Possible change in USMLE in 2004?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.


7+ Year Member
15+ Year Member
Mar 4, 2002
Reaction score

Members don't see this ad.
The founding documents of the United States Medical License Examination™ (USMLE™) call for inclusion of a test of clinical skills when such a test could be shown to be valid, reliable, and feasible. The NBME was charged with conducting appropriate research studies. The NBME has been developing a clinical skills examination employing "patients" trained to present standardized clinical situations; NBME research indicates that a standardized patient (SP) examination adds a valuable dimension to the licensure examination.

In January 1999, the governing body of the USMLE, the Composite Committee, reaffirmed its commitment to include in the USMLE an examination of clinical skills using standardized patients. The Federation of State Medical Boards took similar action in April 1999. At its 1999 Annual Meeting, the National Board of Medical Examiners directed NBME staff to complete investigations necessary for implementation and approved final field tests of the examination.

Having concluded that such an examination would be valid and reliable, the NBME is now proceeding with final studies of logistics for the examination. The examination will probably consist of a minimum of 10 scored cases; examination centers will be designed to permit administration of a 12- or 14-case examination if ongoing research indicates that a longer examination is necessary. Each encounter will last approximately one-half hour, and the overall duration of the examination will be 5 to 6 hours.

Data gathered by the NBME, the Educational Commission for Foreign Medical Graduates, and the Medical Council of Canada indicate that standardized patient examinations identify a different cohort of candidates than multiple choice examinations of cognitive skills. The NBME expects that initial failure rates on the examination for students in medical schools accredited by the Liaison Committee on Medical Education will be similar to those on Steps 1, 2 and 3 of the USMLE. Ultimate failure rates will be lower.

The NBME is reviewing several examination delivery models. One possible model consists of a core of five to seven test centers located at strategic locations throughout the country operating continuously throughout the year. The feasibility of supplemental test sites at medical schools is being evaluated.

If everything goes well, implementation could occur in mid-2004 for the students graduating in 2005, but further approvals of the implementation will be required by the NBME and FSMB.


Membership Revoked
15+ Year Member
Jul 31, 2000
Reaction score
Yeah, these this new test (I think that it's going to be called the OSCE) looks like it's going to be really annoying for med students to have to take. From what I understand of it, the test fee will be ~1,000 dollars, and you will also have to pay for the cost of getting to one of these 6 test sites in the nation and spending the night there before the test. It's really silly that they don't just ask all medical schools to implement their own OSCE, like my med school already does, to save everyone the cost. Fortunately, most of the big medical lobbying organizations (AMA, AMSA) have decided to oppose these changes so I suspect that it will be several years before this new exam is actually implemented.