To the Editor: The article by Sanson-Fisher and Lynagh criticising problem-based learning (PBL)1 has elicited surprisingly little response, especially in light of the fact that these authors are from the University of Newcastle, the institution that first introduced PBL in Australia.

The authors cite evidence that PBL students have inferior overall knowledge and competence than students taught by traditional curricula. Most medical faculties now have in-house education centres which are involved increasingly in learning process rather than content. The education centre in the Faculty of Medicine, Dentistry and Health Sciences at the University of Western Australia, for example, incorporates personal and professional development “as one of the four themes” in the curriculum2 — this includes such topics as ethical behaviour, diversity (what the patient brings to the relationship), self-evaluation (what the doctor brings to the relationship), teamwork, self-care and stress management. The old adage: “Those who can, do. Those who can’t, teach. Those who can’t teach, teach teachers” applies so appropriately to these new education centres.

I support Lawson-Smith in calling on the Minister for Health, the Australian Medical Council, the Australian Doctors’ Fund, the learned Colleges, all interested colleagues and medical students to support the proposal for a national exit exam based on the most important function of a medical school: core knowledge.3

Medical students and medical schools should compete nationally in an examination to assess core knowledge. “Competition promotes the pursuit of excellence” should surely be the mantra of every medical school.