Examination policy

Examination policy
in the Syrian Board for Medical Specialties

SECTION1: Examinations Department

Main tasks of examination department: The Examinations Department has the following powers and responsibilities:
1. Performing the basic procedures of the examination process, which include:
  1. Coordinating and monitoring the examination dates in cooperation with the scientific councils.
  2. Identifying examination centers in cooperation with scientific councils.
  3. Monitoring the examination process.
  4. Grading exams sheet.
  5. Forwarding the examination results to the Scientific Council.
  6. Handle objections from doctors assessed on exam results or the questions.
  7. Following-up objections and reviewing the exam papers.
  8. Announcing the approved results of the examinations.
  9. Archiving the results of the examinations.
2. Working in cooperation with the scientific councils to develop the fundamentals that help raise the examination process level to keep pace with the scientific committees’ work and boards of medical specialties in Arab and international academic bodies.
3. Identify the form of the adopted exam in coordination with the scientific councils for each specialty.
4. Conducting the examinations following the laws, regulations, and instructions in the Syrian Board for Medical Specialties.

Examinations Committee: Each scientific council of the Syrian Board for Medical Specialties forms a committee called the Examinations Committee, consisting of at least three members headed by the Chairman of the Scientific Council or one of the members. Its tasks are the following:
1. Preparing exam questions per the policy adopted (preferably two forms for each exam: A, and B).
2. Handlings questions of the exams from the different council members.
3. Arranging the process of setting up questions with the examination departments.
4. Discussing objections about questions in coordination with the Examinations Department.
5. Approving the exam results before submitting them to the Board of Directors.

SECTION2: Examinations Conditions

Exam language:

The Syrian Board holds examinations for Medical Specialties in Arabic and English provided that questions in English should not exceed 25% of the total number of questions. English is used to encourage resident doctors to read international periodicals and journals.

Types of examinations:

There are two essential examinations: The Primary and The Final ones. The scientific council might arrange other examinations.

a. Primary exam: The trainee takes the first exam at the end of the first year of residence for all It is held twice a year (first term – second term), which is composed of:

1. The written exam that complies with the curricula established:
  1. 70% of questions, basic science principles (physiology, anatomy, pathological biochemistry, and pathology) related to specialization.
  2. 30% of questions, clinical applications of sciences related to the field of specialization – by the scientific councils of different specialties.
2. The Questions are made up of two parts:
  1. the first section tests the trainee’s recall, understanding, and memory skills,
  2. the second section tests logic and application and includes clinical cases, diagnosis, therapeutic management, and other management.
3. The exam contains multiple questions with one correct answer with a total of only 100 questions per exam.
4. The success grade is 60% of the total mark.

General terms for applying for the primary exam:
1. The application form for the preliminary exam with all the necessary documents.
2. A document proving the completion of the training period required to enter the exam, certified by the specialized scientific council.
3. The logbook.
4. Receipt for payment of exam fees.

The scientific council will approve the names of the candidates at least one month before the exam.

b. Final exam:

The final exam consists of two separate sections (the written part, the clinical and oral part)
The resident doctor can take the final exam after completing the approved training period according to the specialty.
The exam is held twice a year (first term- second term) as follows:
1. Final written exam:
  1. Written exam assessing knowledge of advanced clinical sciences and competence in specialty practice. The exam includes clinical competence related to the specialization (less than 30% of questions about basic sciences – 70% minimum in clinical sciences ).
  2. The exam consists of MCQs with a single correct answer. There are 100 questions total in the MCQs.
  3. The success grade is 60% of the total mark.
General terms for applying for the Final Exam:
1. 1. Application form for the final written exam with all the required documents.
  2. A document proving the completion of the training period required to enter the exam, certified by the specialized scientific council.
  3. Success of the preliminary exam or being exempt from the preliminary exam.
  4. At least one full academic year after the preliminary written exam.
  5. Completion of the scientific and practical record of the logbook.
  6. Receipt for payment of exam fees.

The scientific council will approve the names of the candidates at least one month before the date of the exam

2. Final clinical and oral exam:

1. The clinical and oral exam is considered one unit.
2. Only those who have passed the final written exam and have a 60% or higher grade can take the oral clinical exam.
3. The passing grade for the oral clinical exam is 60% and above for each one.
4. The Scientific Council decides the form of the final clinical and oral exam, but it is preferred to include the following three sections:
  1. Power-Point slide’s station: consisting of several images (pathological conditions, equipment or radiological or laboratory issues) followed by questions about these images, and the resident doctor is asked to write the answer, which is granted a mark, that is added to the whole evaluation process.
  2. Oral Examination: Includes the presenting a written clinical case to the resident and asks him to answer orally several questions that gradually rise from the knowledge of the topic to the method of diagnosis, the management, the complications that might happen, and the follow-up within a clear and specific scale where the grades are distributed for each answer straightforwardly.

