I don’t believe you. If you are an aspiring physician who struggles with standardized exams this is the most common feedback you will receive from the self-proclaimed educational “experts” at your medical school. Any suggestion that multiple choice exams are not a valid indication of your abilities will likely be met with equal parts indifference and indignation. Challenging the merits of standardized exams, for a medical student, is not allowed. Identifying yourself as an exam apostate will likely make your life harder and your chances of graduating lower. Medical schools’ inability to defend, or discuss, the cornerstone of their educational product occurs for a simple reason: medical education is not conducted by educators at all.  

If standardized tests do not reflect your abilities, let me share news both good and bad.  The good news: the evidence has never been stronger that standardized tests are flawed. The bad news: it is unlikely leaders in “traditional” professions are aware of the science dispelling these exams. This disparity, between the people that study tests and those that ruthlessly apply them, is due to two factors: selection bias and lack of pedagogical training.

Leaders in fields such as medicine, law, and academia are almost exclusively professionals who have achieved excellent scores on multiple choice exams. This is an expected byproduct of the system that currently exists; standardized exams exclude those not achieving the requisite score(s) to enter these professions. This fact creates tremendous selection bias in favor of those excelling on such exams.

Additionally, it is surprisingly uncommon for professors within medical schools to have formal training in educational theory. Ask yourself how many college acquaintances decided to switch from education majors to “pre-med” coursework versus the reciprocal? Doctors teach doctors the way they were taught. The techniques perpetuated are more analogous to a cycle of educational abuse than evidence-based teaching. 

In the posts that follow I will offer testing strategies that work for professional students. While such information should be required in the curriculum of every medical school, sadly, there is almost no such content currently offered in US medical education. Before these evidence-based suggestions are shared, let me offer a somber warning. Nothing will take the place of tremendous hard work. While the statement, “I am not a good test taker” easily rolls off the tongue, please know that relatively few people are in fact “bad test takers”.  Much more common are poor test “preparers”. For those that have simply not put in the work, there is a simple first step.  Work harder. These two words will lay the foundation for the suggestions, and lessons, that follow.


Twitter @JayMacGregorMD