Replacing high-stakes summative examinations with graduated medical licensure in Canada

<h4><strong>KEY POINTS</strong></h4> <ul> <li>Disruptions to medical licensing exams in Canada during the COVID-19 pandemic have raised an opportunity for reexamination of processes for licensure.</li> <li>No evidence supports the effectiveness of current licensure exams in ensuring patient safety; the current process causes undue stress and directs valuable and limited resources toward passing an exam, potentially detracting from the more meaningful goal of preparing for independent practice.</li> <li>Best practices in medical and continuing education support the use of competency-based assessments, guided by robust programmatic assessment models, to judge fitness to practise, followed by life-long self-directed learning.</li> <li>Credentialing and licensing authorities should advocate for the resources required to replace current high-stakes summative assessments with graduated licensure and to develop quantifiable, nationally synergized, specialty-specific practice standards that support both the oversight of graduated licensure and maintenance of competence.</li> </ul><p></p>