Publications

he purpose of an exit examination at the completion of training is to ensure a minimum level of competency to grant a license to practice Neurology. Until a few decades ago, medical examinations in the developed countries were in the form of essays and oral assessments.[1] Evaluations derived from such assessments were subjective, arbitrary and not reproducible. Subsequently, standardized tests such as multiple-choice questions (MCQs) or Objective Structured Clinical Examinations (OSCE) were developed.[23] Worldwide, the Neurology residency exit examination system is highly varied,[456] and in some countries, there is no formal exit examination.

In India, the neurology exit examinations for granting DM (Doctor of Medicine) degree generally consist of written tests (usually 10 questions each carrying 10 marks) covering basic sciences, clinical neurology, investigations, therapeutics and recent advances, and practical clinical examinations consisting of a “long case” and 2-3 “short cases”. This is followed by neuroradiology spotters, electrophysiology spotters, neuropathology slides and viva voce. There are often variations in this scheme from one university to another. Though this examination pattern appears elaborate and comprehensive, the theory examination and evaluation, viva voce and case presentations are largely unstructured and without a clear blueprint for objective evaluation. During the conduct of the DM Neurology examinations, several opinions and suggestions have been put forward and discussed informally by the examiners regarding the need to revise the current system. In a recent editorial (2020), Pauranik noted the wide variability of quality in DM training and assessment in India, emphasized the need for systematic research in this area and urged the Indian Academy of Neurology to take the lead in this direction.[7] As the number of DM Neurology seats in the country continues to increase over time, it is important to have a system of exit examination that ensures uniform minimum national standards of the trainees. The objectives of our study are to systematically study the perception of examiners from various parts of India on the existing examination pattern for DM Neurology and to know their key recommendations.