DNB exam during Covid-19 Pandemic in India
The year 2020 has brought many uncertainties to the life of students and trainees across all fields and medical education is not an exception.
While the effect which may even last beyond the pandemic itself, is unavoidable, the impact on trainees cannot be overlooked. Across the world, medical students in different stages of training are facing confusion and frustration about their training pathways. A few weeks back the news like ‘Doctors get jitters due to DNB exams’ was making round in Indian media.
Different countries have responded differently to the situation, The medical graduates in the UK have received early registration while Italy scrapped the final exams for graduation.
Given the fact that the covid-19 virus seems unlikely to disappear any time soon, expediting the process of medical education or skipping the pathway doesn’t seem like an answer in my view.
Rather the medical education system will have to find a new way of educating while maintaining the same standards even in the unprecedented times or even try to explore the unexpected advantages the new ways may have to offer!
Novel Medical examinations during novel Coivid 19 Pandemic
Earlier this year Imperial College London conducted an online exam for medical students, which was called as first of its kind in the world. National Board of Examination, India has come up with a similar concept and conducted online theory and practical exams for DNB students.
Apart from those who have taken the exam, many may not be aware of this virtually conducted theory and OSCE exam and its structure. I recently came to know this while talking to Dr. Janani Shankar who kindly agreed to answer the questions which students might have in their mind. She is a valued faculty for DNB in Pediatrics and a NBE examiner for the past many years.
Following is the excerpt from the discussion I had with Dr Janani Shankar
Q: Hi mam, what was the idea behind conducting the virtual exams?
Hi Everyone, Hope you all are well. Due to increasing numbers of cases all over India with lockdown posing travel restrictions, it was impossible to conduct practical exams in its usual pattern.
The practical exam was supposed to be held in April but got delayed due to the increasing cases, finally it was decided to conduct the exam online for the first time ever.
The priority was the health of students and at the same time, it was necessary to ensure continuity of the course while maintaining its standard. Practical exam test the clinical skill and cannot be waived off. The idea was prioritizing health while ensuring that the clinical skills of candidates are tested.
Q: What were the challenges in conducting this exam?
The challenges were of course the exposure of both examiners and candidates to the SARS-COV 19 virus. NBE did not want faculties and students to travel long distances as in past.
There will be no patients to run the exams, There was no previous experience for such an exam to both examiner and candidates.
To avoid COVID-19 killing the routine clinical Exam, we wanted to ensure that all three components: cases, viva, and OSCE should be included for a formal assessment of knowledge gathered during residency.
Q: Every year large no of candidates appear for DNB final exams. What arrangements were made to accommodate this number, given the issues like social distancing?
True, previously the exam was conducted at few centers and on different dates. This would have led to problems with social distancing.
To overcome this NBE arranged about 35 different centers which were almost three times more than the regular non-COVID times in order to make sure that social distancing can be practiced at all centers strictly and hence only around 10-12 candidates were slotted in each center.
Q: What is the pattern of DNB exams during pandemic?
The exam took place on the same day,same time at all 35 centers. A live video stream was relayed to the NBE from all the centers to ensure vigilance.
All three aspects of the practical exam, the cases, viva, and OSCE spots, were covered. The OSCE session was for 3 hours in the morning and this was followed by clinical case discussion which was also virtual.
Viva included testing of skills, Knowledge in Outpatient practice and NRP, etc. The answer sheets were scanned and uploaded immediately to avoid physical contact.
Q: But The DNB students never faced this kind of virtual examination in the past, in fact, none of us ever, how was this dealt with?
The entire schedule was planned meticulously with prior mock sessions for the candidates and examiners on different days. This was done online to give an idea on how the real exam will look and feel like.
Q: what about the results, did the virtual pattern has any impact on the time taken for declaring results by NBE?
No, in fact, Results were also declared within 3 weeks with a good pass percentage.
Q: What about theory examination?
Theory exams which were originally scheduled in June were also conducted during the last week of September.
This was conducted in engineering colleges with multiple computer screens as the question paper was shared on the screen.
There were no hard copies of question papers for fear of fomite transmission of the SARS CoV 2 virus. Again all the answer sheets were scanned and uploaded at the center by the invigilators.
Q: How was your experience with the exam overall?
It was very unique as no university in India has ever conducted a pure virtual examination in the past and I was fortunate to be a part of it. Practical exams were held in all other specialties too.
The exam was conducted smoothly without any hitches, kudos to the NBE team for doing a commendable job amidst the COVID-19 pandemic. This ensured the excellent track record of Pediatric post-graduate education conducted under NBE.
Q: What advice do you have for the students appearing for the next session?
Even though it's a somewhat new way of examination for DNB students and may be uncomfortable for few, we will have to accept it given the unusual circumstances.
I'm sure virtual practicals will continue for another 6 months at least, which is in a way favorable for the students. The example set by National Board for DNB exam will be followed by other medical universities for graduate and post-graduate exams.
While the frustration, medical students are going through is unimaginable, I hope this settles at least some if not all anxiety for you guys. If you have any other questions, leave them in the comments and let us try to get more answers for you. Happy Studying!
More articles by Dr Janani Shankar?
- Ding A. Medical education-collateral damage of COVID-19? Postgraduate Medical Journal Published Online First: 14 July 2020. doi: 10.1136/postgrad med -2020-138332
- Hannon, P., Lappe, K., Griffin, C., Roussel, D. and Colbert‐Getz, J. (2020), An objective structured clinical examination: From examination room to Zoom breakout room. Med Educ, 54: 861-861. doi:10.1111/medu.14241
- Payel Biswas. India’s medical students and residents grapple with uncertain futures in the face of covid-19. BMJ Blogs.
Dr Janani Shankar | DNB (Pediatrics) PhD MNAMS
Dr Janani Shankar is a senior consultant in Pediatrics and Pediatric Infectitious diseases at Kanchi Kamakoti Child Trust Hospital, Chennai, India. She is involved in teaching activities conducted by NBE across the country for many years and also an examiner for the DNB Pediatrics exam conducted by NBE