Exam for the doctor: translation nuances

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Доктор медичних наук, завідувач відділу загальної та молекулярної патофізіології Інституту фізіології імені О. О. Богомольця НАН України, професор, упродовж понад 19 років (до 2014) працював у Національному медичному університеті ім. О. О. Богомольця
Victor Dosenko

22 years ago together with other graduates of Ukrainian State Medical University we were the first in our country, who were passing the American exams “Stem” as a part of the pilot project. These are the best medical tests in the world, and in the USA anyone, who wants to become a doctor, shall pass them. It was expected that the similar system would be introduced in Ukraine to control the training level of future doctors.

We had to respond to glorified, complicated questions. Then there were exams with actors imitating the patients, and we had to “arrive at diagnosis” – after all, the real doctor shall have not only knowledge, but skills as well. I was over the moon, like most of my classmates.

Then I entered the postgraduate training program, started to work in the department of beloved University, while the American “Step” turned into Ukrainian “Krok” (translates to English as “step” – editor’s note). But tests having the same name are totally different. Year over year the complexity degree of questions in our tests was going down, and currently to answer them correctly, sometimes you may not even have special medical knowledge, common wisdom and general erudition is enough for you.

At the same time, from year to year the percentage of incorrect answers, which is acceptable for the successful test passing, was going up. As far back as last year the graduate of higher medical educational institution had to answer correctly to 51% of questions. In other words, you have permission to kill 49% of patients or leave them crippled – that’s fine according to our medical education. No wonder that in so doing the percentage of students, who successfully pass “Krok”, tends to 100. Actually, not on the first try, but on the second, third, fourth – future medical workers pass tests as many times as they need – there is no profit in kicking them off .

As far back as last year the graduate of higher medical educational institution had to answer correctly to 51% of questions. In other words, you have permission to kill 49% of patients or leave them crippled – that’s fine according to our medical education.

There are many foreigners among these students, particularly Indian citizens. Having Ukrainian diploma, they return to their homeland, where they have to pass the Indian tests to prove their qualification. I do not think that these tests are more complex than American ones, but only 12% of those, who have received the Ukrainian diploma, successfully pass these tests. 88% of defects – it’s obviously too much. Of course, that will suit for our universities, since for relatively small amount of money they may get a piece of paper, and afterwards they will think what to do with it.

If the same test is held fairly for all our medical students, I am convinced that that it will be successfully passed by about 10%. It is as paradox, but at the same time Ukrainian medical science has “stupendous” achievements – this is the medicine, where perhaps most of the research theses are being defended. Though, you will hardly ever find the top-rated published materials of Ukrainian scientists-medical workers in peer-reviewed scientific publications. Simply due to the fact that we almost have no real scientific research in the field of medicine. We have simulation instead of it. Simulants-teachers explain the rules of the game to students and inspire them making example of themselves. If the student does not understand the rules immediately, he will understand them later. Or he will go abroad, where his talents and abilities will be appreciated. Now, I believe there is no point in explaining why good doctors in our country – are exception, rather than a rule.

You will hardly ever find the top-rated published materials of Ukrainian scientists-medical workers in peer-reviewed scientific publications. Simply due to the fact that we almost have no real scientific research in the field of medicine.

To make this reversed we shall replace Ukrainian “Krok” with American “Step”. There is nothing impossible here, because this exam is being passed not only in the USA, but in Canada and other countries. Ulana Suprun has passed it, and I would like to believe that she will move to this crucial point. And it would be completely perfect if American tests are held by American company.

We shall inform on the change of testing system in advance: today’s prospective students shall know that when their third year is over they will have to pass “Step 1”. I predict that is will be successfully passed by one student out of ten. Others – shall undergo re-education.

If everything is done in a proper and honest way, than we will have lesser number of higher medical educational institutions. Number of doctors of medical sciences will also go down, but their articles will soon appear in real scientific journals. We will have lesser number of physicians, but they will heal us with no sick fancies and with no garbagemycin – as it should be in the XXI century.

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