Hahnemann Closure: Information on GME Funding for Hahnemann Residents and Fellows

As plans for the closure of Hahnemann University Hospital in Philadelphia unfold, one important issue that must be resolved is the transfer of graduate medical education (GME) funding for physicians in training from Hahnemann to the other hospitals that accept these trainees. Since the issue of funding has received much attention in recent days, ECFMG is sharing the following basic information that may be helpful to Hahnemann residents and fellows as they seek to transition to training programs at other hospitals.

U.S. hospitals are reimbursed for the educational costs of training physicians by the U.S. Government, specifically by the Centers for Medicare & Medicaid Services (CMS). Hospitals are reimbursed by CMS for each resident/fellow that they train, and each hospital is subject to a limit or “cap” on the number of trainees for which it receives reimbursement. Reimbursement for fellows is valued at 50% of the amount for residents.

When a hospital closes and its trainees are displaced, the trainees may continue their training at another hospital. In this case, the hospital that accepts a displaced resident or fellow is eligible to receive the entire CMS reimbursement for his/her position. At this time, Drexel University College of Medicine and Hahnemann University Hospital are negotiating the release of GME funding for Hahnemann’s residents and fellows. Once released, these funds will be available to move with trainees to their new training hospitals.

During these negotiations, Hahnemann residents and fellows should continue to look for positions in other training programs. They also should be aware of the following facts about GME funding for their positions:

  • Funds from CMS for the training of physicians are owned by the training hospital (in this case, Hahnemann), not by any affiliated medical school(s).
  • When a hospital closes and a trainee moves to another hospital, the funding for the trainee’s position moves with the trainee to the new training hospital.
  • When a trainee moves to a new training hospital, the funds that move with the trainee are for all remaining years in the trainee’s program.
  • A hospital is eligible to accept a displaced trainee and to receive his/her funding, even if the hospital is at or over its number of capped positions.

Please monitor this website for updates on this developing situation.

Updated Information on September 2017 Presidential Proclamation for USMLE Step 2 CS Examinees

Updated information on enforcement of President Trump’s September 2017 Presidential Proclamation, “Enhancing Vetting Capabilities and Processes for Detecting Attempted Entry into the United States by Terrorists or other Public-Safety Threats,” including enforcement of visa restrictions, is available on the Resources on Presidential Proclamation page.

Examinees are encouraged to monitor the Resources on Presidential Proclamation web page. New information, as it becomes available, will be posted there.

UPDATE: Review of USMLE Step 2 Clinical Skills Minimum Passing Performance

The USMLE program recommends a minimum passing level for each Step examination. The USMLE Management Committee is responsible for establishing and monitoring these standards, and is asked to complete an in-depth review of standards for each examination every three to four years.

Because severe winter weather resulted in cancellation and rescheduling of one of the standard setting panels that review test content for the USMLE Step 2 Clinical Skills (CS) examination, dates for the review by the USMLE Management Committee and for possible changes in the recommended minimum passing requirements to take effect have changed.

The USMLE Management Committee is scheduled to review the minimum passing requirements for the USMLE Step 2 CS examination at its July 29 – August 1 meeting (originally scheduled for May 2017).

If the Committee determines that a change is appropriate, the new recommended minimum passing requirements will become effective for all examinees who take a Step 2 CS examination on or after September 10, 2017 (originally July 16, 2017).

Examinees are encouraged to read the full announcement and monitor the USMLE website for the latest information.

Step 2 CK – Delay in Score Reporting

Most score reporting of Step 2 Clinical Knowledge (CK) results occurs within four weeks of testing. However, because of necessary modifications to the test item pool, there will be a delay in reporting for some examinees who test beginning the week of July 3, 2017.

The target date for reporting Step 2 CK scores for most examinees testing the week of July 3 through mid-August will be Wednesday, September 6, 2017.  For examinees whose circumstances require that they receive Step 2 CK scores before September 6, it is recommended that they take the exam no later than June 30.

Although the transition will occur quickly at many test centers, there may be some locations where the changes take slightly longer to complete. The overall transition period will likely last approximately 6 weeks. Please note that scores on new and old exam forms will be comparable.

