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.. Objectives: The main objective of this study was to judge the quality of MCQs in terms of their cognition level and item writing flaws, developed by the faculty of a public sector medical college. Setting: This study was conducted in Sheikh Zayed Medical College, Rahim Yar Khan. Duration with Dates: Data was collected between June 2014 to March 2015 and this study was completed in July 2016. Sample Size: A sample of 500 MCQs collected from 25 faculty members were included in the study. Study Design: Quantitative method. Study Type: Cross sectional descriptive analysis. Material and Methods: This quantitative study was conducted in Sheikh Zayed Medical College Rahim Yar Khan over six months period after the approval of the study proposal. Every faculty member is supposed to write 25 MCQs in order to become supervisor. I collected 500 multiple choice questions from 25 faculty members ready for submission to CPSP. The quality of all MCQs was checked in terms of item writing flaws and cognition level by panel of experts. Results: Absolute terms were observed in 10(2%), vague terms in 15(3%), implausible distracters in 75(15%), extra detail in correct option 15(3%), unfocused stem 63(12.6%), grammatical clues 39(7.8%), logical clues 18(3.6%), word repeats 19(3.8%), >then one correct answer 21(4.2%), unnecessary information in stem 37(7.4%), lost sequence in data 15(3%), all of above16(3.2%), none of above 12(2.4%) and negative stem 23(4.6%). Cognition level l (recall) was observed in 363(72.6%), level ll (interpretation) in 115(23%) and level lll (problem solving) in 22(4.4%) items. Total 378(75.6%) flaws were identified and four commonest flaws were implausible distracter 75(15%), unfocused stem 63(12.6%), grammatical clues 39(7.8%) and unnecessary information in stem 37(7.4%). Conclusion: It is concluded that assessment of medical students is very demanding and need of the time. A wellconstructed, peer-reviewed single best type MCQ is best one to complete this task because of cost effectiveness, better reliability and computerized marking. It is very important to start faculty development program in order to decrease the number of item writing flaws and improve cognition level towards problem solving and application of knowledge.

MULTIPLE CHOICE QUESTIONS; DEVELOPED BY THE FACULTY OF A PUBLIC SECTOR MEDICAL COLLEGE