Learning to write exam questions
Three days in Melbourne with the Royal Australasian College of Surgeons Surgical Specialties Examination Committee, learning how to write questions for the College's first part surgical examination.
What the first part examination is
The Royal Australasian College of Surgeons sets the training and examination standards for surgeons in Australia and New Zealand across all the surgical specialties. Its first part examination sits early in the pathway and tests the basic sciences that surgical practice rests on: anatomy, physiology and pathology, applied to clinical situations rather than asked in the abstract.
It functions as a gate. Doctors sit it in order to be eligible to progress, and for many it is the examination that determines whether they continue towards a surgical career at all. That is why the standard has to be defensible in both directions: high enough that passing means something, and fair enough that a candidate who has done the work is not failed by an ambiguous question.
How questions are written
Writing examination questions is a discipline of its own, and surgeons are taught it rather than left to improvise. A question has to test understanding rather than recall, have one defensible correct answer, offer wrong options that are plausible to a candidate who has not understood the material, avoid giving the answer away through its wording, and sit at a known level of difficulty. Questions are drafted, reviewed by other committee members, trialled, and analysed afterwards against how candidates actually performed on them, so that a question which did not discriminate is revised or discarded.
Doing this in a standardised way across hundreds of questions and many specialties is what allows the examination to be comparable from one year to the next.
What struck me as a new member
The dedication and attention to detail involved is considerable, as is the volunteer effort that goes into making the examination as fair as it can be. The exam determines who progresses in surgical training, so the work of setting questions that test understanding rather than recall matters a great deal to the people sitting it.
The team dinner with committee and administration staff was a good evening.
Related information
- Our post on the College of Surgeons Anatomy Committee.
- The shoulder anatomy page covers the anatomy such examinations test.
- The shoulder fellowship page explains the subspecialty training that follows.
- The shoulder surgery page.