The plans to radically revise the bachelor’s programme in Medicine date back to 2019. The revamped curriculum adopts “programmatic assessment”, a system already in use in the Master of Medicine. Rather than attending traditional lectures and tutorials and passing exams to earn ECTS credits, students take charge of their own learning. They build a portfolio to track their development, supplemented by teacher feedback and assessment results. At the end of each academic year, a committee reviews the portfolio to determine whether the student is ready to move on to the next year of the programme.
After several years’ delay – initially due to the Covid pandemic, followed by an additional year to allow for more preparation – the changes will finally be introduced in the Dutch-language bachelor’s programme this September for the new cohort of students. The much smaller English-language track has already been working with programmatic assessment since 2022.
Fair assessments
Even so, it appears students still have some concerns about the new system. During the Faculty Council meeting, familiar questions resurfaced – questions that have been repeatedly raised and addressed in recent years. Chief among them: how can assessments of students remain fair and objective when they rely so heavily on teacher feedback? “Some teachers are stricter than others, aren’t they?” And: “Without exams, how can you compare your performance to that of your fellow students?” Moreover, if everything hinges on one moment at the end of the academic year, “what’s to stop someone from doing nothing all year long and still scraping through at the last minute?”
Programme director Roger Rennenberg believes these concerns are unfounded. “Programmatic assessment is designed specifically to keep students engaged throughout the year – you’re constantly building your portfolio. In the current system, it’s possible to slack off for months and only spring into action during exam weeks.” He also stresses that exams aren’t disappearing entirely; while they no longer translate directly into credits, the results are still part of students’ portfolios. “But exam results only tell us something about knowledge acquisition. Programmatic assessment allows us to pay more attention to other skills, like communication, collaboration and professional conduct.” As for fears about subjectivity in teacher feedback, “teachers collectively agree what to focus on, and besides, you’ll receive input from a lot of different teachers over the course of your studies. Any individual differences will balance out – that’s precisely what makes the system objective.”
No decline
Another concern is that students feel like they’re being used as guinea pigs: “We’ve got no frame of reference for this.” But Rennenberg points out this isn’t a leap into the unknown – quite the contrary. “The Physician-Clinical Investigator (A-KO) master’s programme has always used portfolio-based assessment, and other master’s programmes adopted the system years ago – not only in Maastricht, but also in places like Amsterdam. And we’ve now got three years of experience with the English-language bachelor’s track. Those students are performing just as well on national progress tests as students at other universities or in previous cohorts. Our academic staff haven’t seen a general decline in performance either.” Moreover, the system isn’t unique to Medicine; the UM Bachelor of Psychology also switched to programmatic assessment last September – which sparked similar student concerns.
Rennenberg understands that change isn’t easy for everyone. “Not receiving marks may take some getting used to. Some students like to measure themselves against their peers. We saw the same reaction when we scrapped the ‘cum laude’ distinction – some students found it difficult. But in the real world, it’s not about chasing top marks at all. It’s about so much more than that. Also, we hope to attract students who actively choose this system and are genuinely enthusiastic about it. That’s who we’re trying to select, and so far, we’ve been quite successful. But there will always be some who find the adjustment harder than others.”