Unlike university examinations which are designed to assess acquisition of knowledge, Section III of GAMSAT is written to test for competencies in problem solving via the application of knowledge. This often involves novel contexts that students have never seen; however, the principles underpinning the assessment item should be familiar to students who have studied for the exam. The rationale for the style of assessment in GAMSAT is three-fold:
- Need to assess for prerequisite knowledge – Graduate medical programs are four years in length. Traditionally, the initial two years of a graduate medical program are spent covering theory while the final two years are spent gaining experience in various clinical rotations. From day one, medical programs require students to be ready to study clinical medicine and there is not time to learn basic scientific concepts. Knowledge therefore is a definite pre-requisite for the examination, however high performance requires a more in-depth and intuitive understanding of concepts not typically acquired through tertiary studies.
- The nature of medicine – While medical schools teach students about diseases, patients present with undifferentiated complaints. It is then up to the clinician to bridge the gap between their training, and the unique problem reported by the patient through critical thinking. Section III of the GAMSAT is very similar in that it requires students to take their scientific knowledge and apply it to a unique problem by referring to core principles acquired during their study.
- Efficacy as a selection tool – As the demand for medical school training positions outweighs supply by approximately 10-to-1, a process of selection is necessary. The tools used in this process of selection need to determine both acquisition of a prior body of knowledge and the ability to critically reason through problems. Furthermore, the selection tool needs to be of sufficient difficulty that many candidates cannot achieve maximal results as this would preclude discrimination of the relative quality of such candidates.
What then is the implication of such considerations?
The only way to solve the problems presented in Section III of GAMSAT in a timely manner is to develop an understanding of concepts along with their applications, contexts, and inter-relationships with other concepts already understood. It also means gaining experience in applying such concepts in differing contexts through completion of practice exercises. Concepts understood on a superficial level or not understood at all need to be re-evaluated and modelled to fit within the candidate’s cognitive set.
How is an intuitive understanding of scientific concepts achieved?
Active study is task-directed study that involves students seeking out information to close knowledge gaps and answer questions regarding gaps or inconsistencies in knowledge. The aim is to create an innate understanding of the laws underpinning the sciences (the rules of the game).