The last examinations in the ‘old format’ have now finished, making the editorial and commentaries on ‘The long case is dead’ very timely (Reference AshurstAshurst, 2007; Reference Benning and BroadhurstBenning & Broadhurst, 2007; Reference TyrerTyrer, 2007). In addition, psychiatric training is undergoing significant change, particularly following the difficulties associated with Medical Training Application System, and Modernising Medical Careers.
With the move towards competency-based curricula, it is important to reassess the way that trainees are assessed. Objective Structured Clinical Examinations (OSCEs) are increasingly used to assess medical students instead of the traditional long and short cases. Long cases have been used in examinations since the 1970s and while standardisation of OSCEs is easier, each station provides only a snapshot of a candidate's performance.
Workplace-based assessments are a useful addition in the assessment of trainees’ competences and will now be the main method of evaluating their ability to perform a full comprehensive clinical assessment. However, these are new tools for both trainees and supervisors and it will take time and further development before they become a reliable method of assessment.
Many trainees have prepared for one examination format only to be forced into a new system, while the transitional arrangements mean that some aspects of the curriculum will not be tested in those who have obtained Part 1 and are exempt from Paper 2. Neither of these situations is ideal. An overlap between the old and new examination formats may have allowed an easier transition to a new way of working for trainees and help avoid the significant anxiety experienced by those affected by the changes.
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