DARING TO BE DIFFERENT:CREATING A FAMILY MEDICINE QUALIFYING EXAM WHERE THERE ARE NO FAMILY DOCTORS

Introduction and Objective: Family medicine training is just beginning in Ethiopia. This rural country of 90 million has decided to address health care needs through primary care. TAAAC-FM is a collaboration between University of Toronto and Addis Ababa University. The three year family medicine program is about to graduate its first cohort. AAU’s medical school has a 40 year tradition with summative terminal examinations employing MCQs and Viva. What assessment strategies would be most appropriate for the determination of competence to begin the practice of family medicine? Methodology: 1. Engagement of the community of educators and learners ( participatory action approach) 2. Striving to be different from other previous examination traditions in order to help distinguish family medicine from other disciplines. This included integration of current assessment tools such as Short answer management problems, OSCEs and SOOs (Simulated Office Orals) adapted to the language of the clinical encounter in Ethiopia. 3. The exam should reflect the unique qualities of family medicine – in particular the importance of context. 4. The exam is part of a larger approach to programmatic assessment. Results and Conclusions: 1. Exam creation fostered faculty development in assessment strategies. 2. Exam fostered future teaching ideas using simulation. 3. The ‘Simulated patient’ was introduced as valuable and feasible in low resourced environment. 4. Broader ‘faculty wide’ interest in new assessment tools catalysed by novel family medicine exam. 5. Exam creation oriented teachers and learners to evidence- based teaching and assessment practices that should enhance learner experience. .