OK, so it's not too late to try something radical like getting an injunction to block the test until more safeguards are put in place. Problems exist with the CSE. Examples include the absence of a formal appeal process in the case of failing the exam. Since the exam is graded through subjective opinion of trained observers (not experienced, practicing clinical, physicians) there needs to be an appeal process established prior to requiring the CSE component of step 2.
There is also the reality of testing bias for students residing in a testing site community vs. somebody who has traveled overnight or overseas and might be physically/mentally exhausted. It's true the test is pass/fail however an exhausted student traveling from California to Atlanta will most certainly be at increased risk of failing the exam vs. a student living in Atlanta.
What about economic bias and discrimination. Why should a student in Arizona be required to pay for travel and lodging to a test site, while those local students do not have any extra financial burden. There is potential racial bias. Students with financial resources will be able to afford a flight at decent hours of the day, spend one or two days lodging and then adjust to jet lag and take the test when relaxed and refreshed. Other students will have to leave their hometown at 9 p.m. in the evening, travel through the night and take the test when completely exhausted. How does this not qualify as economic discrimination? I also wonder whether this becomes racial discrimination if a predominance of under represented minority students wind up as those unable to afford the cush travel accomodations.
What about specific instances where an individual's travel is disrupted from increased security alerts at airports. In the worse case, what if somebody's flight is completely cancelled because of security problems. As recently occurred, what if the pilot is drunk and the flight is cancelled. There are currently no processes established to accomodate these types of problems. If this happens, you end up paying a $500 rescheduling fee. Until formal safeguards are in place to handle these types of potential problems, the test should not be mandated.
So far it doesn't look as though they have all of the testing centers finalized. What about a failure of NBME to adequately verify the test itself along with each of the testing sites. They previously used students at just three Philadelphia schools and four Georgia schools and they looked at just one center in Atlanta. Are students from seven east coast schools suppose to represent the entire nation's medical school population? There has simply been no full scale verification of any testing center other than Atlanta which means you are paying $975 to validate the NBME testing process. As I've said before, this is called beta testing, and generally the company pays the test takers. Not the other way around.
All in all the best way to halt or at least delay the CSE is a lawsuit requesting an injuction of the test until the numerous concerns are resolved. The CSE might be a good idea once adequate protection is in place to prevent errors. But until then, the disasterous outcome resulting from NBME error should be considered unacceptable by everyone.
Anybody know a lawyer or perhaps was a laywer in a past career? If there's power in numbers, I'm more than willing to sign my name to a lawsuit.
Stop the CSE!
Here are the sites I base my conclusions on.
http://www.usmle.org/news/cse/step2csfaqs1103.htm
http://www.usmle.org/news/cse/cseftresults2503.htm
http://www.nbme.org/programs/step2csreg1.asp
