Shieh Mei Lai¹
Kim Poh Chan², Rabind Antony Charles³, Li Yi Seah⁴, Rupeng Mong¹, Elaine Ching Ching Tan¹ and Yvonne Guat Keng Goh¹
1 Changi General Hospital
2 Sengkang General Hospital
3 Woodlands Health
4 Joint Committee on Specialist Training

Background

The COVID-19 pandemic affected medical education and examinations around the world, forcing many institutions to cancel examinations, or adapt to the situation with different assessment modes. At the height of the pandemic, Singapore’s Ministry of Health (MOH) instructed healthcare workers to avoid interaction between staff from different institutions. The Emergency Medicine Clinical Viva Exit Examination is a high-stakes examination which, if cancelled, would delay specialist registration. Hence the decision was made in July 2020 to conduct it virtually, using the video conferencing platform Zoom. 

The Clinical viva examination consists of 8 stations, each run by 2 examiners, containing clinical scenarios, with electrocardiograms, radiographs, or laboratory data for interpretation. On examination day, the examiners logged into Zoom using their laptops from home or hospital, and breakout rooms were created for each station. The candidates were at the examination venue, sitting in their own physical room with a laptop. An administrative assistant invigilated, and helped them log into the correct breakout room at each change of station. 

6 candidates sat this examination, and pass rate was 100%. During the examination we encountered problems with network connectivity. One examiner lost connection in the middle of questioning, and the other examiner had to take over for a while. Extra time was allocated to each round, to give allowance for technical difficulties. 

When feedback was obtained, candidates preferred the virtual examination, as it was less intimidating than facing the examiners directly. However, the examiners preferred a physical examination, as it was more stressful for them to share files on Zoom, and deal with technical glitches. 

We found that it was feasible to conduct a postgraduate oral examination virtually during the COVID-19 pandemic. However, good logistical support, reliable internet connection, and extra time allocation, are essential to its smooth running. 

References (maximum three) 

1. Papapanou M, Routsi E, Tsamakis K, Fotis L, Marinos G, Lidoriki I et al. Medical education challenges and innovations during COVID-19 pandemic. Postgrad Med J. 2022 May;98(1159):321-327. doi: 10.1136/postgradmedj-2021-140032. Epub 2021 Mar 29. PMID: 33782202. 

2. Gado AS, Khater RA. Conducting a medical examination in the COVID-19 era: an Egyptian experience. Egypt J Intern Med. 2021;33(1):9. doi: 10.1186/s43162-021-00038-z. Epub 2021 Mar 1. PMID: 33679124; PMCID: PMC7916992. 

3. Gupta VS, Kapur M, Naik M, Mohammad A. Post-graduate exams amidst COVID-19 pandemic: Our experience. Indian J Ophthalmol. 2020 Nov;68(11):2630-2631. doi: 10.4103/ijo.IJO_2672_20. PMID: 33120720; PMCID: PMC7774125.