United States medical licensing examination Step 1 scores are a quantifiably better predictor of American Board of Surgery In-Training Examination success compared to Step 2 scores

ABSTRACT The formal licensing of physicians in the United States began with the 1889 Supreme Court Decision Dent v. West Virginia. From that time forward, tests, in one form or another, have played a crucial role in medical licensing. In this essay we trace the history of testing from its beginnings in Xia dynasty China, 4000 years ago, though its adoption for the Indian civil service system by the British Raj, and finally ending with the 1992 introduction of the modern United States Medical Licensing Examination (USMLE). The focus here is on the most important development in testing since the Jesuits introduced written exams to the West in 1599 — the substitution of a large number of objectively scored multiple choice exam questions for a relatively small number of essays or interview questions. This approach provided increased reliability and validity of score, broadened the number of topics that could be addressed, diminished the cost of the exam, allowed results to be calculated almost instantly, and, through the use of computerized test administration, provided the opportunity for tests to be individually tailored for each examinee while maintaining comparability of scores across all examinees.

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Evaluation of a course to prepare international students for the United States Medical Licensing Examination step 2 clinical skills exam

Journal of Educational Evaluation for Health Professions ◽

10.3352/jeehp.2017.14.25 ◽

2017 ◽

Vol 14 ◽

pp. 25 ◽

Cited By ~ 2

Author(s):

Rachel B. Levine ◽

Andrew P. Levy ◽

Robert Lubin ◽

Sarah Halevi ◽

Rebeca Rios ◽

...

Keyword(s):

United States ◽

Medical School ◽

Clinical Skills ◽

The United States ◽

International Medical ◽

Pass Rate ◽

Pass Rates ◽

Medical Licensing ◽

Licensing Examination ◽

Usmle Step

Purpose: United States (US) and Canadian citizens attending medical school abroad often desire to return to the US for residency, and therefore must pass US licensing exams. We describe a 2-day United States Medical Licensing Examination (USMLE) step 2 clinical skills (CS) preparation course for students in the Technion American Medical School program (Haifa, Israel) between 2012 and 2016.Methods: Students completed pre- and post-course questionnaires. The paired t-test was used to measure students’ perceptions of knowledge, preparation, confidence, and competence in CS pre- and post-course. To test for differences by gender or country of birth, analysis of variance was used. We compared USMLE step 2 CS pass rates between the 5 years prior to the course and the 5 years during which the course was offered.Results: Ninety students took the course between 2012 and 2016. Course evaluations began in 2013. Seventy-three students agreed to participate in the evaluation, and 64 completed the pre- and post-course surveys. Of the 64 students, 58% were US-born and 53% were male. Students reported statistically significant improvements in confidence and competence in all areas. No differences were found by gender or country of origin. The average pass rate for the 5 years prior to the course was 82%, and the average pass rate for the 5 years of the course was 89%.Conclusion: A CS course delivered at an international medical school may help to close the gap between the pass rates of US and international medical graduates on a high-stakes licensing exam. More experience is needed to determine if this model is replicable.

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