Georgian Doctors Only Need a Keyboard for Certification Exam
Medical doctors in the Republic of Georgia need only pass a multiple choice test to be certified. A webpage gives them 150 of the 200 answers. Some of the answers are no longer correct because the questions are outdated, but smart students admit they memorize the webpage, including the wrong answers, to get a high enough score.
Salome Kvekvetsia passed the exam in December 2016 and is certified as a cardiologist.
She says the test is easy and measures your memory, not the medical skills and experience gained during four to six years of medical school in Georgia.
Many of the questions were written five or more years ago and are based on old medical practices no longer in use.
“These questions are about research methods and diagnoses not used anymore," Kvekvetsia said. "There is some terminology which we cannot find in modern medicine. These tests need to be revised".
A Ministry of Health official admits that some test answers are incorrect. “We know about the wrong answers," says Natia Noghaideli, who heads the Regulations Committee in the ministry. "The test was created a long time ago. Some of the answers were correct 5 or 10 years ago, but not today".
Lists of questions and answers for 52 medical specialties feature on the Ministry webpage. Only five have been updated recently. An exam commission picks 150 questions from the webpage. Another 50 questions are chosen that can't be seen in advance. A candidate must answer 151 out of 200 questions to pass.
The ministry in 2011-12 paid around $11,700 (at today's currency rate) to buy the "hidden" questions from professional unions for cardiologists, surgeons and other medical specialties.
Noghaideli was asked why candidates can see any of the questions and answers in advance.
“You know what? As it is, where the majority of the answers can be seen, there are many applicants who still cannot pass the exam," she said, adding that any changes might face protests from applicants. "I think we should change it step-by-step, so that it won’t be a shock for the applicants”.
Since 2005, 21,551 applicants have passed and 5,549 have failed. According to Georgian regulations, an applicant who fails can retake the test every six months. There are no records to how how many failed applicants took the exam again.
Sopho Trapaidze passed the certificate test in cardiology in 2016. “One cannot measure modern techniques using tests written in the 1990s," she said. "It would be good if the exam included an actual medical exam of a patient, and his/her symptoms and medical history. Then the applicant could list future treatment”.
"There could be another option where, based on the results of the patient exam, the applicant should choose a complete treatment strategy. Such an exam would be much more useful for a doctor than the test I passed,” Trapaidze told us.
Noghaideli says Western certification tests are a combination of questions to answer and an assessment of clinical skills. She believes it would be a long, hard process for Georgia to transform to this model.
“We think the exam design should change and focus on assessing clinical skills. None of the test answers should be available in advance. But I cannot say when we could prepare a proper assessment for clinical skills in every specialty," she said.
Sopho Beruashvili took her exam to become a certified endocrinologist in 2016 in Paris. She failed and will try again this year.
“The first part of the exam was made up of written questions on general medicine," she said. "After we had a break, the clinical part started. There is a description of a clinical case, and you are asked to describe the proper patient examination, the diagnosis, and then how you would treat the patient. All of this should be based on logic, not test questions”.
"The competition for an EU-recognized diploma is tough. There were 95 people fighting for 7 places."
Nino Bakradze, ifact.ge