It will not make much of a difference soon, as there is a chance that the USMLE will combine Step 1 and Step 2 into one exam, go be given at the end of year 3. The good news is that you will not have to worry about the 7-yeasr rule, the bad news is that MD-PhD students will have 5 or six years between the time they take anatomy, biochemistry, etc., and being tested on these subjects on the USMLE instead of just one. The USMLE folks say that no decision has been made, but many MD-PhD programs are afraid that it is a done deal. Here is a description of the project from the AAMC:
Comprehensive Review of USMLE
The principal mission of the USMLE is to provide state licensure boards with the valid and reliable independent assessments needed to support their responsibilities for granting the primary license to practice medicine. The USMLE also has important secondary uses. Undergraduate medical schools use USMLE results for curriculum assessment, promotion, and graduation decisions. USMLE results are considered by residency program directors during the residency selection process. International graduates must pass Step 1, Step2 CK, and Step 2 CS of the USMLE for ECFMG certification.
Since it was first designed nearly two decades ago, there has been no in-depth review of the entire USMLE program to ensure that the overall design, structure, and format of USMLE is effectively meeting the needs of primary and secondary users. . It is therefore appropriate to conduct a comprehensive review to assure that it effectively and efficiently serves its stakeholders. The Comprehensive Review of USMLE (CRU) is a data-based, iterative study of the program launched in late 2004.
To date, no decisions have been reached, although there are emerging themes presented today for discussion:
• The USMLE is primarily a licensure exam
• All competencies that can be measured in a valid and reliable way should be included in USMLE
• With regard to the primary mission of USMLE, decisions are necessary at the time of entry into post graduate training, and at the time of entry into unsupervised practice
• Secondary missions should be supported as long as they do not interfere with the primary role of the exam and as long as the information provided is valid and reliable
• The separation of basic science and clinical science in the current Step 1 and Step 2 exams adversely affects the ability of medical schools to develop integrated curriculum models
• There is no consensus on pass/fail versus scored examinations
• Medical schools will need valid and reliable tools for use in curriculum evaluation and internal promotion decisions
Recommendations from CEUP, the Committee charged with the review of USMLE, are expected in early 2008. If a decision is made to change elements of the USMLE, it will take several years to implement change.
