scholarly journals Characteristics and Outcomes of Individuals Engaging in USMLE Irregular Behavior, 2006–2015

2020 ◽  
Vol 106 (4) ◽  
pp. 8-16
Author(s):  
Frances E. Cain ◽  
Katie Arnhart ◽  
Aaron Young ◽  
David Johnson
Keyword(s):  
United States ◽  
The United States ◽  
Outcome Data ◽  
National Board ◽  
Medical Licensing ◽  
Licensing Examination ◽  
Using Data ◽  
Medical License ◽  
Score Reports ◽  
Irregular Behavior

ABSTRACT Medical licensing authorities and other entities utilize and rely on the United States Medical Licensing Examination (USMLE) as a standardized, valid and reliable tool to assess physicians’ knowledge and skills. As such, engaging in irregular behavior during the USMLE process can have a broad and damaging impact on an individual’s ability to complete the USMLE sequence and subsequently obtain a medical license in the United States. While there are also repercussions for the USMLE program and entities overseeing medical students and physicians, the risk to the public of being cared for by someone who did not pass a medical licensing examination by his or her own merit is of great concern. This study reviews data about individuals who engaged in irregular behavior, common sanctions taken against them and their ability to ultimately practice medicine in the United States. Using data from the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), individuals with findings of irregular behavior as part of the USMLE application and/or testing process between 2006 to 2015 were identified, along with their corresponding demographic, examination, sanction and licensure outcome data. A total of 165 individuals were found to have engaged in 170 incidents of irregular behavior. The majority of individuals were male (63%, n = 101), international medical graduates (69%, n = 112) and had a mean age of 33 years old (SD = 8 years, n = 161) at the first incident or finding of irregular behavior. The two most common types of irregular behavior were falsified information (31%, n = 53) and security violations (27%, n = 46). Most incidents (86%, n = 146) were reported to the FSMB Physician Data Center (PDC) and 68% (n = 116) involved a bar from taking the USMLE for a period of time. Only 26% (n = 43) of individuals ultimately passed the entire USMLE sequence and 16% (n = 27) obtained a full, unrestricted medical license in the U.S. by 2019. To help maintain the integrity of a key component for initial licensure in the United States, there is a continued need for rigorous enforcement and safeguarding of USMLE examination applications, content, testing conditions and score reports. Individuals who plan on taking the USMLE should become familiar with USMLE rules and penalties regarding irregular behavior, including the serious implications of such behavior that can severely diminish their ability to practice medicine in the United States. Entities using USMLE information for licensure or admission into medical-related programs need to diligently ensure authentication of USMLE documents and carefully consider if individuals who have engaged in irregular behavior are qualified to practice medicine.

scholarly journals The United States Medical Licensing Examination: Part One

2005 ◽  
Vol 91 (1) ◽  
pp. 21-25
Author(s):  
David Johnson
Keyword(s):  
United States ◽  
The United States ◽  
Test Accommodations ◽  
Patient Centered ◽  
National Board ◽  
Content Quality ◽  
Medical Licensing ◽  
Licensing Examination ◽  
State Medical Boards ◽  
And Function

ABSTRACT The United States Medical Licensing Examination (USMLE), co-sponsored and co-owned by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), was implemented in 1992–94 as the successor of the NBME certifying examinations (Parts I, II and III) and the Federation Licensing Examination (FLEX). It is a three-step examination for medical licensure in the United States. The USMLE assesses a physician’s ability to apply knowledge, concepts and principles, and to demonstrate fundamental patient-centered skills important in health and disease and constitute the basis of safe and effective patient care. Results of the USMLE are reported to medical licensing authorities in the United States for their use in granting the initial license to practice medicine. This article is the first in a series focusing on the USMLE program. The following article provides a broad overview of the USMLE program along with a brief description of the USMLE content, characteristics of test administration, and information on the scoring of the exam. Subsequent articles will focus on development of examination content, quality assurance mechanisms, standard setting and such administrative issues as test accommodations and irregular behavior. The intent of this series is to provide the reader with short, topical articles that collectively provide a better understanding of the nature, role and function of the USMLE in assisting medical licensing authorities in the United States.

