Once the international standards at the student-levels and school-levels were set, a series of reports were prepared and presented to each school in the last week of April 2004. As the confidentiality of the result of this pilot examination was a priority, no school was allowed to see performance of any other school, and students were not allowed to compare their performance with another student's. The only comparisons allowed were with the international "cut point" standards established by the two global committees.

The reports of the pilot examination provided information on areas of strengths and areas which need improvements based on the developed international standards. The Deans of the participating schools received the full results of their individual students' performance. They also received a report on their students' aggregate performance as compared to the average results of students of all participating schools. In addition, each student, each involved faculty member and each university received a certificate confirming their participation in the first international competency examination. These detailed reports on each domain consisted of a four-page summary on each school, and a three-page report on individual student performances. As such, each student, each school and China at large has a blueprint for educational improvement. However, more importantly, the GMER examination process has also left a group of well-trained medical educators in each site who can continue to assess students by using international-quality assessment tools. There is no doubt that the process of improvement in the quality of medical education in China has already begun.

The summary report that includes the aggregated data from all right participating schools on strengths, borderline areas and areas needing improvement was presented to the Minister of Education on April 30, 2004.

This project is the first step in validating the concept of global outcome standards for the profession. With further administration of this assessment prototype in other countries, aggregate performance of students from different countries may provide better international performance data for future standard setting procedures. It should be also re-emphasized that the Global Minimum Essential Requirements are not intended to describe the complete competencies of medical graduate in any country. These competencies represent, at best, 60% of what constitutes competency for practice in any one location because of reasonable differences in local, regional, and national healthcare expectations and practices.


Format of Examination Report Presented to Schools

Your IIME Examination Report contains four sections: scores by International Domain, scores by International Sub-Domain, scores by Discipline, and correlations between your school examinations and the relevant IIME examination by discipline (in the case of schools that sent us internal exam scores). For each row in each table, you will find that the scores are calculated from one or more of the assessments that your school participated in last fall: Multiple Choice Questions (MCQ), Objective Structured Clinical Examination (OSCE), or faculty observations over three months. Most scores are based on a percent correct score (0 to 100%), some scores from the OSCE and faculty observations are on a 1 (low) to 5 (high) scale.

The average score for all Chinese students who participated are provided in the next column. The average score of your students are provided in the next column. An international panel of medical experts met and reviewed all the test materials, providing a "cut score" above which an individual student is considered to meet minimum competency standard for that item. The percentage of your students falling below the standard is in the next column.

For a subset of scores, an international panel of experts also identified the internationally acceptable failure rate for all students at a school. For example, 10% of students at one school may have scores below the international cut score. For this domain, the international experts may have identified a failure rate of 15% as acceptable. Therefore, this school would still be considered to have met the competency level for this domain. These values are listed only for Section 1, along with whether your school achieved this standard, was at the borderline, or could use improvement.

The purpose of this examination was primarily to evaluate the strengths and areas for improvement of schools in relation to international standards. The purpose was not individual student performance. Particularly for the OSCE and faculty observations, some individual student scores may actually be higher or lower because we observed your individual performance in only a limited number of settings, and the effects of observers can bias your score when few observations are recorded.

Students at your school have been provided individual reports with their scores in each of these areas. Student reports do not contain information on other students or other schools in China, only the international standard cut score, so that students can determine if their performance falls above or below the international standard.