
A disaster is stressful for students because their score at the end of the exam counts for 30% of their final grade. Worried that “one point less in the final score, we've lost 1,000 places in the ranking”, James, in his 6th year at Tours, after the letters, could have the chance to finish his studies in the same city with his girlfriend, who is also in 6th grade. Because this year is decisive for students: after the competition, their ranking determines both the specialty they can pursue, but also the city they can settle in for the first years of their life. The stakes of such an exam are high and the pressure to perform well is high.
unfair trial
The oral exam, over two days, required them to solve 10 diagnoses based on pre-defined role-playing games. A system to be established before D-Day and mock verbals on March 12 to make it possible. Although they only made 5 clinical cases, the trend of the trials gave them some cold sweats. “Each topic lasts 8 minutes, and we have a jury, one from our university and one from outside. We have to play the role of a doctor, we have standardized patients in front of us, from civilian life, not necessarily trained in the medical world. First, in the internship the jury has a The doctor may have been, they may not have liked us during our training, and then, standard patients make mistakes or sometimes forget their text! »
Louis took oral exams at the University of Tours. “We had a scenario where the patient collapsed in the house of an 80-year-old man and had a conversation with the patient's brother or sister. We had to look for all the reasons that contributed to the falling of the house. When I asked my actor what he saw, he told me he had gone to the toilet so I could ask him fewer questions about the actual circumstances of the fall. Others told me that their actor responded that he sat next to the patient and watched him fall. Still the patient needs to be graded! », Luis regrets: “We don't have the same methods of accessing knowledge. The same thing: when I asked if his brother took medicine, But we only have 8 minutes to investigate everything, and we don't have time to rearrange our requests three different ways! »
For example, an oral exam, different from the French baccalaureate, requires us to explain a work and what we understand about it. “For us, simulation is about dealing with someone who can make a mistake or react. It's artificial and far from reality,” James adds: “In real life, we have to provide universal care to the patient and above all do no harm, whereas in OSCEs, the aim of the game is What' is to find the key words. ' are at the point in order not to lose the points, which would mean losing the initial purpose: to heal. »
“We know the tests are unfair! »
Students Started a petition It has collected more than 7,000 signatures today and intends to go further. “We are considering using a lawyer to start urgent proceedings. We do not intend to eliminate these oral presentations, but to validate them rather than categorize them. They make it possible to assess empathy and the ability to listen to the patient, yes, but they don't classify the students”, Carla continues: “We know that the tests are unfair, the topics are leaked. Nor did the standardized patients tell the students the same thing! »
The configuration of the rooms poses a problem. Although Tours acted as a good organizer for James and Louis, once through the selection door, difficulties arose. “Some stations are quiet, especially when we have to do a medical examination. The walls are thin, so I can hear the station next to me talking, I've already passed or I haven't passed yet… In some universities, these are screens that allow us to separate the stations! »
Two minutes after the candidate has left, the Jury shall discuss the latter paragraph and clear the schedule of any draft or note that may affect the next candidate. “Unfortunately, we were prescribed when the diagnosis wasn't necessary,” laments Lewis, “between 6:30 a.m. and 5 p.m. or even 6 p.m.” “They are human beings,” continues James, “sometimes they nod or make facial expressions to guide the candidates. But they can't contain the weariness of the day! »
Will there be any developments?
On the part of the Ministry, we are trying to reassure the students. “The OSCE training day on Tuesday March 12 is intended to test examination centers for preparation for the national OSCEs in May,” explains the Ministry of Higher Education: “A certain number of difficulties were encountered. Found (…). As indicated in ANEMF press release We are in touch with them and we are committed to the Ministry of Health to be transparent about the discrepancies and responses we provide to the national tests in May. A conference of Medical Deans and National Management Center will shed light on the dysfunctions observed and the responses provided. So the commitment of everyone in this final phase is complete: the services of the ministries of higher education and research, the ministry responsible for health, the medical deans and the university services together with the national management centre. »
When contacted, the Deans' Conference did not respond to us but gave an assurance contacted Although aware of the problems these tests may raise, support the reform: “The 'categorical' nature of ECOS imposes very important institutional constraints (…) The Convention is very aware of the implementation of the system and argues for a gradual progress from February 2023. Moreover, most countries organizing such elections Just doing it within the checking framework. » It is enough to give students a little hope, “Although the system is governed by the decree of the State Council, changing the rules is subtle, and next May the test will be subject to minor changes. »
As of now there is nothing to quell the students' discontent. “We know very well that if things go badly, a good number of students will be prepared to appeal,” Carla points out. “If students refuse to take these oral exams and repeat a year, we may further strengthen the shortage of interns in hospitals. »
(*First names have been changed)
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