“Half a point less and we lose 1,000 places”: medical students warn about the sixth-year competition

“Half a point less and we lose 1,000 places”: medical students warn about the sixth-year competition

This is the first year that the medical studies reform applies to sixth-year students. “It was organized in the context of wanting to change the competition, so that it would be easier for students, not in terms of studying, but easier to live with for good,” explains Carla*, a student at a Parisian university. -Presence of students. This is the first year to undergo this reform. »

The principle on paper seems clear: instead of a single written exam at the end of the sixth year of study, the exam consists of a written exam at the beginning of the year and an oral exam at the end. “The idea was to avoid crowding, but the workload is terrible, especially since we have less time to prepare for the competition,” Carla explains. “Even if preparing an oral exam is interesting, as much as it is evaluated on our clinical skills and our ability to empathize with patients. But in reality it is disaster. “

A disaster increases students' stress because their grade at the end of the test represents 30% of their final grade. “One point below the final mark and we lose 1,000 places in the rankings,” worries James, a sixth-year student in Tours who after the writings could have a chance to finish his studies in the same city as his girlfriend, also in sixth form. Because the year is crucial for these students: once the competition is over, their ranking determines the major they can enter, as well as the city they can settle in for the first years of their career. The stakes involved in such a test are high and the pressure to perform well is great.

Unfair test

Over two days, the oral exam requires solving 10 diagnoses based on pre-determined role-playing games. An organization must be established before D-Day, and the imaginary word of mouth on March 12 must make it possible to do so. Even though they only consisted of 5 clinical cases, the course of tests gave them a little cold sweat. Carla explains: “Each topic takes 8 minutes, and we have a judging panel, one of whose members is from our university and the other from outside it.” We have to play the role of doctor and in front of us are uniformed patients, from civilian life and not necessarily trained in the world of medicine. First of all, we may have had one of the doctors on the internship judging panel who may not have been a fan of us during our internship, and then the standard patients make mistakes or sometimes forget their script! »

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Louis took oral examinations at the University of Tours. “We had a scenario where the patient was 80 years old and fell at home and we interacted with the patient's brother or sister. We had to look for all the reasons that could have contributed to the fall at home. When I asked the actor what he saw, he told me he had gone to the toilet so “I can actually ask him fewer questions regarding the circumstances of the fall. Other people have told me that their representative answered that he was sitting next to the patient and saw him fall. And yet the patient is supposed to be standardized!”, Lewis laments: “We don't have the same methods of arriving at knowledge. Same thing: When I asked if his brother was taking medication, the actor gave me a prescription while a friend answered “I don't know”, he had to give the word prescription so he could give it to him. But we only have 8 minutes to investigate whatever is there, not We have time to rephrase our requests in three different ways! »

An oral exam differs from the French Baccalaureate, for example, and requires an explanation of a work and what we understand about it. “For us, there is an interaction with the one who emulates, and he may make a mistake or react. “It is artificial and far from being real,” explains James, who adds: “In real life, we must provide world-class care to the patient and, above all, not be malicious, whereas in the OSCE, the aim of the game is to find” the words. Home ” ' is in the grid so as not to lose points, even if it means missing the initial goal: healing. »

“We know that tests are unfair!”

Students I launched a petition Today, it collects more than 7,000 signatures and intends to move forward. “We are thinking of using a lawyer to initiate emergency procedures. We do not want to remove these verbal presentations but make them verifiable rather than grading. “They make it possible to assess the ability to empathize and listen to the patient, yes, but not that they grade students,” Carla continues. We know that tests are unfair, that there are leaked topics, and that standardized patients did not say the same thing to students! »

The configuration of the rooms itself is a problem. Even if Tours was a good organizer for James and Louis, as soon as they entered the exam door, difficulties arose. “Some stations will be quieter, especially when we have to simulate a clinical examination. Since the walls are thin, I can hear the next station talking, and I may or may not have passed them yet… On some campuses, these screens allow the stations to be separated!”

The jury, which has two minutes after the candidate exits, must deliberate on the last pass and clear the tables of any draft or note that could influence the next candidate. “Unfortunately, we happened to be referred when we didn't necessarily have the diagnosis,” regrets Lewis, who did not point a finger at the examiners, “who are present from 6:30 a.m. until 5 or even 6 p.m.” “They're human,” James continues, “and sometimes they nod or make facial expressions toward candidates.” But they couldn't hold back the wear and tear of the day! »

Are there any upcoming developments?

On the part of the Ministry, we are trying to reassure the students. The Ministry of Higher Education explained that “the OSCE training day on Tuesday, March 12 was intended to test the examination centers in preparation for the national OSCE examinations in May,” explaining: “A certain number of difficulties were encountered that were discovered (…) ” As shown in ANEMF press release We are in contact with them, and we are committed with the Ministry of Health to be transparent about the anomalies detected and the responses we will submit for the national tests in May. The Conference of Deans of Medicine and the National Management Center will also highlight the imbalances observed and the responses provided. Therefore, everyone's commitment is complete in this final stage: services from the Ministries of Higher Education and Research, the Ministry responsible for Health, University Services in conjunction with the Deans of Medicine and the National Administration Centre. . »

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The Deans' Conference was contacted and did not respond to us, but he confirmed to us in A I reported Support for reform despite being aware of the problems that such tests could raise: “The 'classical' nature of the Economic and Social Council imposes very important regulatory constraints (…) The Conference is very vigilant about the implementation of the system and calls for a gradual intensification by February 2023.” However, most countries that regulate such tests do so within the framework of simple verification.” It is enough to give a little hope to students, even if “this regulation is subject to a decree of the State Council, the adjustment of the rules will be precise, and the test next May cannot It should be subject to only minor modifications.”

At present, there is nothing to calm students' discontent. “We know very well that a fair number of students will be ready to appeal if things get worse,” Carla points out. “If students refuse to take these oral exams and therefore repeat them for a year, this could increase the shortage of trainees in hospitals.”

(*First names have been changed)

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