How to ‘substantiate with reasons’

Disclaimer: This article is primarily intended for my students, but may be useful to others as well.

Background Information:

One of the question types in Kerala University of Health Sciences (KUHS) examinations is the ‘substantiate’ type (example below).


‘Substantiate your answer with reasons:

The World Health Organization establishes and promotes international standards in the field of health.’ (February 2018)


The dictionary meaning of substantiate is to ‘justify’, or ‘provide supporting evidence in favour of something’.

Step 1: Understand what you are supposed to do

Here, the student is supposed to take a stand for or against the given statement, and defend that position.

In the example above, students may either agree or disagree with the statement that the WHO promotes international standards in health.

Step 2: Understand the statement (motion/ thesis)

One of the main reasons students struggle with such questions is that they misunderstand or misinterpret the statement. Therefore, this step is crucial.

While it is desirable to have better proficiency in English, it is impractical to devote time towards that just before a university examination. Therefore, I suggest that students try to determine the meaning (or at least guess it) by breaking the statement into its key words.

Here, the key words are: WHO, establishes, promotes, international standards, health.

Even if a student is unfamiliar with the term ‘establishes’, the other words should enable an educated guess: the WHO promotes international standards in health.

Step 3: Take a position (for or against the statement)

Although the easiest option is to agree with the statement, this is not mandatory. As long as a reasonable justification is provided, learners can take any position- for or against the statement.

The choice of position will depend upon the following factors:

  • your confidence that you have properly understood the statement
  • your familiarity with the topic in question (here, one requires familiarity with the functions of the WHO)
  • the number of points for or against the statement
  • your ability to present an argument to defend/ support your position
  • your actual viewpoint

Note that it is more important to have a credible argument in support of your position, than stating your actual viewpoint- you are being assessed on your ability to take a position and defend it successfully.

Step 4: State your position

By now, you must be sure of your position and supporting arguments. The most important task at this juncture is stating your position clearly, and succinctly.

Avoid using words that are ambiguous, and check your sentences for clarity and meaning.

Tip #1: If you are in doubt, agree with the statement- usually it is expected that you will do so.

Tip #2: If your English language skills are poor, use the statement provided to begin your answer:- ‘Yes, the WHO establishes and promotes international standards in health’.

Step 5: Justify your position

This is the most critical aspect of the answer- merely agreeing with the statement without providing any reasons for agreeing will result in a much lower score.

You must present the various points in favour of your position in a clear, point-wise manner. Doing so will make it easier for the examiner to spot your argument(s), and often yields higher scores than unstructured paragraphs (because paragraphs are more difficult to read quickly; and the points are often buried therein- this increases the chance that the examiner will not spot the points made).

Take care to present points based on facts, not personal opinions. For instance, if you dislike the WHO for some reason, don’t write:

‘The World Health Organization does not establish and promote international standards in the field of health. It is simply an organization that implements western standards in the rest of the world.’

The above argument is based on opinion, not facts. Therefore, the argument is weak.

On the contrary, if the response was based on facts, one might write:

‘Yes, the World Health Organization establishes and promotes international standards in the field of health. It does so by

  • developing guidelines and protocols in health
  • developing and supporting comprehensive health programmes
  • promoting biomedical research
  • collecting and publishing health statistics and information
  • disease surveillance
  • maintaining international cooperation between countries and organizations.’

The above points are present in the textbook, and can be independently verified as well for accuracy. Therefore, these make for a strong argument in support of your position.

Step #6: Restate your position and conclude

After justifying your position, you must draw the attention of the examiner back to the original position- either for or against the statement. This is best done by restating your position in conclusion.

Here, one could conclude by stating:

‘Thus, the WHO establishes and promotes international standards in health.’

Additional considerations:

The minimum number of points in support of your position depend upon the statement, and marks available for the question under consideration. Since the assigned mark for such questions is two, you should ideally aim for four points (minimum two points).

The validity and clarity of your supporting arguments will determine  how many marks you receive on the answer. Therefore, resist the temptation of writing whatever comes to your mind first. Instead, write a carefully considered answer that best reflects your learning of the topic in question.


‘Substantiate your answer with reasons’ type questions require candidates to take a position (regarding a statement), and justify/ defend that position.

There are six steps in answering such questions:

  1. Understand what you are supposed to do
  2. Understand the statement (motion/ thesis)
  3. Take a position
  4. State your position
  5. Justify your position
  6. Restate your position and conclude

One may choose to either oppose or support the original statement, but should provide clear, fact-based justification for doing so.


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