Exams. Why?

My daughter was pulling my shirt one day and refusing to let go.

"Daddy! Daddy! Play with me!" She wailed.

"Cannot la, I gotta study for my exams......" I replied her as the tug of war continued. She was surprisingly strong for a 4-year-old.

She stopped for a moment and asked, "Daddy, why do you need to study?"

She was of course not the only person to be puzzled. Last week I rejected an invitation for supper from a non doctor friend and just yesterday I gave up free tickets to a midnight movie (transformers no less) from another friend. I could almost visualize their bewildered look when I told them I had to study for my exams. The commonest reaction I get is "Huh??" followed by outbursts of laughter.

So why do doctors (and I'm not talking about medical students here) need to study all the time? Why do we need exams even at an advance speciality level? Why can't we be assessed in a formative (and more meaningful) manner?

1) Exams are a major money churning industry. Look at the inexplicable fees we have to pay for each and every exams. The money we pay goes into supporting an entire industry of clerks, adminstrators as well as one dysmorphic looking and weird executive.

2) Have you ever notice that half of the books in Yunnan or Research are How to Do Well or Pearls of This and That Exams preparatory books? Exams help to maintain an entire medical literature industry. Also note that the books are often overpriced! Can you ever find anything less than $30? The authors are often senior doctors banking (and unethically so) on our exams anxiety. The books are often just cut and paste efforts with contents not worth the paper they are printed on.

3) Becoz books are often priced beyond the financial capabilities of junior doctors in general and my hospital MSW flatly refused to subsidise me in any way, we spin off a third industry. I was at a Katong shopping complex and one particular photocopy shop had more medical books than our YLL Library. At least I like the uncle there.....

4) Of course, its not always about money. Our training comm are made up of really nice people and they can never tell a trainee, "Alamak! I think you don't have the aptitude to do what you are doing. Maybe try admin!" Trainees don't ever get chopped, unless they chop themselves. So what better way to let them go than to let them fail their exams? Unfortunately, the weird ones are often self selected to pass exams coz they have no friends, don't do any work at work and spend all their time mugging photocopied versions of exams preparatory books.

Although I was quite pleased that my daughter had achieved an adequate developmental milestone and was asking questions. I thought it was appropriate to prepare her for the sinister world of exams ahead of her.

"Daddy need to study because its my last exam, you also will have lots of exams ahead of you la!"

She ran off crying. Ah, brillant! She is cognitively way ahead of her time!