The abandonment of the RANZCP OCI - and why we may live to regret it

Abstract

Objective: The objective of this article is to explore the tension between what should be complementary notions of medical education and professional identity formation, referencing a major recent change to the assessment program of the Royal Australian and New Zealand College of Psychiatrists (RANZCP). The College recently determined that the observed clinical interview (OCI) is to cease with equivalent skills assessed by multiple workplace-based assessments within a competency-based education program. The literature relating to the change is briefly reviewed. The shortcomings of the OCI include concerns regarding reliability, validity, sustainability and transparency. Arguments in favour of keeping the OCI are then considered, including those made on grounds of reliability of the new instruments, validity of the new assessment program as a whole, the importance of professional identity formation and cultural considerations within the specialty. Conclusion: Education and professional identity formation are not synonymous. Applying educational evidence alone to assessment design may mean an opportunity for trainees to demonstrate qualities previously assessed at the OCI is lost. This may have negative consequences for the quality of RANZCP trained psychiatrists and for our patients. The OCI is a flawed instrument but the new system will be flawed in different and possibly more important ways.