scholarly journals The United States Medical Licensing Examination (USMLE): Maintaining the Integrity of the Examination Process

2006 ◽  
Vol 92 (3) ◽  
pp. 16-19
Author(s):  
David A. Johnson
Keyword(s):  
United States ◽  
The United States ◽  
Program Staff ◽  
Medical Licensing ◽  
Primary Means ◽  
Licensing Examination ◽  
State Medical Boards ◽  
Testing Protocols ◽  
Irregular Behavior ◽  
Examination Process

ABSTRACT Maintaining the integrity of the USMLE is critical to the state medical boards that rely upon the exam as an integral part of their assessment of physician candidates for licensure. The USMLE program defines irregular behavior as “any action...that subverts or attempts to subvert the examination process.” Program staff routinely monitor compliance with registration and testing protocols. Suspected cases of irregular behavior are referred to a committee for final determination. A finding of irregular behavior carries significant potential implications for the examinee. The USMLE transcript is the primary means for alerting staff at state medical boards to confirmed instances of irregular behavior. The transcript is routinely accompanied by a determination letter summarizing the case and committee’s finding of irregular behavior.

An Assessment of USMLE Examinees Found to Have Engaged in Irregular Behavior, 1992–2006

2009 ◽  
Vol 95 (4) ◽  
pp. 26-35
Author(s):  
David Alan Johnson
Keyword(s):  
The United States ◽  
International Medical Graduates ◽  
Medical Graduates ◽  
Medical Licensing ◽  
Computer Based ◽  
Licensing Examination ◽  
Medical License ◽  
State Medical Boards ◽  
Irregular Behavior ◽  
Examination Process

ABSTRACT Purpose: The United States Medical Licensing Examination® (USMLE®) program takes active measures to ensure the integrity of the licensing examination process. This study looks at the examinees found by the USMLE program to have engaged in irregular behavior and their subsequent success in completing the examination sequence and obtaining a full, unrestricted medical license. Methods: Working with the Office of the USMLE Secretariat, all individuals determined by the program to have engaged in irregular behavior related to the examination were identified for the period 1992–2006. These individuals were then searched against databases at the Federation of State Medical Boards for board action history and licensure status. Results: A total of 433 individuals were deemed to have engaged in irregular behavior by the USMLE Committee on Irregular Behavior. Subgroups disproportionately represented included males (66.7%) and international medical graduates (78.8%). Document falsification was the most common infraction under computer-based test administration. Less than half of the irregular behavior cohort (45.7%) successfully completed the USMLE sequence. Only 37.2% completed the USMLE sequence and obtained a full, unrestricted medical license in a U.S. jurisdiction. Graduates of U.S. and Canadian medical schools were the subgroup most likely to complete the USMLE sequence and obtain their medical license. Conclusions: A finding of irregular behavior by the USMLE carries significant potential consequences. State medical boards have denied licenses to individuals with irregular behavior and been unwilling to support the prospective licensure of individuals barred from the program indefinitely.

scholarly journals Medical student wellness and professional development are harmed by the current state of medical licensing examination: a student perspective on Step 1

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Lucas Lebovitz ◽  
Brian Wu
Keyword(s):  
Professional Development ◽  
United States ◽  
Medical Student ◽  
The United States ◽  
Student Perspective ◽  
Student Wellness ◽  
Current State ◽  
Medical Licensing ◽  
Licensing Examination ◽  
Medical License

The first part of the United States Medical Licensing Examination, also known as Step 1, has stood since its inception in the 1990s as a requirement for prospective doctors to obtain a medical license. (...)

scholarly journals The Route to the USMLE: The Shibboleth of Modern Medical Licensure

2014 ◽  
Vol 100 (4) ◽  
pp. 21-28
Author(s):  
Howard Wainer
Keyword(s):  
United States ◽  
Reliability And Validity ◽  
Supreme Court Decision ◽  
The United States ◽  
British Raj ◽  
Medical Licensing ◽  
History Of ◽  
Licensing Examination ◽  
Multiple Choice Exam ◽  
The Cost

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.

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

2017 ◽  
Vol 14 ◽  
pp. 25 ◽  
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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