The study focuses on the cognitive assessment of certification examination in medicine. The purpose was to investigate the relationship between the structure of the examination questions and the examinees' written responses. The responses from three groups of residents with undergraduate degrees from McGill (3), Toronto (2) and Manitoba (2) medical schools were used. A sample of one basic science and two clinical question in Endocrinology were selected. The responses were analyzed using cognitive methods which provided a qualitative assessment of subjects' knowledge structures relative to task. / The results showed that the responses did not always correspond to task requirements. There was a general tendency to focus on specific details that the subjects understood at the expense of the global aspect of the question. There was a greater variation in performance within groups than between groups. The results also suggest that undergraduate education may have less influence on the performance in certification examination than residency training. The importance of developing examination questions with high construct and criterion validity is discussed.

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