Qualifying Exams for Medical Students: Are both major finals and continuous assessment necessary?

Students' performance in the Final Examination at Bristol Medical School was compared to their performance as assessed by in-course assessment. Over the six-year period studied, 5.5% of the 734 students failed the final examination at the first attempt but all subsequently passed. The overall continuous assessment score was a significant predictor of failure by the students in the final examination. It is argued that in the light of these findings and because of the documented disadvantages of a major final examination, such an examination is unnecessary.