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Table 4 Summary of Driving and Hindering Forces along with strengths and weaknesses of a national medical licensing examination in Saudi Arabia

From: The need for national medical licensing examination in Saudi Arabia

Driving Forces Hindering Forces
1. Increase in number of medical schools over short period 1. Cost and time
2. Inconsistency and variable expertise in using valid and reliable assessment methods 2. Natural resistance to change
3. Large number of foreign medical graduates 3. Fear of discovering medical schools' weaknesses
4. Saudi medical students on scholarships to various countries 4. Restriction of medical schools freedom and flexibility on the choice of curriculum and assessment methods
5. What is taught is not necessarily what is learnt. Issues of planned, delivered, assessed and hidden curriculum 5. Difficulty on agreement on a set of educational objectives
6. Standardized testing for admission to medical schools and exit from residency calls for standardization of exit from medical school 6. Language barrier for non-Arabic speaking physicians in the OSCE part of the licensing exam
Strengths Weaknesses
1. Standardization of medical education leads to graduating medical students with the minimal required competences 1. Standardization of medical education leads to loss of creativity and innovation required of a critical thinker physician
2. Strengthens public trust and maintains the reputation of Saudi trained physicians 2. League tables might be potentially detrimental to the morale of staff and students of "weak" medical schools
3. Fair assessment of medical students and selection of candidates into residency program and jobs pool 3. The risk that students might be exam-oriented
4. Provides quality assurance and feedback on curriculum implementation and instructional methods across all medical schools 4. One time assessment is not as comprehensive as ongoing assessments of medical schools
5. Frees medical teachers to teach and do research and leaves the complexity of conducting examinations to the national organization 5. Burdens the students with additional financial commitment
6. Saudi Arabia may act as a regional center for high quality medical licensing examination