Validation of core medical knowledge by postgraduates and specialists

BACKGROUND: Curriculum constructors and teachers must decide on the content and level of objectives and materials included in the medical curriculum. At University Medical Centre Utrecht it was decided to test relatively detailed knowledge at a regular level in study blocks and to design a progress test aimed at the medical core knowledge that every graduating doctor should possess. This study was conducted to validate the level of knowledge tested in this progress test. AIM: We designed a questionnaire to investigate whether postgraduate trainees and experienced specialists agree with item writers on what is required core knowledge. METHODS: Postgraduates and specialists received a questionnaire with 80 items designed to test core knowledge. Respondents were asked to indicate to what extent the items actually represented the core knowledge required of a recently graduated medical student. RESULTS: Of the clinical questions, 82.4% were judged to reflect core knowledge, whereas only 42.4% of the basic science questions were judged to reflect core knowledge. There was a strikingly high correlation on the mean judgements per item of postgraduate trainees versus medical specialists (r = 0.975). CONCLUSION: Many items, written to reflect core knowledge, appear to be judged by postgraduates and clinicians as pertaining to non-core knowledge. Postgraduate trainees appear to be as capable as experienced specialists of making judgements regarding core knowledge. Fewer basic science items are regarded as core knowledge than clinical items. This may suggest that, specifically, basic science teachers do not agree with physicians on what is to be considered medical core knowledge for graduating doctors.