FAQs
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Questions About the Comprehensive Review of USMLE (CRU)
When will the talked-about changes be implemented?
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Some of the changes anticipated, for example, introducing new item types (multimedia) and enhancing the representation of fundamental science in Steps 2 and 3, will be implemented over several years and have already begun. Others are anticipated to unfold over the next two to five years, subject to the development and testing necessary to validate new item types.
Date Posted: December 2009
What are the new types of items that will be used? How will interpretation of literature and information gathering be assessed?
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In addition to enhanced assessment of clinical skills as envisioned above, we also anticipate developing items to measure examinees' ability to interpret and apply both scientific and medical literature. We also anticipate developing assessments that reflect the realities of current medical practice and the availability of rich information resources at the point of care via various technologies. As information becomes available about specific formats that will appear on examinations, the USMLE web site will be updated to reflect current knowledge.
Date Posted: December 2009
Will Step 1 and 2 CK be combined into one exam?
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Steps 1 and 2CK will exist as separate, discrete examinations for at least the next several years. During this time, evolution in content coverage is likely. At some point as USMLE evolves, the current Step 1, 2CK, 2CS, 3 structure could shift. If this occurs, stakeholders will be advised of changes well in advance of any change. Plans for transitioning to a new structure will be provided well in advance so that the phase-in will be smooth and equitable, to minimize potential disruptions for examinees, schools, licensing boards, or other constituencies. Additionally, the NBME will be attentive to other uses of USMLE performance data and strive to meet educationally sound secondary uses.
Date Posted: December 2009
If Step 1 disappears, how can medical schools that make promotion decisions (from MS2 to MS3) continue to make these decisions?
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Changes in the structure of USMLE exams may have little or no impact on schools using USMLE performance for other purposes. However, the NBME recognizes that medical schools use the results of USMLE examinations for the assessment of both individual students and of the schools' educational programs. In implementing changes to the USMLE exam sequence, the NBME will be attentive to other assessment needs and the secondary uses of USMLE.
Date Posted: December 2009
What is going to happen to the CS exam?
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During the next two years the Step 2 CS examination will retain its current structure and organization, though we do expect to enhance assessment of clinical skills (eg, though new station formats) within that structure. Over a longer time period, as USMLE continues to evolve, it is likely that the CS examination may incorporate new stations and simulation formats, more sophisticated assessment of communication and physical examination skills, more complex cognitive tasks, and/or hybrid assessments that could incorporate other question formats and assessment activities into the standardized patient assessment.
Date Posted: December 2009
Will you continue to report scores, or change to pass/fail?
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In conversations with the various stakeholder groups that occurred as part of the USMLE review process, strongly held opinions were expressed on both sides of this question. Some felt that maintaining numeric score reporting is essential while others felt that numeric scores should be abolished. For the present, we do not anticipate changing current practice. As the examination sequence evolves, potential changes in score reporting would be weighed in light of validity research, including intended use of scores.
Date Posted: December 2009
What are the “competencies”? Are they all going to be assessed in USMLE? How?
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In accordance with direction from the USMLE Composite Committee and the Committee to Evaluate the USMLE Program, USMLE governance will consider changes to the examination sequence in the context of competencies that have become increasingly prevalent in recent years as a means of organizing medical education and assessment. One of the most commonly used competency frameworks was developed collaboratively by the ACGME and the ABMS. This framework identifies six competencies: medical knowledge, patient care, communication and interpersonal skills, professionalism, practice-based learning and improvement, and systems-based practice. Some in the medical education and practice community have also identified a seventh competency related to surgical and other technical procedural skills.
The NBME will explore how best to assess examinees in all competency areas. It is likely that the assessments available via a revised USMLE will not be able to measure all competencies to an equal degree. It is possible that one or more competencies will not be measurable in a valid manner in the context of the USMLE. During implementation of changes to the USMLE, staff will identify how best to assess examinees’ performance in each of the competencies using available methods, develop a research agenda to expand assessment tools for competencies not adequately measured presently, and identify competencies that cannot be reliably measured in USMLE so that assessments in other contexts (e.g., residency training programs) can supplement the information provided by the USMLE.
Date Posted: December 2009
General | BIMS | CRU | FRED 2.0 | Orientation/Practice Materials | Scores | Step 2 CS