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The AMA House of Delegates went to bat for medical students by voting to "oppose the implementation of the Clinical Skills Assessment Exam as part of the United States Medical Licensing Examination by any means, including possible legal action."
No one questions the importance of teaching and evaluating clinical skills in medical schools, the delegates said. What was cause for concern at the AMA's June 14 -19 annual meeting in Chicago, however, was the proposed implementation date of the exam -- as early as June 2004. Delegates were concerned that this timetable could delay graduation for some students. That's because some schools require students to take and pass Step 2 -- soon to include this clinical skills component, in addition to the current clinical knowledge component -- in order to graduate. Such a delay could, in turn, mean a late start in residency training.
According to the National Board of Medical Examiners and Federation of State Medical Boards, which co-sponsor the USMLE, the new requirement pertains to all U. S. and Canadian medical students with graduation dates in 2005 or later. It will also affect students with earlier graduation dates who "have not passed the current clinical knowledge component of Step 2 taken on or before June 30, 2005."
For further details on the exam and the rationale behind it, go to http://www.usmle.org/news/cse.htm and click on "Clinical Skills Exam: FAQs."
The pending exam has been on the radar screens of AAFP student members for quite a while. Delegates at the 2002 National Congress of Student Members asked the Academy to "urge the National Board of Medical Examiners and Federation of State Medical Boards to delay implementation of the clinical skills assessment exam pending NBME investigation of methods to decrease the financial and travel burdens on students taking the CSAE and release of those findings."
Since that resolution was introduced, however, "it has become crystal clear that NBME is going forward with this no matter what," said Perry Pugno, M.D., M.P.H., director of the AAFP Division of Medical Education. "The decision was made to focus, instead, on encouraging NBME to try to minimize the costs to students and to ensure that the exam is available in as many sites as possible to mitigate travel costs," Pugno said.
Cost information is also available at http://www.usmle.org/news/cse.htm under "Costs of the Clinical Skills Exam."
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