scholarly journals National Board of Medical Examiners and Curriculum Change: What Do Scores Tell Us? A Case Study at the University of Balamand Medical School

2020 ◽  
Vol 7 ◽  
pp. 238212052092506
Author(s):  
Mode Al Ojaimi ◽  
Megan Khairallah ◽  
Rayya Younes ◽  
Sara Salloum ◽  
Ghania Zgheib

Objectives: This study describes the results of NBME (National Board of Medical Examiners) implementation in Balamand Medical School (BMS) from 2015 to 2019, after major curricular changes were introduced as of 2012. BMS students’ performance was compared with the international USMLE step 1 (United States Medical Licensing Examination, herein referred to as step 1) cohorts’ performances. The BMS students’ NBME results were analyzed over the successive academic years to assess the impact of the serial curricular changes that were implemented. Methods: This longitudinal study describes the performance of BMS preclinical second year medicine (Med II) students on all their NBME exams over 4 academic years starting 2015-2016 to 2018-2019. These scores were compared with the step 1 comparison group scores using item difficulty. The t test was computed for each of the NBME exams to check whether the scores’ differences were significant. Results: Results revealed that all BMS cohorts scored lower than the international USMLE step 1 comparison cohorts in all disciplines across the 4 academic years except Psychiatry. However, the results were progressively approaching step 1 results, and the difference between step 1 scores and BMS students’ NBME scores became closer and not significant as of year 4. Conclusions: The results of the study are promising. They show that the serial curricular changes enabled BMS Med II students’ scores to reach the international cohorts’ scores after 4 academic years. Moreover, the absence of statistical difference between cohort 4 scores and step 1 cohorts is not module dependent and applies to all clinical modules. Further studies should be conducted to assess whether the results obtained for cohort 4 can be maintained.

2013 ◽  
Vol 37 (4) ◽  
pp. 370-376 ◽  
Author(s):  
Andrew R. Thompson ◽  
Mark W. Braun ◽  
Valerie D. O'Loughlin

Curricular reform is a widespread trend among medical schools. Assessing the impact that pedagogical changes have on students is a vital step in review process. This study examined how a shift from discipline-focused instruction and assessment to integrated instruction and assessment affected student performance in a second-year medical school pathology course. We investigated this by comparing pathology exam scores between students exposed to traditional discipline-specific instruction and exams (DSE) versus integrated instruction and exams (IE). Exam content was controlled, and individual questions were evaluated using a modified version of Bloom's taxonomy. Additionally, we compared United States Medical Licensing Examination (USMLE) step 1 scores between DSE and IE groups. Our findings indicate that DSE students performed better than IE students on complete pathology exams. However, when exam content was controlled, exam scores were equivalent between groups. We also discovered that the integrated exams were composed of a significantly greater proportion of questions classified on the higher levels of Bloom's taxonomy and that IE students performed better on these questions overall. USMLE step 1 exam scores were similar between groups. The finding of a significant difference in content complexity between discipline-specific and integrated exams adds to recent literature indicating that there are a number of potential biases related to curricular comparison studies that must be considered. Future investigation involving larger sample sizes and multiple disciplines should be performed to explore this matter further.


2020 ◽  
Vol 12 (02) ◽  
pp. e251-e254
Author(s):  
Saif A. Hamdan ◽  
Alan T. Makhoul ◽  
Brian C. Drolet ◽  
Jennifer L. Lindsey ◽  
Janice C. Law

Abstract Background Scoring for the United States Medical Licensing Examination (USMLE) Step 1 was recently announced to be reported as binary as early as 2022. The general perception among program directors (PDs) in all specialties has largely been negative, but the perspective within ophthalmology remains uncharacterized. Objective This article characterizes ophthalmology residency PDs' perspectives regarding the impact of pass/fail USMLE Step 1 scoring on the residency application process. Methods A validated 19-item anonymous survey was electronically distributed to 111 PDs of Accreditation Council for Graduate Medical Education-accredited ophthalmology training programs. Results Fifty-six PDs (50.5%) completed the survey. The median age of respondents was 48 years and the majority were male (71.4%); the average tenure as PD was 7.1 years. Only 6 (10.7%) PDs reported the change of the USMLE Step 1 to pass/fail was a good idea. Most PDs (92.9%) indicated that this will make it more difficult to objectively compare applicants, and many (69.6%) did not agree that the change would improve medical student well-being. The majority (82.1%) indicated that there will be an increased emphasis on Step 2 Clinical Knowledge (CK) scores, and many (70.4%) felt that medical school reputation will be more important in application decisions. Conclusion Most ophthalmology PDs who responded to the survey do not support binary Step 1 scoring. Many raised concerns regarding shifted overemphasis on Step 2 CK, uncertain impact on student well-being, and potential to disadvantage certain groups of medical students including international medical graduates. These concerns highlight the need for reform in the ophthalmology application process.


