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September 2016

Time to Eliminate the Step 2 Clinical Skills Examination for US Medical Graduates

Author Affiliations
  • 1Harvard Medical School, Boston, Massachusetts
  • 2Now at Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 3Now at Department of Medicine, Duke University Hospital, Durham, North Carolina
  • 4Now at Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
JAMA Intern Med. 2016;176(9):1245-1246. doi:10.1001/jamainternmed.2016.3753

The public charges physicians with a fundamental trust: preventing and treating disease. This duty requires the highest standards of knowledge, behavior, and skill. For this reason, testing has an essential role in the medical licensure process. But just as physicians are trained to be deliberate, evidence-based, and cost-conscious, certification processes should be held accountable to the same high standards. In our view, the required Step 2 Clinical Skills (CS) examination, which purports to evaluate clinical and communication skills, fails to meet these standards. Herein, we argue that the Step 2 CS examination should be discontinued as a part of the US Medical Licensing Examination (USMLE) series for graduates of US medical schools. As of June 13, 2016, 16 000 medical students and physicians had signed an online petition that we organized to demonstrate the widespread support for this position.1 As a profession, we must ensure excellence in clinical skills and communication among physicians—and the Step 2 CS examination is the wrong way to achieve this goal.

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