Log in

No account? Create an account
Nobody wears a white coat any more...
...a tribute to becoming a doctor.
11 whispers echo . o O ( ... ) O o . whisper a word
turnberryknkn From: turnberryknkn Date: May 24th, 2005 03:45 pm (UTC) (etched in stone)
(nods nods) It's a real challenge.

I can sympathize for many reasons, ayradyss, as your thoughts have a lot of personal resonance for me not just as someone who has to take the exam, but as someone whose activist career was born fighting it...

A long time ago, I was one of the fools who touched off the five year fight against the Clinical Skills Step 2 exam, which was originally supposed to come into effect in 1999-2000ish. Obviously, we didn't win, but we did manage to throw enough sand in the gears that my younger brother went entirely through med school without having to take the damned thing. A lot of stories of a lot of politics, which I've told in bits and pieces in my diary along the way. Always an interesting situation when the body which makes the money from the exam is linked directly to the body which decides whether said exam is necessary. Said fight was a huge part of the lives of fellow activists like culfinriel, resonance42 and mdrnprometheus. And now, as incoming Chair, mdrnprometheus is gearing up to formally fight the NBME's idea for a *fifth* licensure exam (after the three written USMLE exams Step I, II CK, and III) and the Step II CS you directly cite, what the NBME is calling the "professionalism" exam, an exam whose origin was first mentioned waaaay back when I was still wearing my AAMC hat as official AAMC pain-in-the-NBME's-arse and we hadn't even finished the fighting on Step II...

And to those four licensure exams (maybe five) comes of course your Family Practice Resdiency Board Certification exam, and if you do a fellowship of some kind, the separate Fellowship Board, which will make a grand total of anywhere between five and eight major national exams from start to finish, depending on how they do things. Except now, for you and I and all the rest of us in our generation, we, unlike our predecessors, don't just take those last two exams once in a lifetime, like lawyers take the Bar. We will retake our Residency Boards and our Fellowship Boards every five to ten years for the rest of our profesional lives.

And that's not even counting "continual recertification", which I know Internal Medicine and other specialties are experimenting with, which amounts to mini-licensing exams in between the offical big licensing exams. All of which we get to go places and pay money to do.

And the NBME has often floated the idea of making the Step 2 clinical skills exam also a renewal requirement -- that is, not just once, but every ten years or so, at $900+ a pop. I mean, the NBME gets a lot of money for doing it, and we don't really have a whole lot of say in the matter save whatever sand in the gears we can throw in via activist work like yours and mine...

All what we signed up for, of course, but I understand your feelings. It's a pretty interesting little road we've signed up for, no?
mdrnprometheus From: mdrnprometheus Date: May 24th, 2005 05:55 pm (UTC) (etched in stone)
And mdrnprometheus is really wondering if, on a money and time basis, it might not cost less to just hire someone to go after Dr. Peter Scoles' knees with a tire iron.

At this point, I think our best hope actually lies with something called the Initiative to Transform Medical Education. It's the beginnings of the "Flexner 2.0" process we've all heard about for years. If we can move meded away from being so memorization-based, it'll force a re-examination of the entire USMLE process, and then, then perhaps the tests can once again actually test ability to care for patients.
11 whispers echo . o O ( ... ) O o . whisper a word