Examinations are an essential element of medical education, which generates vehement debate but unfortunately a relative lack of rigorous critical analysis. There appears to be a background anxiety that research findings that might suggest an examination has been less than fair will lead to endless arguments with candidates who have failed that examination. It is a major responsibility of all those involved in examining to seek evidence of the fairness, reliability, and validity of the methods and the organisation of the tests. Computers have made analysis of results much easier. Access to shared banks of all types of questions and answer sheets should allow examiners to select the subject first and the assessment tool second but from a range of tested and continually modified questions which allow comparison of candidates' performance both in time and between institutions. The creation of examination materials and their evaluation must be considered as valuable an activity as research in academic life. There is little point in child health research if the advances in knowledge and skills that this generates cannot be shown to have been acquired eventually by present and future paediatricians.
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