The AAFP recognizes the importance of meaningful assessment of medical students’ clinical skills throughout their training and at the time of graduation. It is the responsibility of allopathic, osteopathic, and international medical schools to ensure their students’ competency in the performance of patient evaluation that includes a medical history, physical examination, and appropriate documentation. An evidence-based approach to learners’ clinical skills development should utilize standardized patient encounter simulations as a training and assessment tool. All individual medical schools to should provide their students with comprehensive clinical skills training, follow standardized guidelines to assess clinical skills, evaluate their students' on a consistent and reliable basis, provide students with dependable and transparent feedback, and remediate those who do not demonstrate competency. If medical schools cannot consistently provide an objective assessment of clinical skills, then other resources should be used to assure competence at various points during medical school and at the time of graduation.
If the National Board of Medical Examiners (NBME) or the National Board of Osteopathic Medical Examiners (NBOME) provide a clinical skills exam that is required by medical schools for graduation and/or by residencies for application, it should be both affordable and conveniently accessible to all medical students and international medical graduates. Efforts should be made by these boards to reduce test costs and other barriers that make accessing these required examinations a financial and logistical burden for those taking the exam. Performance standards and consistent reproducibility of a national clinical skills licensing exam should be updated regularly and made publicly available, along with outcomes data confirming the effectiveness of the examination’s capacity to document competence. Pass rates should not be set at certain percentages but should reflect the competent performance of the tested standards.
Without a clinical skills assessment requirement through NBME or NBOME, state licensing boards should not maintain a United States Medical Licensing Examination Step 2 Clinical Skills or Comprehensive Osteopathic Medical Licensing Examination of the US Level-2 Performance Evaluation score as an application requirement for residents or practicing physicians. (2010 COD) (January 2022 COD)