COLLABORATION. The first structured clinical skills exam for doctors who are newcomers to Sweden, the OSCE, was recently carried out at Medicinareberget. Sahlgrenska Academy is offering the exam as part of a collaboration with Umeå University, which is responsible for the National Board of Health and Welfare’s “fast track” certification of newly arrived doctors.
The National Board of Health and Welfare has created a so-called “fast track” to allow recently emigrated doctors to join the Swedish healthcare system’s workforce more quickly and easily. This means that doctors who have received their education outside the EU/EEA must first take a theoretical exam as well as a practical one, which prove that their skills meet the requirements imposed upon doctors practicing in Sweden.
The practical exam has been dubbed the “Objective Structures Clinical Examination” (OSCE for short). At the end of March, the practical exam was administered for the first time in Gothenburg. Over the course of two days, 13 foreign doctors went from room to room of the KTC’s premises at Hälsovetarbacken, carrying out the various tasks involved in the practical exam.
During the course of the exam, the doctors encountered a new clinical scenario in each of these rooms. On the first day, the foreign doctors were given six minutes to handle 14 medical tasks/cases in as many rooms, and on the second day, they were faced with four additional stations, at each of which they were given 14 minutes to carry out more complex tasks.
“Of course, it’s extremely important that the exam be carried out correctly and that those taking the test don’t feel that anyone is given an unfair advantage. I won’t be evaluating the exam results, because I was part of the medical team who participated along with the doctors – but my personal impression is that everything went well,” says Associate Professor of Surgery Lars Börjesson.
The exam’s pass rate is over 50%
Lars Börjesson has extensive experience in carrying out clinical skills exams, and is responsible for coordinating Sahlgrenska Academy’s involvement in the National Board of Health and Welfare’s fast track program. Jennie Bengtsson, an academic adviser at the Institute of Clinical Sciences, is assisting him with the related administrative duties.
It was a big advantage that the exam could be carried out at the KTC (Sahlgrenska Academy’s clinical training center):
“We have to use all the KTC’s facilities, on two separate floors, which posed some logistical challenges. The KTC’s personnel really got involved, and were wonderfully supportive. Without their help and cooperation, it would have been a lot harder to administer the OSCE,” reflects Jennie Bengtsson. Lars concurs.
The 13 doctors who underwent the exam are all recently arrived in Sweden, and have taken up residence throughout the country. All of them had already passed the theoretical exam, which is the first step in the National Board of Health and Welfare’s fast track program. A clear majority of these doctors passed the practical portion of the exam, which they underwent here in Gothenburg. This means that they may now carry out a six month-long clinical medical residency, after which they may apply for a Swedish medical license.
The exam will be offered out on a biannual basis
Sahgrenska Academy will carry out the practical exam on a biannual basis; the next opportunity to take the exam will be in November of this year. The examination is being offered in collaboration with Umeå University, which is one of the academic institutions that has long been implementing the OSCE as a part of their ´regular medical training program. The National Board of Health and Welfare has put the university in charge of its fast track program for doctors educated in countries outside the EU/EEA.
“In recent years, many foreign doctors have arrived in Sweden. Umeå asked us if we might be willing to assist them with the exam process. For us, this means that we gain experience in the administration of a new form of proficiency test. If the proposed six year extension of our collaboration with Umeå is approved, the OSCE could eventually be included as a part of our medical training program,” elaborates Lars Börjesson.
Umeå University already administers similar practical exams to their medical students, and has therefore been put in charge of administering the OSCE to doctors who have recently arrived in Sweden from countries outside the EU/EEA, and who wish to obtain a Swedish medical license. Just before Christmas of last year, Umeå administered the practical exam to recently arrived foreign doctors for the first time. A group of course directors from Gothenburg were in attendance. Over the course of two days, assessors for 15 of the 18 exam stations learned more about how the practical exam process works in real life.
Many course leaders are involved
Demand for the exam is expected to grow, and the number of recently arrived foreign doctors who request admission to the National Board of Health and Welfare’s fast track program is projected to increase. The exam’s format is resource intensive, because each station must be manned by two assessors, and a third person (playing the role of the patient) is usually required, as well. Sahlgrenska Academy’s preparations for the OSCE have been extensive, and all-in-all have necessitated the involvement of roughly 75 people.
In order to be eligible to take the practical portion of the exam, the doctors must first have passed the National Board of Health and Welfare’s written proficiency exam for recently arrived doctors who received their training outside the EU/EEA. Doctors who wish to take the theoretical exam may prepare by studying on their own, or by taking part in an introductory training course developed by the National Employment Service in collaboration with the University of Gothenburg. The training course is held in Gothenburg, and is carried out over the course of a ten week period. The first introductory training course was offered last autumn. More information is available on the Akademiliv website: http://www.akademiliv.se/2016/12/37248/