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Letters
January 26, 2005

Changes in the US Medical Licensure Examination and Impact on US Medical Schools

JAMA. 2005;293(4):421-425. doi:10.1001/jama.293.4.424

To the Editor: The education and deployment of physicians is necessarily a 2-part process. First, a student must gain the knowledge and skills required by the educating body. Second, regulatory authorities must be assured that the newly minted physician is capable of safe and independent practice. Recently, the US Medical Licensure Examination has added a new testing component, the Step 2 Clinical-Skills (CS) examination. The Step 2 CS requires examinees to show their knowledge of history taking, physical examination, diagnostic reasoning, and communications skills, using highly trained simulated patients at 1 of 5 official sites.1 Given that the US Medical Licensure Examination offers legitimate and important content that can help validate a school’s educational programs, and that a school’s philosophy may be to help prepare students to pass state licensure examinations, most medical schools require passage of 1 or more of the US Medical Licensure Examination step examinations as a prerequisite for graduation.2 We sought to assess the impact of adding the Step 2 CS on medical school curricula, graduation requirements, and costs.

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