Not only the candidates feel challenged when preparing for a Federal medical examination. Before MC questions are ready for examinations, they pass through numerous review and revision stages.

In the written part of the Federal Licensing Examination in Medicine, the primary concern is with assessing basic acquired knowledge rather than highly specialised subject knowledge. Moreover, it needs to be ensured that the tested knowledge is actually taught in all faculties. If, for instance, an MC question in the Federal licensing exam in Human Medicine is composed by an expert from Zurich, it has to be tested whether the students from Geneva, Basel, Lausanne and Bern are also able to answer it.

In terms of content, the work takes place on three levels:

• First, the questions are composed by subject experts from the various faculties,
• Next, they are discussed and revised within cross-faculty, subject-specific expert groups,
• Finally, they are reviewed by a National Review Board (consisting of experts from different subject areas) and, if necessary, revised again.

The Department for Assessment und Evaluation (AAE) supports this process in terms of both methodology and organisation.

Beyond the aspect of content, exam questions are also revised with respect to linguistic form. In this regard, the AAE draws up suggestions for avoiding possible solution hints (so-called “cues”), for eliminating superfluous information, and for standardising formulations, and it systematically compares all language versions (mostly German and French). In this way, exam questions become “well-rounded”. All candidates should understand the questions immediately. The questions should not test the students’ combination skills, but rather first and foremost their knowledge and their medical competences.