July 2002 • Volume 8 • Number 7 |
If the prospect of adding an additional six or seven hours to the already arduous United States Medical Licensing Examination somehow fails to bring tears of joy and thanksgiving to your eyes, you'll soon have a perfect opportunity to mount your soapbox and say so.
Just don't fool yourself: This thing IS going to happen. It's simply a matter of when, where and how much.
This topic will be addressed at one of three town hall meetings to be held Aug. 1 at the 2002 National Conference of Family Practice Residents and Medical Students in Kansas City, Mo.
Peter Scoles, M.D., NBME senior vice president of assessment, gave a brief recap of the issue:
"A clinical skills exam using hospitalized patients was part of the NBME examination program until 1964, when it was dropped -- with regret -- because of concerns about reliability," said Scoles. Recognizing the value of the clinical skills portion of the exam, the governance of NBME directed staff members to continue to pursue reliable methods of clinical examination.
The 1985 NBME Task Force on Licensure recommendations that led to the current USMLE called for inclusion of a clinical skills examination in the USMLE when such an exam could be shown to be valid and reliable. Since then, the NBME has worked with more than 50 medical schools on clinical skills exams that have been administered to tens of thousands of U.S. medical students.
"We are satisfied with the psychometric characteristics of the examination," said Scoles. "Our current round of field trials is specifically designed to test the logistics of administration of a standardized exam at two fixed test centers."
The exam will most likely consist of a minimum of 10 scored cases, with testing centers designed to permit administration of 12 to 14 cases should continuing research indicate a longer test is preferable. Each "patient encounter" will last about 20 minutes.
Cost for the added testing? Estimates based on costs for similar exams used by the Medical Council of Canada and the Educational Commission for Foreign Medical Graduates run from $750 to $1,200. And that's without travel costs.
Pilot testing in Philadelphia will be wrapped up later this summer, and an Atlanta pilot will begin in the fall. Assuming all goes as planned, the testing program is scheduled to launch in fall 2004.
FP Report is published by the
AAFP News Department.
Copyright © 2002 by
American Academy of Family Physicians.