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Comment & Response
February 2017

Value in the Step 2 Clinical Skills Examination

Author Affiliations
  • 1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
  • 2Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas
JAMA Intern Med. 2017;177(2):292. doi:10.1001/jamainternmed.2016.8227

To the Editor In a Viewpoint1 in a recent issue of JAMA Internal Medicine arguing that the Step 2 Clinical Skills (CS) examination should be eliminated for US medical school graduates, Flier et al, without explicitly stating it, indicated that international medical graduates should continue to take the examination. Flier et al state the Liaison Committee on Medical Education (LCME) ensures that US medical schools are held to high standards. Yet deficiencies in the physical examination skills of US medical school graduates have been reported despite LCME monitoring.2 The LCME does not accredit osteopathic medical schools; it is unclear if the authors recommend that physicians with degrees from such schools be exempted from the examination. Standardized language examinations can be used to assess the English proficiency of international medical graduates. A majority of medical schools in the United States now use objective structured clinical examinations, on which the Step 2 CS examination is based. Such examinations are used in more than 50 countries.3 Objective structured clinical examinations are financially and technically feasible across wide cultural settings, and there are successful international collaborations.3

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