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Possible changes to USMLE scores – continuing the discussion

Posted: October 08, 2019

A podcast featuring two members of the Invitational Conference on USMLE Scoring (InCUS) planning committee, Dr. Michael Barone, Vice President of Licensure Programs for NBME, and Dave Johnson, Senior Vice President, Assessment Services for the Federation of State Medical Boards, is now available. They discuss themes from the public comments, upcoming improvements to USMLE, and insight into the vision for the program.

You can listen to the podcast here.


USMLE Step 1 and Step 2 CK content changes scheduled for mid-2020

Posted: November 05, 2019

Beginning in mid-2020, the Step 1 and Step 2 Clinical Knowledge (CK) examinations will include an increased number of questions assessing communication skills, system-based practice and patient safety, and legal/ethical skills and professionalism. The length of the testing days for Step 1 and Step 2 CK will not change.

Decisions about the balance of content on USMLE examinations are the responsibility of two groups: the USMLE Composite Committee and USMLE Management Committee. Both are composed of educators, practicing physicians, members with experience on state medical licensure boards, and public members. These committees approved the increase in the number of test items assessing the important competencies listed above. 

Timetable:

  • Beginning in May 2020, Step 1 will include additional questions assessing communication skills.
  • Beginning in June/July 2020, Step 2 Clinical Knowledge will include additional questions on systems-based practice, patient safety, legal/ethical issues, and professionalism.
  • No changes to the Step 3 examination are planned during this timeframe. 

Sample test items illustrating assessment of communications skills, systems-based practice and patient safety, and legal/ethical skills and professionalism are provided in the Step 1 Content Description and General Information booklet (pp. 7-11) and in the Step 2 Clinical Knowledge Content Description and General Information booklet (pp. 8-11).

The practice materials available on USMLE.org will be updated in early 2020 to reflect these changes in the distribution of exam content across content categories on Step 1 and Step 2 CK.


Computer-assisted scoring coming to Step 2 CS

Posted: September 26, 2019

The United States Medical Licensing Exam (USMLE) program is committed to applying the best available technology and the most current assessment practices to ensure accuracy and validity for all its examination programs. Beginning October 2019, computer-assisted scoring technology will be used to score patient notes created by examinees for the USMLE Step 2 Clinical Skills (CS) examination.

The use of computer-assisted scoring will not change the cost of the exam, nor the timing with which examinees receive their scores. The computer-assisted scoring program is based on the scoring rubrics developed by experienced physician note raters. For cases in which computer-assisted scoring is used, notes with machine scores below the 50th percentile in performance will also be scored by physician patient note raters. The machine scores and physician scores will then be averaged to produce the examinee’s score on the patient note portion of the Step 2 CS exam.

Much consideration has gone into the implementation of computer-assisted scoring. Most importantly, the crucial role of clinical judgment in the evaluation of Step 2 CS performances will be preserved. Second, the examinee experience will not be adversely affected. The expert judgment of physicians will be used on an ongoing basis for the development of patient note scoring guidelines and in the training of the computer-based scoring system.

Click here for FAQs related to computer-assisted scoring. To read more about NBME’s work with natural language processing, see a recent article in Academic Medicine here.


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