News

Changes to the Step 2 Clinical Skills (CS) Examination

One of the recommendations emerging from the Comprehensive Review of USMLE (CRU) process is that USMLE consider ways to further enhance the testing methods used in the Step 2 Clinical Skills (CS) examination. As previously announced in the 2012 Bulletin of Information, these enhancements are scheduled for implementation in mid-2012. These changes will be introduced in Step 2 CS for examinations delivered beginning June 17, 2012.

The reporting schedule for examinees testing from June 17, 2012 through November 3, 2012 will be 2-3 weeks longer than for examinees testing during other periods.

More information about the Step 2 CS score reporting dates for examinations delivered in 2012 is provided in the Step 2 CS Score Reporting Schedule.

Changes to the assessment of Communication and Interpersonal Skills (CIS)
The CIS subcomponent of Step 2 CS has been redesigned to assess a fuller range of competencies.  Background information about these changes is provided on pages 5-6 of the Fall 2010/Winter 2011 NBME Examiner. The new approach divides communication skills into a series of functions. These functions have been further divided into sub-functions. Beginning June 17, 2012, the Communication and Interpersonal Skills (CIS) scale will focus on five functions:

  1. Fostering the relationship
  2. Gathering information
  3. Providing information
  4. Making decisions: basic
  5. Supporting emotions: basic

Several additional functions are still under development; these include making decisions: advanced; supporting emotions: advanced; and helping patients with behavior change. A list of the functions and sub-functions is available.

Changes to the patient note
Also beginning June 17, 2012, a new patient note will be introduced. The patient note is completed by the Step 2 CS examinee after the encounter with the standardized patient. In the new note, examinees will continue to be asked to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered. Examinees will also be asked to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports (or refutes) each potential diagnosis. The new patient note provides examinees with an opportunity to document their analysis of a patient’s possible diagnoses. A sample of the new patient note is available for review.

Practice materials
Updated practice materials for Step 2 CS will be posted to the USMLE website in March 2012. These include the Step 2 CS Content Description and General Information Booklet, onsite orientation video, sample patient notes, and a simulation of the program for typing patient notes.

Fee Increases for USMLE Examinations

Effective January 1, 2012, the fees for those applying to ECFMG for USMLE Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS) will increase.

The examination fees for USMLE Step 1 and Step 2 CK will increase from $780 to $790 for each exam registration.

The examination fee for Step 2 CS will increase from $1,355 to $1,375 for each exam registration.

The new fees will be assessed for all USMLE applications submitted to ECFMG on or after January 1, 2012.

For more information on the fees associated with applying for USMLE Step 1, Step 2 CK, and Step 2 CS, refer to Exam Fees in the ECFMG 2012 Information Booklet.

Field Trial of New Step 2 CS Assessment Formats

The National Board of Medical Examiners® (NBME®) is developing new assessment formats for use in its Step 2 Clinical Skills (CS) examination. A field trial of these new formats is planned between January 11 and January 23, 2012, at the National Board of Medical Examiners, Philadelphia, PA. This trial is primarily a test of new case formats and measurement instruments that will resemble USMLE Step 2 CS. It will give participants a chance to “practice” a clinical skills examination under USMLE conditions.

View full announcement on the USMLE website.

(posted September 9, 2011; updated December 7, 2011)

Additional Changes to USMLE Procedures for Reporting Scores

As was reported previously, the USMLE program has begun the process of eliminating the reporting of results on the 2-digit score scale to parties other than the examinee and any state licensing authority to which the examinee sends results.

Because USMLE will continue to report the 2-digit score to examinees and to state licensing authorities, the program will be making changes in scoring procedures to minimize the impact of future shifts in the relationship between 2-digit and 3-digit scores that result from USMLE’s periodic review of standards. The new scoring procedures will be implemented with the reporting of results for examinees who take a Step 1, Step 2 CK, or Step 3 examination on or after October 1, 2011.

View full announcement on the USMLE website.

Important Information about Step 2 CS Testing and Score Reporting in 2012

As noted in the 2012 USMLE Bulletin of Information, changes to the assessment of communication skills and patient note are planned in mid-2012. In order to introduce these changes to the examination, there will be no Step 2 Clinical Skills (CS) examinations from May 20 through June 16, 2012.

Please note the following information regarding the testing schedule in the second half of 2012:

  • Additional testing sessions – including evening and weekend sessions – have been added to the calendar before and after the May/June shutdown.
  • The reporting schedule for examinees testing from June 17, 2012 through November 3, 2012 will be 2-3 weeks longer than for examinees testing during other periods.
  • Examinees who test on or before December 31, 2012 will have results reported in time for the 2013 “Match.”

