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COMPUTER-BASED MEDICAL AND DENTAL COLLEGE ADMISSION TEST (MDCAT) IN PAKISTAN: A REFORM OR COMMOTION?

In Pakistan, there used to be a separate system of examinations in each province to get admission in Bachelor of Medicine, Bachelor of Surgery (MBBS) and Bachelor of Dental Surgery (BDS).It was a very efficient, transparent, reliable and authentic system unless it was decided to hand-over the task of conducting the exam to a private company called TEPS. In 2019, upon the dissolution of Pakistan medical and dental council (PMDC) and replacing it with Pakistan medical commission (PMC), it was unanimously decided to conduct a centralized examination across the country to provide a level-playing field by hiring a private company “TEPS”. Well, it made sense that this decision was in the best interest of students according to PMC and a way forward to standardization. However, assigning such a major task to the private company not only put the reliability of PMC at risk but also raised queries against its integrity. TEPS was not an authentic body to be given such a crucial task. Later on, in 2021, not only the examination was centralized but also it was taken on tablets computers with so many faulty techniques and errors, which raised many concerns amongst the students. This action put the student’s future at stake and turned out to be a disaster causing more harm than good.  
Initially, this decision was unacceptable to pre-medical students because they weren’t aware of this new pattern and weren’t prepared for it. Also, COVID-19 hit hard in 2020 and since then it resulted in the loss of precious time and studies of students. The students were not satisfied with the whole process, but somehow exam was conducted. According to the president of PMC, a total of 194,133 students appeared in the Medical and Dental College Admission Test (MDCAT) from 30th August to 2nd October 2021. Out of all, 68,680 students succeeded in the exam, making an outcome of 35.4 per cent pass percentage.1 The president reiterated and kept vouching for the authenticity and transparency of the exam.   
On the other hand, PMC was assailed by the pre-medical students after the exam. According to students, the examination was conducted on multiple days, with few being the most challenging than others in respect to the difficulty level. Ironically, during the exam, they weren’t provided with a good internet facility; thus, in most cases, students were unable to answer skipped questions and even some of them weren’t able to finish the exam in time.2 Questions were also raised regarding critical technical issues in construction of multiple choice questions (MCQs) without any item analysis or difficulty/discriminatory index by the experts. The credibility of MDCAT results was further jeopardize by declaration of results by PMC which were full of errors and blunders.3,4 
Apart from this, PMC launched a question bank for preparation prior to the exam, which was not readily available to everyone since it was costly and not many were aware of it. Students complained about hacking of TEPS website as they were not getting access to the practice test on the website for few days. Questions were also raised about the contract of PMC with TEPS for conducting MDCAT examinations, which was later on declared as a violation of the rules of Public Procurement Regulatory Authority.5 
 Moreover, the evaluation of exam through a third party and revision of results further raised eyebrows. It gave an impression that the firm that was assigned this task to conduct exam was not prepared and the quality of MCQS and their reliability was questionable. However, PMC’s officials denied all the grievances and kept reassuring that the exam was conducted on a local network, irrespective of the need for internet connectivity. Similarly, it was reported that few questions were out of course and students faced a lot more difficulty in answering them. Furthermore, they added that the course syllabus was already shared on their website and all questions were reviewed by the subjects’ specialists.6  
Students have their own excuses and PMC responds with their own arguments, but there is an obvious gap and lack communication between them. It’s a call for urgent attention of the president of Pakistan and other concerned officials to take notice of this newly imposed system by PMC and revisit it for better improvements. It’s completely unfair to be oblivious to such an issue. Nevertheless, it has caused more damage to the students and in many cases, they are in a terrible dilemma and reluctant to pursue a medical career in future.