Best type of medical exams-essay or mcq?

[medstudent100]

In my course we have MCQs, EMQs and essay exams. The class average is generally lower in the essay exams than the other two, however my grades are significantly different. If I get an A or B in an Mcq i'm likely to get a C or even a D in the essay exam. Some people in my class seem to be able to score A+s in essays, however I am fairly sure that no matter how much I know/do I will never score higher than a B in an essay (even if I would get an A+ in an mcq). I have noticed this with other people too, the people who seem to be good at english/essay writing seem to be able to consistently get Bs wheras in mcqs they dont do so well. It occurs to me that quality of english used, even quality/speed of handwriting! may even be major factors in determining grades.

Being able to describe/paragraph and write you're thoughts well, on paper, doesnt necessarily mean understanding it better than if you can't write coherently, and is much less important. In MCQs you do not have to describe your understanding or thought process, but rather come to the correct answer whichever way you choose. I think this is more important than being able to describe the topic coherently and having a general overview but possibly not being able to solve problems with that knowledge; so I think exams where 'getting the answer' results in perfect grades are better.

Essay exams seem to reward good english rather than good understanding.

Has anyone noticed this? (ps I need help improving my essay grades as they are a huge part of my exams!)

[kotoreru]

Have some faith in the system lol I'm sure that legibility and grammar (within reason!) have only a small bearing on the grade.

My last degree was MCQ and essay based. I used to prefer the essays.

It could be argued that better grades in essays indicates better knowledge of the subject...but our MCQs have 16 choices. If you can get the right answer from that lot then you probably do know your stuff.

There are arguments for and against any method of assessment. I tend to agree with you though - medicine isn't as philosophical as most other science degrees (i.e. there IS a right and wrong answer) so essays seem less relevant to it.

[Clarkey]

I prefer and always do better in essay based exams. I like being able to structure my answer and draw on knowledge that I feel is relevant.

To each their own.

[The Fantastic Dr. Fox]

i dont rate MCQs as a way to test medical students. Whenever you do an MCQ all 5 potentil answers are prompts that you dont get in real life. The answer to every question is right under your nose. I belive you should be able to come up with your own list of differentials/possible investigations as no oen is ever going to think them up for you on a ward. just my thoughts

[Frank E]

I agree Dr Fox. If I can answer (some of) them they are too easy.

[kotoreru]

Yeh sure, except our MCQs have 16 choices, not 5. I see your point, though.

[oxford873]

the best thing is that the question in the exam include both essay and MCQs in order to be a Justice in the exam for all type of student
regarding me i prefer MCQs

[The Fantastic Dr. Fox]

Im not sure it should be about 'justice for the student' as such. I think that it should be about which one best tests the the clinical knowlede and reasoning you will need in practice and student preference should not even come into it.

[The Fantastic Dr. Fox]

Of course i am going to differ from most students. Most students are going to campaign for the type of exam that they find easiest, not necessarily the one that best tests their effective clinical knowledge. As I said before, exams styles should be chosen because they are reliable tests of clinical capability, not because they please students.

[wanabanana]

I disagree on several fronts:

r/e Dr Fox: What's common in medicine is common. Most patients that present in the clinical setting either have an immediately obvious diagnosis or 90% of the time will have one of the most common 3/4 differentials for that presenting complaint. Therefore the mcq (particularly the best of 5 answer) can match the clinical decision making a doctor makes.

Essay questions promote learning in a parrot fashion as it's all too easy to spurt out a list of things you have learnt without really understanding the concepts. Mcqs and emqs promote understanding in that you don't have to memorise lists as you know the answer will be in front of you, but encourages understanding behind the knowledge. It also recreates real life as most of the time as a doctor you will always have a reference book with all the answers in it anyway (ohcm anyone?)

Just my 2 cents anyway, probably biased by the fact I hate writing essays