Comprehensive Review of USMLE (CRU)

2017-08-29

When will the talked-about changes be implemented?
New multiple-choice question formats: Test material committees have developed multiple choice questions that assess an examinee's ability to appropriately interpret information presented both in the form of a research abstract and a pharmaceutical advertisement. A small number of these item types have been introduced into the Step 2 CK and Step 3 examinations.
Enhancements to the Clinical Skills (CS) examination: Enhancements to the Step 2 CS examination, including a new patient note program and redesigned Communication and Interpersonal Skills subcomponent, were introduced into the USMLE Step 2 CS examinations on June 17, 2012.
Posted: December 2009
Updated: March 2011
Updated: August 2012
Will Step 1 and 2 CK be combined into one exam? What changes to USMLE exam structure and format will occur within the next 1-5 years?
There are no plans to combine Steps 1 and 2 CK. However, the focus, design, format, and structure of each may change in the future. Such changes, if made, would occur no earlier than 2016, and any significant changes will be announced well in advance.
The USMLE Composite Committee and USMLE parent organizations (the National Board of Medical Examiners and the Federation of State Medical Boards) have approved changes to the design, format, and structure of the Step 3 exam. These changes will occur no earlier than 2014. The plans call for the division of Step 3 into two separate exams, each one day in length, focusing on different sets of competencies. The proposed examinations will continue to be administered by computer using multiple choice questions and computer simulations. The two examinations will be scored separately and examinees will be expected to pass each.
Additional information about this change is available.
Posted: December 2009
Updated: March 2011
Updated: August 2012
If the current Step structure changes, how can medical schools that make promotion decisions (from MS2 to MS3) continue to make these decisions?
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.
Posted: December 2009
Will you continue to report scores, or change to pass/fail?
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.
Posted: December 2009
What are the "competencies"? Are they all going to be assessed in USMLE? How?
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.
Posted: December 2009