Background: Osaka University has introduced a new oral examination that evaluates comprehensive clinical competency. The purpose of this study was to clarify the characteristics of this examination.
Method: We compared the scores of this examination with those of other aßeßments: basic medicine, clinical medicine, computer–based testing （CBT）, objective structured clinical examination （OSCE）, and clinical clerkships.
Results: The Pearson correlation coefficient between this examination and other examinations was relatively low: basic medicine, 0.32; clinical medicine, 0.36; CBT, 0.44; OSCE, 0.39; and clinical clerkships, 0.24. Principal component analysis revealed that this examination could be grouped with OSCE and clinical clerkships, whereas basic medicine, clinical medicine and CBT could be grouped.
Conclusions: This new oral examination evaluates aspects of the examinees distinct from aspects evaluated by other examinations and could be an indicator of ability to solve clinical problems.

Background: In 2011, Osaka University abolished the paper–based final examination at the end of 6th year of medical school and introduced a new examination that evaluates comprehensive clinical competency after clinical training.
Method: For this examination, sequential scenarios were developed that demonstrate the process of problem solving in patient care. The examiners administered an oral test to students using the scenarios in the same manner as ward rounds and evaluated the clinical competency of students according to their attitudes, knowledge, and thinking.
Results: The examination was administered smoothly. Eighty–nine percent of examiners and 59% of students affirmed the significance of the examination in a questionnaire.
Discussion: Our reform of the final examination was met with acceptance, especially by examiners. To assess clinical competency more accurately, our next goal is to integrate performance–based assessment into the sequential scenarios..

OBJECTIVE: To investigate the utility of serum squamous cell carcinoma antigen (SCC-Ag) levels upon the diagnosis of recurrent cervical cancer for decision making in patient management. METHODS: Clinical records from 167 cervical cancer patients who developed recurrence between April 1996 and September 2010 were reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of serum SCC-Ag levels at the time of recurrence. The effects of various salvage treatments on survival outcomes of recurrent cervical cancer were examined with respect to serum SCC-Ag levels. RESULTS: Serum SCC-Ag levels were elevated (>2.0 ng/mL) in 125 patients (75%) when recurrence was diagnosed. These patients exhibited significantly shorter postrecurrence survival than those with normal SCC-Ag levels (log-rank; p=0.033). Multivariate analyses revealed that an elevated serum SCC-Ag level was an independent prognostic factor for poor postrecurrence survival. In patients with SCC-Ag levels <14.0 ng/mL, radiotherapy or surgery resulted in improved survival compared with chemotherapy or supportive care. In contrast, in patients with SCC-Ag levels of > or =14.0 ng/mL, salvage treatment with radiotherapy had only a minimal impact on postrecurrence survival. CONCLUSION: The serum SCC-Ag level measured when cervical cancer recurrence is diagnosed can be useful for deciding upon the appropriate salvage treatment.
Antigens, Neoplasm ; Carcinoma, Squamous Cell ; Decision Making ; Humans ; Multivariate Analysis ; Recurrence ; Serpins ; Uterine Cervical Neoplasms