MFSRH question writer and examiner: the art and science of ‘creation and revelation’
Date: 06 Sep 2023
Author: Dr Sujit Mukhopadhyay

In this blog, I explore the reasons that attract doctors to become question writers and examiners. The Irish writer, Oscar Wilde, proclaimed that “a writer is someone who has taught his mind to misbehave”—an assertion that can be applied to most creative individuals. Question construction is all about creativity.
The FSRH Exams Committee is responsible for establishing the content and recommending to the Education Board the format of Faculty examinations. The Committee is responsible for setting, marking, and reviewing questions and question papers to ensure the standard, validity and fairness of examinations and produces appropriate pass lists.
Applicants can apply to become a question writer for either Part I (basic science) or Part II (clinical science) of the MFSRH examinations. Successful candidates are then encouraged to produce questions (Single Best Answer, Extended Matching Questions, or OSCE’s) related to their specific areas of interest in FSRH practice.
Question construction is usually a time-consuming and daunting task. Novice question writers are provided with an induction and taught how to produce valid and reliable questions for exam use. The exam platform also allows us to understand medical statistics and the principles of standard setting. OSCE circuits are a valuable resource to improve upon our own communication skills: I tend to learn a lot from the best-performing examinees.
The hallmark of a good question writer is one who thinks the unthinkable—not by thinking outside the box but by mentally uniting several boxes of unconnected thoughts to create a totally novel thought. It is precisely this reason that attracted me to the fascinating subject of question construction and examining candidates.
CPD credits set aside, this charitable work for the faculty is academically an extremely fulfilling exercise. It allows us an opportunity to put our own learning into perspective: constructing questions related to both clinical and basic science. Needless to say, a eureka moment arises when one witnesses one’s questions being accepted for exam use and being banked successfully. It also allows a huge range of networking between other individuals from diverse places and to learn from each other’s clinical and non-clinical experiences.
Basic science proceeds by way of abstraction, focussing on revealing fundamental properties of living systems. By contrast, the complex world of disease is the focus of the clinician. Good quality question construction seeks to achieve a balance between these two domains and allows a question writer to focus on the most important aspects of our work.
The modern question writer’s state is best epitomized in the aphorism by Brown and Goldstein: ’Bewitched, bewildered, and bothered – but still beloved’’.
- J. Clin. Invest. Volume 99, Number 12, June 1997, 2803-2812
It is this beauty of question construction that enthrals me the most: generating a piece of scientific work that gives me a “cerebral chill” and an “intellectual kick” — one that combines the qualities of significance, generality, and unexpectedness.