2010 ◽  
Vol 2 (3) ◽  
pp. 316-321 ◽  
Author(s):  
Jeremy R. Rinard ◽  
Ben D. Garol ◽  
Ashvin B. Shenoy ◽  
Raman C. Mahabir

Abstract Objective We explored the impact that attributes of US medical school seniors have on their success in matching to a surgical residency, in order to analyze trends for National Resident Matching Program (NRMP) match outcomes in surgical specialties between 2007 and 2009. Methods Using Electronic Residency Application Service data and NRMP outcomes, we analyzed medical students' attributes and their effect in successfully matching students into residency positions in surgery, otolaryngology, orthopedic surgery, plastic surgery, and obstetrics and gynecology. Attributes analyzed included self-reported United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Alpha Omega Alpha (AOA) Honor Medical Society membership, research experience, additional graduate degree status, and graduation from a top 40 National Institutes of Health (NIH)–funded medical school. Odds ratios were calculated for each criterion, and 95% confidence intervals were used to determine significance. Results Between 2007 and 2009, the number of surgical specialty residency positions increased by 86, and the number of applicants increased by 34. Membership in AOA, USMLE Step 1 and Step 2 scores, research experience, and graduation from a top 40 NIH-funded medical school frequently had a significant impact on residents successfully matching into many specialties, while additional graduate degrees had no effect on matching into surgical specialties (range 0.64 to 1.2). Conclusions Although the statistical significance varied across specialties, higher USMLE Step 1 and Step 2 scores, AOA membership, research experience, and graduation from a top 40 NIH-funded medical school generally had a positive impact on match success to surgical residency for US allopathic seniors. Test preparation and seeking research experience during undergraduate medical education may be effective approaches for increasing the likelihood of success for US seniors matching into a surgical specialty.


PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Eron Drake ◽  
Julie P. Phillips ◽  
Iris Kovar-Gough

Introduction: The United States Medical Licensing Examination (USMLE) Step 1 will transition to a pass-fail format in 2022. This is likely to result in an increased focus on Step 2 Clinical Knowledge (CK) scores. Thus, academic advisors must provide evidence-based guidance for preparing students. While prior research has examined the utility of academic indicators to predict student performance on the USMLE exams, no significant scholarly effort has described or evaluated students' study approaches. The research study's goal was to understand what strategies and resources students utilized when preparing for the Step 2 CK exam and investigate the relationship(s) between these approaches and performance. Methods: Students at a single US medical school were surveyed about their Step 2 CK preparation. We analyzed self-reported exam preparation strategies and the use of specific resources to determine their relationship with Step 2 CK score. Results: Student performance on Step 2 CK was correlated with performance on previous exams, including school-specific examinations, National Board of Medical Examiners clerkship shelf exams, and Step 1. Two study strategies were positively correlated with Step 2 CK score in preliminary analyses: completing more working practice questions, and the proportion of a question bank completed. In hierarchical regression, only completing more working questions remained predictive, after controlling for demographic variables and Step 1 performance. Conclusions: Faculty and staff can optimize students' Step 2 CK performance by encouraging them to work through case-based, clinically-focused questions. Further study is needed to describe optimal preparation strategies better.


2011 ◽  
Vol 135 (10) ◽  
pp. 1349-1352 ◽  
Author(s):  
Jennifer Picarsic ◽  
Jay S Raval ◽  
Trevor Macpherson

Context.—Factors that correlate with success or failure on the American Board of Pathology (ABP) examination are not known. Other medical residency programs have shown that standardized test scores correlate with specialty board examination scores; however, data from pathology programs are lacking. Objective.—To investigate whether the 2-digit score on step 1 of the United States Medical Licensing Examination (USMLE) was correlated with ABP examination performance at a large university pathology program. Design.—Nine years of data (2001–2009) from pathology residents (n  =  72) at the University of Pittsburgh Medical Center (UPMC, Pittsburgh, Pennsylvania) was collected from existing files and deidentified. Step 1 USMLE 2-digit scores and ABP failure rates for first-time test takers were compared. Results are reported as the percentage of residents who failed either the anatomic pathology or clinical pathology part of the ABP examination in cohorts by their USMLE 2-digit score (≤80, 81–85, 86–89, ≥90). Results.—The rolling 5-year (2005–2009) ABP average failure rate for first-time test takers of the anatomic pathology examination was 3.1% (UPMC) and 14.1% (nationally); in clinical pathology, it was 13.8% (UPMC) and 23.6% (nationally). At UPMC, no resident failed the anatomic pathology or clinical pathology parts of the ABP examination if his or her 2-digit USMLE step 1 score was 90 or more across 9 years of training (2001–2009). Conclusions.—In the UPMC pathology program, 2-digit scores on USMLE step 1 of 90 or more and 80 or less were strong measures of ABP first-time pass/failure rates, whereas scores of 81 to 89 were less-accurate measures. The USMLE step 1 score is one of many criteria that can be used for screening applicants for a pathology residency program.


