Reintroduction of Licensure Exams in Zambia by HPCZ

The Health Professions Council of Zambia (HPCZ) in a memo dated 28th April 2022 announced the resumption of licensure exams for newly graduated health professionals. This will be a prerequisite for practicing as a health professional which will bring it in line with other more advanced nations like the USA. This is following a hiatus of three years. The exact timeline of when the exams will start is not clearly stated but is earmarked for the third quarter of 2022. According to the memo, the move is backed by the Ministry of Health of Zambia and several stakeholders. This will have a direct effect on all new medical graduates wanting to practice medicine in Zambia. This will also affect all other health professionals like pharmacists, biomedical scientists and dentists.

Licensure exams will provide unifying exams to assess the competencies of the numerous medical graduates who have had varied medical training both locally and internationally. Currently, local graduates are not assessed outside of their medical university’s internal examination. They are allowed to seek provisional registration immediately after completion of their medical education and subsequently allowed to apply for full registration on completion of their internship. International medical graduates, however, are required to write an examination prepared by the HPCZ before they can be allowed to apply for provisional registration.

With the soon to be reintroduced exams, this will mean that local and international graduates will now write the same exams for licensing allowing for a more uniform assessment of the numerous medical graduates graduating every year. There are 8 medical schools registered on the World Directory of Medical Schools in Zambia with several others operating or planned to start operations. With average enrolments ranging from just below 100 to over 2000 per medical school this is a significant number of medical students in these universities who will eventually be medical graduates seeking registration. In addition, there is a significant cohort of Zambian and non-Zambian medical students pursuing their medical education in Eastern Europe and China amongst other countries that have plans of pursuing a medical career in Zambia. This diverse group of graduates will now have the opportunity of having a single exam for registration.

The format of the exams has not been released, but will most likely include a written paper, a viva which is an interview style exam where various medical scenarios are discussed and an objective structured clinical examination (OSCE) which is a set of stations involving performing various clinical tasks and answering a series of questions.

No schedule has been indicated but it would most probably be held in fixed intervals of time allowing for the medical graduates to be examined in groups. This may be similar to other licensure exams in other countries where exams are held either biannually, every quarter, every moth, every fortnight or even every day.

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There are a lot of mixed feelings concerning the reintroduction of the exams, with several argument being raised for and against them. Those in support feel that with the increasing number of medical universities and medical graduates coming from them, a standardized method of assessing these graduates effectively would in the long run be helpful for the quality control and improved patient safety, which is one of the most important principles of medicine, “primum non procere”, first do no harm. However, this would increase the red tape in getting locally trained medical graduates into the healthcare system who in all essence are often assessed by the same examiners who may be utilized for the licensure exams.

Ultimately, more information regarding the licensure exam will only be revealed once the third quarter rolls in.