Management of clinical cases on an actual patient: either in the form of an clinical examination in the internal specialties, pediatrics, anesthesia and other similar clinical specialties (Objective Structured Clinical Examination) (OSCE), or surgical procedure in surgical specialties according to the nature of the specialty.

5.Grading the Final GPA: The final graduation grade is calculated according to the following formula:

_{60% of the written final exam grades + 40% of the oral clinical exam grades}

The resident doctor will pass the final exam if he passes all parts (written, clinical and oral) and receives a cumulative grade of 60% or above. The grade rating is graded as follows:

Final GPA	Degree
95%-100%	Honor
85% – 94.9%	Excellent
75% – 84.9%	Very good
65% – 74.9%	Good
60% – 64.9%	Fair

6.Opportunities to take the two main exams:

1. Opportunities to take the preliminary exam:
  1. A resident doctor is given four chances to take the exam, set at the same hour on different dates. After having fulfilled the entry requirements, his/her opportunities start counting on the first exam date. If a doctor’s exam opportunities expire, he/she will be written off the residency program.
  2. A resident doctor’s non-attendance to any of the four opportunities shall be counted as a taken opportunity with no reasonable justification.
  3. An additional opportunity may be given exceptionally at the discretion of the Scientific Council, which shall provide reasonable grounds for such action.

1. Opportunities to take the final exam (the oral and clinical):
  1. A resident doctor is given five chances to take the final exam, set at the same hour on different dates. His/her opportunities start counting on the first exam date, to be conducted after the doctor has achieved the conditions for entering the exam.
  2. In case of success in the final exam in its written part and failure in the oral clinical part, the trainee retains the written exam grade four times. If failing after these chances, the doctor must repeat the final written exam.
  3. An additional opportunity may be given exceptionally at the discretion of the Scientific Council, which shall provide reasonable grounds for such action.

7.Examinations in sub-specialties: Only a final exam is conducted in the sub-specialties (after the basic specialization). The trainee submits the exam according to the previous conditions of submission for the final exam. Direct sub-specialties are subject to the requirements of the general specialty’s needs.

8.Additional exams: The scientific councils can conduct additional examinations for residents at times specified by the council, such as:

1. The annual examinations which are conducted at the end of each academic year and do not affect the passing of the resident from one year to another.
2. An exam that evaluates clinical or surgical skills.
3. Examinations insignificant subjects within the specialty that the resident should pass during one of the years of residence, such as OB/GYN council set obstetric exam in the first year and examination of the anatomy of the upper limb in orthopedic surgery.

9.The number of exam times per year:

1. Preliminary exam: Twice a year.
2. The final exam is in two parts: twice a year.
3. Special sessions: determined by the decision of the specific scientific council.

Doctors' apologies for taking exams:

The resident doctor can apply for an apology for taking for the examinations if he/she sends a formal request signed by the president of the Scientific Council to the examination department. If the resident doctor does not comply with apologizing for the entrance to the exam, he/she is charged with an examination opportunity. If an acceptable excuse for not taking the exam, the fee is transferred to the next session.
The resident doctor can apologize for taking the exam only three times provided that the request for an apology is accepted. Then he/she must sit for the exam until the examination opportunities have been removed.
The reasons for accepting an apology are:
- A severe illness to the doctor who is applying for the exam.
- Serious illness/death of a first-degree relatives.
- Accidental conditions that significantly delay travel to the exam site include extreme weather conditions or road or airport closures.
Emergency security conditions outside the control of the resident (force majeure) that are reported at the time are such as displacement and shelling. A reason why absenteeism is not counted as an exam opportunity, as each case is estimated on a case-by-case basis.

The resident physician must provide documentation about the above circumstances, such as medical reports, airline cancellation or delay notices, etc. Additional documents may be requested. It must be received within 10 (10) working days of the application.

SECTION4: The Reliableness of the exam results:

The passing grade on the examination is 60%.
The related Scientific Council, in cooperation with the Examination Department, analyze the results of the examinations so that they are within the normal distribution average range, for example, questions that are not answered will not be calculated (score), either because the quesion is not clear, or very difficult to be answerd, then its mark will be added to the rest of the questions. The process must be reported, mentioning the deleted question and the reason for deltion, with the voting process, metioning all the members who contribute in the process, signed by the Chairman of the Scientific Council and Examination Officer.
Students with 58 or 59 marks are assisted by adding one or two marks to pass the exam.

