In reply: We appreciate the insightful responses to our proposal.1 Lawson-Smith alludes to one of the most significant justifications for a national examination — fairness. One cannot expect foreign medical graduates to attain a standard comparable with that of Australian graduates if we do not measure this standard. We propose that we owe fairness not only to foreign graduates coming to Australia, but also to Australian medical students who have a right to confidently expect an education that will lead to similar knowledge, skills and attitudes, irrespective of which university they choose. And finally, we owe fairness to society, which would also expect the same standards of graduates irrespective of where they come from. Unless we consider what are acceptable standards, we operate within an environment where standards of outcome differ from place to place and as we do not measure outcomes uniformly, we do not know how they differ nor have a system to address potential deficiencies.
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