A Malaysia (UPM) Medical Research Ethics Committee. This was a cross-sectional

The first-year Package 1 to Package 6 examinations comprise written assessment (multiple choice and HematoxylinMedChemExpress Haematoxylin shortChew et al. We used these as our primary study outcomes because they were important objective summative assessments. Scores on these tests decide whether the first-year students would proceed to the second year; and the final-year students to be conferred the medical degree. The first-year continuous assessment comprised the average percentage of the total of five end-of-package examinations on basic medical sciences. The final-year continuous assessment comprised the average percentage of the total six surgical and medical postings. These end-of-posting assessments comprise written assessment (multiple choice questions) and clinical examinations (long-case and/or short-case clinical examination). The final examination marks for first-year students was the end of the Package 6 examination. Final examination marks for final-year students were the aggregate Professional Examination III, which consists of multiple choice questions (MCQ), modified essay questions (MEQ), objective structured clinical examination (OSCE), long-case and short-case clinical examination. The first-year Package 1 to Package 6 examinations comprise written assessment (multiple choice and shortChew et al. BMC Medical Education 2013, 13:44 http://www.biomedcentral.com/1472-6920/13/Page 3 ofanswer questions) and objective structured practical examinations (OSPE). Performance was coded using the standard A to F grading system, with the following cut scores for each letter grade: A 75 , B + =70?4 , B 65?9 , B- 60?4 , C 50?9 and F