2020 ◽  
Vol 12 (02) ◽  
pp. e277-e283
Author(s):  
David Cui ◽  
Ingrid U. Scott ◽  
Heidi Luise Wingert

Abstract Purpose This article investigates the perspectives of ophthalmology residency program directors (PDs) regarding the impact of the United States Medical Licensing Examination (USMLE) Step 1 change from graded to pass-fail scoring on ophthalmology resident selection and medical education. Methods The PDs of all United States ophthalmology residency programs accredited by the Accreditation Council for Graduate Medical Education were identified using a public, online database. An anonymous web-based survey constructed using REDCap was emailed to each PD in February 2020. Results Surveys were completed by 64 (54.2%) PDs, with the majority (81.2%) disagreeing with the change to pass-fail scoring. The majority of PDs believe this change will negatively impact the ability to evaluate residency applicants (92.1%) and achieve a fair and meritocratic match process (76.6%), and will decrease medical students' basic science knowledge (75.0%). The factors identified most frequently by PDs as becoming more important in evaluating residency applicants as a result of the Step 1 scoring change include clerkship grades (90.6%), USMLE Step 2 Clinical Knowledge score (84.4%), and a rotation in the PD's department (79.7%). The majority of PDs believe the Step 1 grading change to pass-fail will benefit applicants from elite medical schools (60.9%), and disadvantage applicants from nonelite allopathic schools (82.8%), international medical graduate applicants (76.6%), and osteopathic applicants (54.7%). Conclusion The majority of ophthalmology PDs disagree with the change in USMLE Step 1 scoring from graded to pass-fail and believe this change will negatively impact the ability to evaluate residency applicants and achieve a fair and meritocratic match process, and will decrease medical students' basic science knowledge.


Author(s):  
Béla Szende ◽  
Attila Zalatnai

SummaryThis article discusses the impact of the ‘second’ Vienna Medical School, hallmarked by Karl Rokitansky, Joseph Skoda and Ferdinand Hebra, on the study and practice of medicine in Hungary. Six medical doctors’ lives and achievements are outlined, who formed a bridge between Vienna and Budapest through their studies and work. Four of them returned to Hungary and promoted the cause of medicine and medical education there. Lajos Arányi (1812–1877) founded in 1844 the Institute of Pathology at the University of Pest. János Balassa (1814–1868) took the Chair of the Surgical Department. Ignaz Philip Semmelweis (1818–1865), the ‘Saviour of Mothers’, received a position at the Department of Obstetrics and Gynaecology in Vienna in 1846. Gustav Scheuthauer (1832–1894) became Arányi’s successor. Each of them continued to keep contact with their tutors in Vienna, especially with Karl Rokitansky, and followed the clinicopathological conception pioneered by the Vienna Medical School regarding diagnostics, treatment and prevention of diseases. Two physicians remained in Vienna: Mór Kaposi (1837–1902), who became known worldwide posthumously due to the connection between Kaposi’s sarcoma and AIDS, was the director of the Department of Dermatology of the Vienna University in 1878. Salomon Stricker (1837–1898) undertook the leadership of the Department of General and Experimental Pathology in 1872.


2017 ◽  
Vol 9 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Christopher J. Richards ◽  
Kenneth J. Mukamal ◽  
Nikki DeMelo ◽  
C. Christopher Smith

ABSTRACT Background  The fourth year of medical school has come under recent scrutiny for its lack of structure, cost- and time-effectiveness, and quality of education it provides. Some have advocated for increasing clinical burden in the fourth year, while others have suggested it be abolished. Objective  To assess the relationship between fourth-year course load and success during internship. Methods  We reviewed transcripts of 78 internal medicine interns from 2011–2013 and compared the number of intensive courses (defined as subinternships, intensive care, surgical clerkships, and emergency medicine rotations) with multi-source performance evaluations from the internship. We assessed relative risk (RR) and 95% confidence interval (CI) of achieving excellent scores according to the number of intensive courses taken, using generalized estimating equations, adjusting for demographics, US Medical Licensing Examination (USMLE) Step 1 board scores, and other measures of medical school performance. Results  For each additional intensive course taken, the RR of obtaining an excellent score per intensive course was 1.05 (95% CI 1.03–1.07, P < .001), whereas the RR per nonintensive course taken was 0.99 (95% CI 0.98–1.00, P = .03). An association of intensive course work with increased risk of excellent performance was seen across multiple clinical competencies, including medical knowledge (RR 1.08, 95% CI 1.04–1.11); patient care (RR 1.07, 95% CI 1.04–1.10); and practice-based learning (RR 1.05, 95% CI 1.03–1.09). Conclusions  For this single institution's cohort of medical interns, increased exposure to intensive course work during the fourth year of medical school was associated with better clinical evaluations during internship.


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