“Why Examine the Same Competence Twice?” — FGMSA Questions MDC’s Common Registration Exam (CRE)

The Federation of Ghana Medical Students’ Associations (FGMSA) has called for a rethink of the Medical and Dental Council’s (MDC) Common Registration Examination (CRE), questioning the need for an additional stand-alone examination for locally trained medical and dental graduates where the competencies being assessed can already be rigorously established through nationally harmonised and regulator-supervised final qualifying examinations.

Speaking to the Federation’s position, FGMSA President and Chief Spokesperson, Samuel A. Issifu, said the concerns being raised by medical and dental students should not be mistaken for resistance to regulation or rigorous competency assessment.

Rather, he said, the Federation’s case rests on a distinction between strengthening standards and duplicating assessment. “Our concern is not with standards. It is with duplication.”

The position forms the centrepiece of a statement issued by FGMSA on October 1, 2026, in which the Federation, representing more than 6,000 medical and dental students across Ghana, outlined its concerns with the CRE and proposed an alternative approach to assuring graduate competence.

Why another examination?

FGMSA says Ghana must have a medical and dental education system in which the competence of every graduate can be trusted, irrespective of the institution in which that graduate was trained.

The Federation has consequently welcomed efforts by the MDC to harmonise and standardise final qualifying examinations across accredited medical and dental schools. Its disagreement is over whether achieving that national standard requires another stand-alone examination after students have already satisfied their final qualifying requirements.

At the heart of FGMSA’s position is one question:

“What additional competency is the separate CRE intended to establish that a properly harmonised, nationally benchmarked and effectively MDC-supervised final qualifying examination cannot establish?”

Medical and dental students undergo years of academic and clinical training before sitting final qualifying examinations intended to establish whether they possess the knowledge, clinical skills, judgement and professional competencies required of graduates.

Where legitimate variations exist in the quality or rigour of these examinations across institutions, FGMSA argues that the regulatory response should be to address those variations at their source.

Strengthen the final examinations

Rather than opposing greater regulatory involvement, the Federation is advocating stronger MDC oversight of institutional assessments.

Its proposals include common national competency standards and assessment blueprints, harmonised final qualifying examinations, standardised OSCE structures and scoring, examiner training and calibration, stronger external moderation and deeper MDC participation in final examinations.

Where an institution fails to meet prescribed national standards, FGMSA believes regulatory intervention should address the deficiencies identified and hold the institution appropriately accountable.

“These are not alternatives to quality assurance. They are quality assurance at its source,” the Federation stated.

FGMSA has also pointed to the MDC’s own efforts towards harmonising institutional final examinations, including measures announced for aligning theory and OSCE assessments with national standards.

For the Federation, strengthening that approach offers a more coherent route to national competency assurance than requiring every locally trained graduate to demonstrate substantially the same competencies through another stand-alone examination.

Issifu stressed that the position should not be interpreted as seeking a lower threshold for entry into medical or dental practice.

“We are not asking Ghana to assess its future doctors and dentists less rigorously. We are asking Ghana to assess them more coherently.”

More than a question of cost

FGMSA has also raised concerns about the cumulative academic, financial and welfare implications of another high-stakes examination following final qualifying examinations.

However, the Federation says its principal objection is not financial.

Even if the CRE were administered at no cost, it argues, the substantive question would remain whether the separate examination establishes an additional competency that cannot already be reliably assured through strengthened, nationally standardised and MDC-supervised final examinations.

FGMSA calls for meaningful engagement

The Federation has also raised concerns about stakeholder engagement surrounding the implementation of the CRE.

FGMSA said it previously wrote formally to the MDC requesting an opportunity to present the concerns, questions and proposals of affected medical and dental students. According to its October 1 statement, that request had not resulted in the audience sought as of the date of publication.

Issifu said the Federation’s call for engagement does not mean that every position advanced by students must prevail. Rather, FGMSA believes those directly affected by such a consequential reform should have a genuine opportunity to be heard, have legitimate questions answered and receive sufficient clarity on its implementation.

The Federation has consequently indicated that it will pursue the matter through appropriate institutional and policy channels, including engagements with relevant state institutions, professional bodies and other stakeholders.

FGMSA maintains that the effort is not intended to create confrontation with the regulator, whose responsibility to safeguard professional standards and patient safety it acknowledges.

Instead, it wants the responsibilities of the regulator, training institutions and students brought into greater alignment.

A broader question for medical education

For FGMSA, the CRE debate ultimately raises a larger question about the medical education system Ghana wants to build.

If standards differ, the Federation argues, they should be harmonised. If examinations require strengthening, they should be strengthened. If regulatory oversight is insufficient, it should be deepened. And where institutions fail to meet the required standard, the deficiencies should be addressed where they occur.

The Federation says it remains open to constructive engagement with the MDC and other stakeholders towards a framework that maintains rigorous national standards without unnecessary duplication.

Its concluding message captures the balance it is seeking:

“We are not asking Ghana to choose between high standards and its students. We are asking Ghana to build a system capable of upholding both.”

#ReThinkTheCREMDC