亚裔医生组织大多数都反对USMLE 改变考试成绩报告方法。

来源: 高山峻岭流水人家于 2019-08-03 17:04:59 [档案] [博客] [旧帖] [给我悄悄话] 本文已被阅读：次 (111120 bytes)

July 25, 2019

Michael Barone, MD, MPH
Vice President, Licensure Programs
National Board of Medical Examiners® (NBME®)

Andrew T. Filak, Jr., MD
Interim Senior Vice President for Health Affairs and Dean, College of Medicine
University of Cincinnati
Chairman of the Board of Directors, Educational Commission for Foreign Medical Graduates

David Johnson, MA
Senior Vice President, Assessment Services
Federation of State Medical Boards (FSMB)

Susan Skochelak, MD, MPH
Group Vice President, Medical Education
American Medical Association (AMA)

Alison Whelan, MD
Chief Medical Education Officer
Association of American Medical Colleges (AAMC)

USMLE

3750 Market Street

Philadelphia, PA 19104-3102
Telephone: (215) 590-9700
Fax: (215) 590-9460

Re: Preliminary recommendations regarding the USMLE

Dear Honorable USMLE Officers:

?On behalf of the Coalition of Asian American IPA, Association of Chinese American Physicians, Chinese American Medical Society, Korean IPA, Federation of Chinese American and Chinese Canadian Medical Societies, CAIPA Foundation, Myanmar American Medical Education Society, Federation of Chinese American and Chinese Medical Societies, Asian American Accountable Care Organization, Myanmar Global Medical& Health Foundation, Chinese American Pathologists Association, Chinese American Neurological Association, Chinese American Physicians Society, Bangladesh Medical Association of North America andScholastic Merit Fund, we present for consideration the following comments on the preliminary recommendations regarding the USMLE.

?The recommendations should be viewed in the larger context of promoting and sustaining excellence in American medicine. The creation and maintenance of a physician workforce that is talented, well read, well trained, compassionate, and skillful in patient care is the goal that will keep American medicine the best in the world.

For the first recommendation, we strongly oppose the notion to change the USMLE scoring system from a three-digit score scale to pass/fail. While we recognize the need to promote holistic reviews of residency applicants, this modification may hinder that goal. For many medical students, the USMLE Step 1 provides an opportunity for distinction in their residency applications. Switching to pass/fail scoring will completely negate this achievement and will blur the line between the mediocre/passing students and the truly outstanding high quality/high pass students. The current situation illustrates the great need for ways to identify good students and converting to pass fail will cause more confusion.

Importantly, the USMLE is currently the only standardized method of assessing all medical students. Instead of diminishing the significance of these exams, we support creating other standardized approaches for assessing medical students to enable good students to stand out in their residency applications. This might require a conference between medical schools and residency programs todevelop a consensus statement about student assessments based on empirical findings and/or observational studies. Such an approach would provide program directors with more ways to determine the qualifications of applicants, rather than solely relying on the USMLE scores. Additional ways of assessing medical studentswould also contribute to the wellbeing of medical students by enabling well rounded development of students and recognition of other components of medical education. Perhaps a national medical knowledge test should be developed to address the need felt by both educators and students to identify good students and relieve the US MLE of this unintended role.

Regarding the second recommendation to “accelerate research on the correlation of USMLE performance to measures of residency performance and clinical practice,” the citations from the InCUSliterature review suggest that students who know more (step 1) and have better clinical skills (step 2) tend to do better in residency, and that other variables may also be important. There is such heterogeneity in the residency system that further research, even a very large study, is unlikely to yield additional insights. Studies as suggested in recommendation 2 will only increase pressures to use the USMLE test scores for residency screening. A consensus should be developed across residency programs about residency performance. If the conference between medical schools and residency programs as suggested above can reach a consensus, future studies could then be performed to help correlate standard student assessments with residency performance and clinical practice.

Lastly, in response to Recommendation #3, we applaud theintent to minimize racial differences in USMLE test performance. More analyses and publications on USMLE scores in this area would be helpful. A diverse workforce will enable more connections between patients and doctors, which can play a substantial role in the healing process. While supporting diminishing racial differencesin test performance, our longer term vision is well rounded medical education, opportunities for all medical students to excel, standardized assessments, and the selection of the best qualified students for training. We are appreciative of the concern for the potential impact of these changes on International Medical Graduates that was expressed in parts of the Summary Report.

The issues we are all dealing with now cannot be resolved by solely adjusting the reports for the USMLE. As indicated in The Summary Report and Preliminary Recommendations from the Invitational Conference on USMLE Scoring (InCUS), March 11-12, 2019, this is part of a systemic problem. By working together on the steps, we have outlined, including establishing more standardizedassessment methods, and a consensus between medical schools and residency directors on student assessments, we can improve the wellbeing and careers of medical students, and the residency application system in the United States of America.