View the 2012 Step 2 CS score reporting schedule.

ECFMG 2012 Information Booklet and Application Materials Are Available

The ECFMG 2012 Information Booklet and the 2012 exam application materials are now available on the ECFMG website.

For Step 1/Step 2 CK, you can use the 2012 materials to apply for:

  • available Step 1/Step 2 CK eligibility periods ending in 2011 (September 2011-November 2011 and October 2011-December 2011) and
  • all Step 1/Step 2 CK eligibility periods ending in 2012, beginning with the November 2011-January 2012 eligibility period.

For Step 2 CS, you can use the 2012 materials to obtain a 12-month eligibility period that begins on the date that the processing of your application is completed.

(posted July 29, 2011; updated September 15, 2011)

Relationship between USMLE’s 2-digit and 3-digit Score Scales

It was recently announced that starting July 1, 2011, USMLE would begin the process of eliminating the reporting of results on the 2-digit score scale to all score users except the examinee and the state licensing authority to whom results are reported at the examinee’s request.

Other users of USMLE results who have focused on the 2-digit score scale in the past will need to transition to using the 3-digit score. A table that will allow users to look up the 3-digit score(s) that corresponds approximately to a specific 2-digit score on recently administered Step 1 (since January 2010) and Step 2 CK (since July 1, 2010) examinations has been posted on the USMLE website. This table will not apply for results reported October 1, 2011 and later.

View full announcement on the USMLE website.

New Attempt Limit for USMLE Examinations

The USMLE program is introducing a limit on the total number of times an examinee can take the same Step or Step Component. When this limit takes effect, an examinee will be ineligible to take a Step or Step Component if the examinee has made six or more prior attempts to pass that Step or Step Component, including incomplete attempts.

The effective date for the six-attempt limit depends upon whether an examinee has taken any Step or Step Component (including incomplete attempts) before January 1, 2012.

Examinees Who Have NOT Taken Any Step Or Step Component Before January 1, 2012
If you have not taken any Step or Step Component before January 1, 2012, the six-attempt limit will go into effect for all exam applications that you submit on or after January 1, 2012.

Example 1: On January 15, 2012, Examinee A submits his application for his first attempt at any Step or Step Component. The six-attempt limit will be effective at that time for all Steps and Step Components and Examinee A will be allowed to take each Step or Step Component no more than six times, including incomplete attempts.

Examinees Who Have Taken Any Step Or Step Component Before January 1, 2012
If you have taken any Step or Step Component (including incomplete attempts) before January 1, 2012, the six-attempt limit will go into effect for all exam applications that you submit on or after January 1, 2013.  Beginning on that date, all attempts at a Step or Step Component will be counted toward the limit, regardless of when the exams were taken.

Example 2: Examinee B’s application for a seventh attempt at a particular Step or Step Component is received on December 15, 2012. For this examinee, the six-attempt limit will not prevent the seventh attempt, since the application was submitted before January 1, 2013.  However, if Examinee B fails the exam, he will not be eligible to submit an application on or after January 1, 2013 to retake that Step or Step Component.

Example 3: Examinee C attempts to submit an application for a seventh attempt at a particular Step or Step Component on or after January 1, 2013. The application will not be processed, since all exam applications submitted on or after January 1, 2013 will be subject to the six-attempt limit.

ECFMG Named One of The Principal 10 Best Companies for 2011

The Educational Commission for Foreign Medical Graduates (ECFMG®) has been named a 2011 winner of The Principal® 10 Best Companies for Employee Financial Security. Presented by The Principal Financial Group®, The Principal 10 Best Companies is a national program recognizing growing companies that excel at helping employees build their financial futures through excellent benefits programs. Winners are selected by an independent panel of financial services and human resources experts that evaluate entrants on criteria such as the variety of financial benefits offered; the financial value of benefits offered; level of commitment to the financial security of employees; and the entrants’ industry, strength of benefits for that industry, and the demographics of their workforce.

ECFMG’s mission, promoting quality health care for the public, is critically important. Retaining the skill and expertise represented by ECFMG’s employees is essential to fulfilling this mission and to continuing to be responsive to its examinees and other constituencies. As observed by ECFMG’s President and Chief Executive Officer, Emmanuel G. Cassimatis, M.D., “Working in a positive environment and having colleagues who are happy to be here makes for a better atmosphere for everyone—and, ultimately, results in better service to our customers.”