Writing exam questions
Several days in Melbourne at the Royal Australasian College of Surgeons with the Surgical Specialties Examination Committee, writing anatomy questions for the surgical primary examination.
The surgical primary examination is the gateway to progressing in surgical training, and anatomy is a substantial part of it. Setting questions that genuinely distinguish understanding from memorisation is harder than it sounds, and it is work the profession does for itself.
The Royal Australasian College of Surgeons
The Royal Australasian College of Surgeons is responsible for surgical training, examination and professional standards across Australia and New Zealand, covering all of the surgical specialties. Specialist surgical qualification in this region is awarded through the College, and the College continues to set the requirements for professional development afterwards.
What an examination committee does
An examination committee writes, reviews and validates the questions used in the College's examinations. That involves more than drafting. Each question has to be unambiguous, pitched at the right level, defensible against challenge, and genuinely discriminating, meaning that candidates who understand the material answer it correctly and those who do not, do not. Questions are reviewed by the committee before use, and how they performed is analysed afterwards.
Why anatomy carries so much weight
Anatomy is what makes a surgical approach safe. Reaching a joint means knowing which nerves and vessels lie between the skin and the target, and which of them can and cannot be moved aside. Around the shoulder the axillary nerve, the musculocutaneous nerve and the brachial plexus all lie close to the structures being operated on, and the margins are measured in millimetres. A trainee who holds that anatomy securely has a different kind of knowledge from one who has memorised a list.
Setting the examination is also how senior surgeons define what the next generation is required to know, which is why the work is done by practising surgeons rather than delegated elsewhere.
Related information
See our shoulder anatomy page, and our posts on the Surgical Specialties Examination Committee and the Gordon Taylor Award.