[Prescribing knowledge in final-year medical students attending a curriculum without a summative prescribing exam]

In Sweden, unlike some other European countries, there is no prescribing exam at the end of the final year of medical school. To investigate the level of knowledge achieved without such an exam, we developed an anonymous test consisting of 48 multiple choice questions which was completed by 80 final-year medical students at the University of Gothenburg (median age: 26 years; 56% female). Median percentage of correct answers was 51%. The test included 31 questions from the prescribing exam in the Netherlands. Using the pass mark from the examination in the Netherlands for these questions (85% correct answers), 7.5% of the Swedish students reached a sufficient level of knowledge. Only 12% of the students agreed that medical school had prepared them well for prescribing. In free text answers, more focus on pharmacotherapy education and training as well as undergraduate exams were frequent suggestions to increase junior physicians' professional competence in prescribing. To direct learning activities and student engagement as well as to ensure sufficient prescribing skills, we suggest the introduction of a prescribing exam in Sweden.