Korean J Med Educ.  1989 Dec;1(2):54-61.

National Licensing Examination for Physicians : Its Future Renovative Directions

• Kim YI

Abstract

The National Licensing Examination for Physicians (NLEP) is a public evaluation tool to determine the minimum professional competence of medical school graduates necessary to practice medicine in the community. Thus, it plays a critical role not only to determine the national standard of health care but also to give a great impact on the level of educational objectives in each medical school. Currently, the Korean NLEP system has been the target of public critics for last twenty years because of its lagging behind expected functions as a national parameter to assess the competencies of the applicants. This failure is largely related to the unrealistic and irrelevant system and ignorance of the changing health needs in the community. Among many other features the followings are the important characteristics of Korean NLEP system contributing to its failures ; (1) qualification and licensing are not separated and are under the control of a same government authority ; (2) Executive process of the examination is managed by the bureaucratic operational body with no adivice from expertees in educational evaluation and no integral coordination or machinary for educational feedback from medical school objectives ; (3) Test Committee remains under the governmental authority only as an advisory body and little opportunity for comprehensive planning or renovative effort ; (4) One day written examination with 340 multiple choice questions cover 5 major disciplines and 8 minors ; (5) Passing level is fixed at 60 percentile of the total scores minimum baseline scores no more than 40 percentile in every disciplines. Despite continuous efforts for better NLEP system and efficient operation since 1975, only a tip of improvement has been made in the administrative aspect of the examination in the present Korean setting. This article outlines a proposal for future renovative plan of Korean NLEP based on the previously identified issues and problems. Followings are the summary of recommendations. 1) Foundation of the National Board of Licensing Examinations for Physician, a semi-independent, non-profit organization, can solve the problems with regard to the educational irrelevance of the present system. Organizational remodelling of the existing Test Committee along with strengthening of the executive and planning functions may be the alternative. 2) Appropriate research and development on future renovative planning should be based on and integrated with medical school objectives and community needs. 3) Specific issues and related resolutional plans regarding roles of the testing body are proposed and discussed along with improvement of system itself and technical renovations. Included are feasibility on the establishment of discipline-based testing subcommittees, independency of qualification and licensing procedures, preview of applicants' quality and of educational institutions, and liaison with medical school dean's council. In addition, appropriate procedures to determine the disciplines to be tested, passing level, tables of specification, number of test items, item bank, automation, recruitment of expertees, improvement of test item construction, and test item analysis are stressed.

MeSH Terms

Automation
Delivery of Health Care
Licensure*
Organizations, Nonprofit
Professional Competence
Schools, Medical