What Medical Students Should Know About Post-COVID Exams

Introduction

In the wake of the COVID-19 pandemic, nearly every sector of society experienced a seismic shift—and medical and dental education was no exception. Licensing exams, which serve as pivotal gateways to professional practice, were significantly affected. With test centers shuttered, schedules disrupted, and anxiety levels soaring, students and institutions were forced to adapt to an evolving landscape of virtual assessments, delayed timelines, and new regulations.

This comprehensive guide explores how COVID-19 transformed medical and dental licensing exams, the lasting impacts of these changes, and what the future may hold for candidates preparing for these high-stakes evaluations.

Chapter 1: A Global Disruption – The Initial Shock

When the pandemic began in early 2020, it caused widespread closure of testing centers like Prometric, Pearson VUE, and university-based exam facilities. Exams that were typically conducted in tightly monitored rooms were either postponed or canceled outright.

Immediate consequences included:

• Mass cancellations: INBDE (Integrated National Board Dental Examination), USMLE Step 2 CS, NEET, PLAB, and other major exams were halted globally.
• Student distress: Anxiety and uncertainty plagued candidates who were unsure how long delays would last.
• Accreditation issues: Schools and governing bodies scrambled to figure out how to fairly assess final-year students and international medical graduates (IMGs).

Chapter 2: The Move Toward Online Assessments

One of the most significant transformations was the shift toward remote proctoring and online testing platforms. Institutions like the NBME (National Board of Medical Examiners), AMC (Australian Medical Council), and various dental boards experimented with secure online exams.

Key changes included:

• Remote proctoring tools: AI-based invigilation software was introduced to monitor students through webcams, screen sharing, and audio detection.
• Open-book or modified formats: Some exams adopted open-book systems to reduce academic dishonesty.
• Flexible scheduling: Examinees were given extended windows for scheduling to reduce crowding and allow social distancing.

This move made exams more accessible for candidates in remote or underserved areas but also raised concerns about exam integrity, technical failures, and digital inequality.

Chapter 3: Permanent Closure of the USMLE Step 2 CS

Perhaps the most radical change in the landscape was the permanent discontinuation of the USMLE Step 2 Clinical Skills (CS) exam in January 2021. Originally designed to test real-time patient communication and examination skills using standardized patients, the exam had long been criticized for its high cost and questionable relevance.

Impact on future assessments:

• Schools developed internal OSCEs (Objective Structured Clinical Examinations) to fill the gap.
• Increased focus on telemedicine and virtual patient interviews.
• Standardized assessments replaced by school-led competency evaluations.

Chapter 4: Delays and Backlogs in Licensing

With exams delayed, thousands of students faced bottlenecks in their progression toward residency programs or clinical practice.

Consequences:

• Delayed graduation: Many students were unable to meet licensure requirements on time.
• Residency placements postponed or canceled: Especially in international programs like UK Foundation Programme or Canada’s CaRMS.
• Visa issues for IMGs: Travel restrictions complicated exam access and application timelines.

Chapter 5: Adaptation by Governing Bodies

Regulatory bodies such as:

• The General Medical Council (UK),
• The National Board of Examinations (India),
• The Medical Council of Canada, and
• The American Dental Association (ADA)

implemented emergency protocols to accommodate candidates, including:

• Temporary licensing for students close to graduation.
• Waivers for specific practical components.
• Modified scoring and evaluation criteria based on available data.

These measures revealed the need for greater flexibility and resilience in medical education systems.

Chapter 6: The Surge in Online Study Resources

As in-person coaching centers and university libraries shut down, students pivoted toward online platforms.

The boom included:

• YouTube channels and video lectures.
• Web-based MCQ banks (e.g., AMBOSS, Lecturio, Osmosis, Pastest).
• Live Zoom coaching sessions and webinars.
• Virtual OSCE simulators and interactive dental case platforms.

This era birthed a new self-directed learning culture, making resources more accessible but also overwhelming due to the abundance of options.

Chapter 7: Equity Challenges in Remote Testing

Remote proctoring, while innovative, was not without controversy.

Challenges faced by students:

• Unstable internet connections leading to automatic exam failures.
• Privacy concerns about being recorded for hours at home.
• Bias against neurodivergent or disabled students, who struggled with non-human monitoring systems.

The pandemic highlighted the need to make testing more inclusive and universally accessible.

Chapter 8: Mental Health and Burnout

Medical and dental students were among the most severely affected in terms of mental health during COVID-19.

Stress factors included:

• Uncertain career timelines
• Exam rescheduling and financial strain
• Lack of access to clinical rotations
• Grief and fear from working on the front lines during clinical internships

In response, some exam boards introduced mental health support hotlines, free extensions, and resit waivers, but many students felt these were insufficient.

Chapter 9: Long-Term Implications on Licensing Exams

The effects of COVID-19 will ripple through medical licensing for years. It forced educators, licensing bodies, and candidates to reimagine assessment in a digital-first, post-pandemic world.

Potential future trends:

• Hybrid models of testing (in-person and online).
• Greater use of simulation-based exams.
• More emphasis on continuous assessment over high-stakes finals.
• Remote clinical interviews and OSCE stations via video.

These changes may make exams more adaptable and competency-focused—but the healthcare field must continue investing in equitable technology and robust frameworks to support this shift.

Chapter 10: Conclusion – A Turning Point for Medical and Dental Education

COVID-19 was a stress test that exposed weaknesses in the traditional licensing exam model—but it also sparked innovation. By accelerating the adoption of digital tools, encouraging systemic flexibility, and spotlighting student well-being, the pandemic may have catalyzed a long-overdue transformation in medical and dental licensing.

For current and future candidates, the key will be staying updated, adapting to new formats, and embracing technology as a core part of the journey to licensure.