The National Board has a formal procedure that allows and encourages all candidates to challenge the content of specific test items during written examinations, or procedural matters during the Part III Clinical Skills Examination. For written examinations, space is provided on the back of each answer sheet for candidates to note possible ambiguities in individual test items or to make any other comments about examination quality issues. For Clinical Skills, candidates are given an incident report form, which they can complete at the end of the examination. Candidate comments are used by the appropriate examination council for review and possible action.