The US Medical Licensing Examination (USMLE) Step 2 Scientific Expertise (CS) evaluation is switching to a distant digital format, in response to an announcement detailed in a podcast on Thursday.
The all-day examination, which historically requires take a look at takers to have bodily contact with standardized sufferers, has been suspended throughout the pandemic for security causes.
Thursday’s announcement got here as a shock, as sponsors of the take a look at had introduced in Could that they’d proceed to droop Step 2 CS for the following 12 to 18 months, as reported by Medscape Medical Information.
“As Quickly as Potential”
Christopher Feddock, MD, MS, govt director of the Scientific Expertise Analysis Collaboration, stated on the podcast that the timeline has not been set for implementing the adjustments.
“Whereas we wish to relaunch the modified examination as quickly as doable,” he stated, “the examination has an impression on residency match timelines, college curricula calendars and momentary eligibility coverage adjustments presently in impact for each Step 3 and ECFMG (Instructional Fee for Overseas Medical Graduates) certification.”
David Johnson, MA, chief evaluation officer with the Federation of State Medical Boards, stated updates are anticipated “early in 2021” on the USMLE web site and on social media.
Feddock stated that surveys have gone out to first-year residents and program administrators to gauge the core actions of interns and the extent of talent anticipated for residents starting supervised follow.
Announcement Met With Criticism
Bryan Carmody, MD, a pediatric nephrologist on the Kids’s Hospital of The King’s Daughters, in Norfolk, Virginia, who has written extensively about adjustments to the licensing exams, questioned the timing of the announcement, which got here 2 days after a decision adopted on the American Medical Affiliation (AMA) Home of Delegates (HOD) assembly.
He advised Medscape Medical Information that the decision referred to as “upon the AMA to take ‘fast expedited motion’ to encourage the NBME (Nationwide Board of Medical Examiners) and NBOME (Nationwide Board of Osteopathic Medical Examiners) to remove USMLE Step 2 CS and COMLEX-USA [Comprehensive Osteopathic Medical Licensing Examination of the United States] Stage 2-PE (efficiency analysis).”
“[The HOD] referred to as for a ‘alternative examination course of’ to be administered by accredited medical colleges. Possibly the timing is simply coincidental, however for me, it was two massive items of USMLE Step 2 CS information dropping in nearly as many days.”
Audio system who had testified in help of the decision stated the examination “has an especially excessive go fee” and has not recognized critical deficiencies in college students’ schooling and coaching “used to justify” the expense and assets wanted to take the take a look at.
The USMLE’s determination to maneuver the examination to digital and distant generated some pointed responses on social media.
Mike Sales space, MD, affiliate dean at College of North Dakota College of Medication in Bismarck and writer of the adopted AMA decision, advised Medscape Medical Information that the proposed change within the Step 2 CS format is “ridiculous. …The entire level of the examination is to place the coed in entrance of a affected person in a stay interview format.”
“Waste of Cash”
Johnson acknowledged that sponsors have heard many complaints concerning the take a look at, together with the restricted variety of take a look at websites, the price of the examination (between $1300 and $1600), the “synthetic nature” of the standardized affected person, and the restricted suggestions examination takers obtained together with their scoring.
Stanislav Lazarev, MD, is certainly one of a number of who really feel that the Step 2 CS must be scrapped completely. He tweeted Thursday that it’s “a completely pointless take a look at,” motivated by revenue. “Each US medschool has medical expertise exams in yr 3 for every main specialty and these checks are adequate,” he writes.
Like Lazarev, Sales space, and others argue that the CS examination shouldn’t be obligatory and the associated fee and assets it makes use of “must be put to higher use.” Sales space says that the CS examination is “waste of cash and a waste of assets. …Ninety-nine p.c of the scholars do go the examination,” he stated. “The take a look at is not efficient to find issues. We’re chasing an issue that does not exist.”
He stated that in his years of educating solely three college students of 175 have ever failed it and that the take a look at is redundant given the thorough analysis of expertise already being performed in medical colleges.
The take a look at directors “haven’t been in a position to duplicate that,” he stated. “It is a very synthetic setting with plenty of flaws.”
Sales space agrees with the necessity for testing typically however says that the CS examination is not efficient and the proposed adjustments solely make issues worse.
“Why does NBME wish to be in the midst of this when now we have well-paid, extremely motivated medical college individuals who could be there within the room or within the subsequent room by a mirror watching what is going on on?” he asks.
Carmody stated that many college students have lengthy been against Step 2 CS, for a number of causes. It is doable, he stated, that the computer-based examination would tackle a number of the persistent objections.
“Though they have not introduced the registration price, a digital examination is likely to be inexpensive,” Carmody stated, “and may remove the necessity to journey to one of many testing websites. However implementing a computer-based examination will gas a number of the different issues about Step 2 CS, equivalent to its lack of predictive validity. Even the face validity of the examination to medical boards and the overall public could also be diminished by testing on this format.”
He stated he might be watching to see if the NBOME follows go well with.
“Sometimes they emulate regardless of the NBME/USMLE does, and their COMLEX-USA Stage 2-PE has come below heavy hearth as a result of, till not too long ago, they’d refused to decide to a long-term suspension of the examination, and had as an alternative continued to insist that osteopathic college students ought to journey to Chicago (a metropolis with a quarantine for guests) to take the COMLEX-USA medical expertise examination.”
“I’m wondering if they will attempt to do away with the in-person format when their take a look at resumes, too,” Carmody stated.
Carmody has disclosed no related monetary relationships.
Marcia Frellick is a contract journalist based mostly in Chicago. She has beforehand written for the Chicago Tribune, Science Information, and Nurse.com, and was an editor on the Chicago Solar-Instances, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Instances. Observe her on Twitter at @mfrellick.
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