Examinees should monitor the USMLE website for the latest information.

Enhanced Security Policies at CSEC Test Centers

Enhanced security policies will take effect in all Clinical Skills Evaluation Collaboration (CSEC) test centers beginning April 4, 2017. The enhanced security procedures are being conducted to inspect for electronic devices.

The USMLE Step 2 Clinical Skills (CS) examination is administered at CSEC test centers in Atlanta, Chicago, Los Angeles, Houston, and Philadelphia.

Beginning April 4, 2017, CSEC administrators will conduct inspections of all eyeglasses, jewelry, and other accessories.

  • All examinees will be required to remove eyeglasses for visual inspection by the test center administrators. These inspections will be brief and will be performed during the check-in process.
  • Jewelry, except for wedding and engagement rings, is prohibited.
  • Hair accessories are subject to inspection. Examinees should not wear ornate clips, combs, barrettes, headbands, and other hair accessories. Examinees wearing any of these items on test day may be asked to store such items in their lockers.

IMG Performance in the 2017 Match

For the 15th consecutive year, the number of first-year (PGY-1) residency positions offered through the National Resident Matching Program® (NRMP®) Main Residency Match® increased. A total of 28,849 first-year positions were offered in the 2017 Match. This represents an increase of 989 positions compared to last year and an increase of more than 8,200 positions since 2002.

Compared to 2016, the number of international medical graduates (IMGs) who participated in the Match decreased by 435. While the number of IMGs who matched to first-year positions decreased by 47, the percentage of IMGs who matched increased. Of the 12,355 IMGs who participated in the 2017 Match, 6,591 (53.3%) matched. In the 2016 Match, 6,638 (51.9%) IMGs were matched to first-year positions. (The preceding data include a very small number of Fifth Pathway applicants who participated in the 2016 and 2017 Matches. For 2017, these data include two Fifth Pathway participants who are not represented in the data below.)

Of the 7,284 IMG participants who were not U.S. citizens, 3,814 (52.4%) obtained first-year positions. The number of non-U.S. citizen IMGs who obtained positions increased in 2017 for the sixth year in a row, this year by 45.

Of the 5,069 U.S. citizen IMG participants, 2,777 (54.8%) were matched to first-year positions, a decrease of 92 from last year. The number of U.S. citizen IMGs matching to first-year positions has increased in 12 of the last 14 Matches.

About the Match

The annual NRMP Match is the system by which applicants are matched with available residency positions in U.S. graduate medical education (GME) programs. Participants submit to the NRMP a list of residency programs, in order of preference. Ranked lists of preferred residency candidates are likewise submitted by U.S. GME programs with available positions. The matching of applicants to available positions is performed by computer algorithm. The Match results announced in March of each year are for GME programs that typically begin the following July.

Additional Resources on the Match and Match Results

The preceding Match data are based on the Advance Data Tables: 2017 Main Residency Match® compiled by NRMP. These tables provide detailed information on the positions offered and filled by the Match in 2017 and prior years. To access these tables, or to obtain further information on NRMP, visit www.nrmp.org.

In December of each year, JAMA: The Journal of the American Medical Association traditionally publishes an in-depth analysis of graduate medical education in the United States. This analysis includes the number of IMGs entering and continuing in U.S. GME programs and a breakdown of IMG resident physicians by specialty and subspecialty. Visit your medical school’s library or http://jama.jamanetwork.com/journal.aspx.

Understanding Your USMLE Score Report

A short video designed to help examinees interpret the USMLE score report, and understand decisions and actions that can be taken based on exam performance, is available on the USMLE website.

The video is part of a USMLE Program effort to address frequently asked questions from examinees and others about the USMLE examination process. Additional videos will be forthcoming.

Examinees should monitor the USMLE website for the latest information

Updated Practice and Informational Materials for the Step 1 Examination Are Available

Updated practice and informational materials for the Step 1 examination have been posted to the USMLE website.

Examinees planning to take a Step 1 examination should read the following materials and practice with the updated sample items:

Examinees should monitor the USMLE website for the latest information.