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I don't like these tests. They test your PASSIVE knowledge, not your ACTIVE knowledge. For example, most people from India have high scores on these tests (like 8.5/9.0/9.5), but they are not given nice jobs in US/Canada easily.
I know of many Indians who are MDs (medical doctors),and have passed all needed valuation exams, but they are not given license to work as MD because they have terrible COMMUNICATION skills, many times US/Canadian patient cannot even understand what they are saying, because of their thick accents...Not everyone in India speaks English with RP accent, most people speak English with the local accent.
You can imagine what is like...you're in pain, you want be treated, yet you don't get what your doctor is saying...That's why these people need to work REAL hard to get nice jobs in the medical field (unless they opt for jobs with no patient contact, like laboratory medicine)...I've heard of many Indian and Pakistani MDs working as taxi drivers or delivering pizza.
It would be easier for EVERYONE if there were tests that test your ACTIVE knowledge of English too...if this was possible, we wouldn't see many people with high TOEFL/IELTS grades failing the USMLE CS (CS=Clinical Skills test)...these doctors have skills, but their PRACTICAL English is not good enough to take a patients history or have an interview with the patients.
So, please: ACTIVE KNOWLEDGE test please!
I agree: ACTIVE KNOWLEDGE has to be tested.
I once heard a physician from ( ) give an order for a heart medication that was, oh, thousands of times the usual dose. Don't worry, the patient was NOT given the dose, but you can understand the problem- especially with numbers.
What is ACTIVE KNOWLEDGE?