SECTION5: Exemption from the examination:

The initial or final written exam may only be waived under the following conditions:
1. Trainees who have been trained outside the SBOMS programs and their training programs match the training programs of SBOMS. Those trainees are supposed to already passed the primary or final written examination. In such case, the trainee is to bring a passing certificate, then pay the registration fees for the SBOMS program – The examinations submitted to these trainees in their previous years of residency are considered equivalent to the primary or final written examination conducted by SBOMS, provided that no more than five years have passed since the date of their success.
2. Arab and foreign doctors who are subject to training programs outside Syria are exempted from similar training programs of SBOMS. They passed the initial or final written exam. They spent the necessary training period, provided that no more than five years have passed since the date of their success in the exam, provided that there are MoUs between parties.
It is not permissible to exempt from the final oral clinical examination (the interview), regardless of the status of the resident doctor and the evidence presented by him/her, as it is not possible to grant a certificate of specializations by SBOMS without passing the final practical interview examination in any way.
In cooperation with the examinations department, the specific scientific council will study the applications submitted to make the appropriate decision and then submit the proposal for an exemption to the Chairman of the board of directors.
No exemption shall be granted except after payment of all fees for registration with SBOMS.

SECTION6: Exam fees:

The resident doctor must pay all the required fees at least two weeks before date of examination.
If the resident’s excuse for taking the exam is accepted in the current session, the paid exam fee will be transferred to the next session of examinations.
It is not permissible to refund any of the exam fees paid by the doctor if he/she wishes to withdraw from the specialization.

Important note:

There is a bridge between the third and fourth year of residence for all specialties, and therefore the resident will not move from the third to the fourth year unless he/she has passed the initial exam.
The resident doctor moves from the current academic year to the next year after 12 calendar months (full calendar year) without requiring him to pass the preliminary written exam except for the transition from the third to the fourth year.
The Scientific Council can propose a transitional exam at the end of each academic year or at the end of one of the academic years to evaluate the resident doctor’s performance, but this is not mandatory and is specific to each scientific council.

SECTION7: Exam sanctions

1. With the intention of cheating, the resident doctor facilitating the cheating process for others, jamming, acting, or violation of the examination system shall be punished by issuing a warning during the exam. In case of repetition, the resident doctor who committed the offense is to be expelled from the hall and prohibited from taking the exams until the examination department decides the appropriate punishment.
2. The resident doctor who commits the offense shall be punished by deprivation of two exam sessions if he/she is found to possess any exam relevant note. This punishment is due in both cases whether the resident doctor who committed the offense benefits from the note or not or cheated in any way (small papers, writing on the seat, etc.).
3. The resident physician who carries a mobile phone, even if it is closed, is punished by depriving him of taking the exam for one or more exam sessions and may be dismissed from the specialty if the mobile phone was working or if he/she uses Bluetooth or Wireless transmission and benefits from it.
4. The resident doctor shall be punished by referring to a commission of investigation to issue the appropriate punishment in the case of conflicts with the invigilators of the exam, failure to comply with their exam instructions and laws, causing intentional rioting in the hall, or not delivering the examination papers at the end of the examination time.
5. The resident doctor shall be punished by the denial of the exam for two examination sessions in case of not handling the exam question papers (or one of the papers) to the invigilators of the exam for the sake of leaking questions.
6. The resident doctor shall be punished with the final dismissal of the SBOMS program if it is proven that he/she impersonated someone else intending to examine on his/her behalf. Likewise, the doctor who admitted a person instead of him/her for this purpose, and both shall be referred to the judiciary.
7. If the examination violation is repeated, the resident doctor shall be punished with a more severe penalty that may dismiss the specialty.

SECTION8: Requests for objections:

1. - Every resident doctor applying for the exam has the right to object to the questions or any problem that occurred in the exam within three days, provided that the objection is sent to the official email for the examinations.
  exam.office@sboms.org
  - Objection requests are studied by the Examinations Department and the specific Scientific Council, and the results are issued in no more than one week, and the results are confirmed in the exam transcript.
  - A resident doctor who is punished with being prohibited from examinations in one or more exam courses is registered and continues the residency program. The deprivation times is not counted from the number of exam opportunities allowed.