National standards in medical education: Being accountable and striking a balance

Tom Lee


Dr. Tom Lee
Emergency Medicine Consultant
MBChB, BSc, MSc (Medical Education), MRCP (UK), MCEM (UK), FCEM (UK), FACEM

Dr. Lee is a senior emergency medicine consultant at the Lyell McEwin Hospital in Adelaide and currently studying for his PhD in Education at Flinders University.


The recent suggestions of a national curriculum and a national examination have created important discussions about Australian medical education and its future. [1-2]

The debate surrounding their merits and disadvantages is likely to remain ongoing without reaching a consensus amongst all involved stakeholders. [3] With the significant increase in the number of medical graduates and heterogeneity of current and future medical curriculum and programmes, [4-5] there is an urgent need for regulatory authorities of medical practitioners (such as the Medical Board of Australia and the Australian Medical Council (AMC)) to ensure all Australian medical graduates have reached agreed standards of delivering adequate and safe patient care. [6]

One of the most practical and effective measures that can be immediately taken by the AMC is to conduct an annual external review and audit of each medical school’s final examinations. This will serve the important function of ensuring that valid and reliable assessments are being put into place. The final examinations should be properly “blueprinted” to check that the medical graduates have truly met important learning outcomes and have achieved the competencies set out in their curriculum or programmes. [7] It will also provide opportunities for the AMC to maintain the national agreed standard for Australia. [8] The current key issues here are social accountability and patient safety, both of which are extremely important topics amongst the Australian medical education community and all state health services. [9]

The annual external review and audit of final examinations can also strike a balance, allowing medical schools to maintain autonomy over curriculum development,the AMC is to conduct an annual external review and audit of each medical school’s final examinations. This will serve the important function of ensuring that valid and reliable assessments are being put into place. The final examinations should be properly “blueprinted” to check that the medical graduates have truly met important learning outcomes and have achieved the provided they can demonstrate that their graduates meet the national agreed standard.