Safe Conduct of Professional Examinations During the COVID-19 Pandemic in Hong Kong: A Descriptive Study

Background: Many medical schools and specialist accreditation bodies worldwide have cancelled or postponed professional examinations due to the COVID-19 pandemic. In Hong Kong, final-year medical students are not required to sit public examinations to qualify; rather rely on internal assessment. We therefore proceeded to administer all scheduled final-year statutory examinations during the months of April and May 2020. Methods: All 206 graduating medical students sat both written and objective structured clinical (OSCE) examinations under conditions of strict infection control, including self-reported health declaration forms (HDF), temperature screening and viral polymerase chain reaction (PCR) testing. Findings: Between 201 and 203 students who submitted a clean HDF were permitted to attend the examination venues. Fifteen (7·3%) students were found to have a tympanic temperature of ≥37·5°C on April 1, 2020, but their posterior oropharyngeal saliva samples taken on the same day were COVID-19 PCR-negative. Another 2 and 1 students were found to have a temperature ≥37·5°C on April 3, 2020 and April 9, 2020 respectively, but who were also tested COVID-19 PCR-negative. The tympanic temperatures of these 18 candidates were significantly higher than the rest throughout all examination days of the written (p≤0·0014) and OSCE (p≤0·039) examinations (except on April 15, 2020), suggestive of a higher basal body temperature. All staff members and participating patients with close contacts with the candidates/staff were free from COVID-19 before and after all examinations, up to 14 days post hoc. Interpretation: Rigorous clinical professional examinations could be safely conducted during the COVID-19 pandemic provided stringent infection control measures were followed. The choice of body temperature cutoff could significantly impact the assessment process for which we propose a number of mitigating measures for future reference. Funding Statement: None Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This cohort study was approved by HKUMed and designed by the investigators.