Annual Report on the United States Medical Licensing Examination®
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- Bu səhifədəki naviqasiya:
- 2016 STEP 1 ADMINISTRATIONS *
- 2015-2016 STEP 2 CLINICAL KNOWLEDGE (CK) ADMINISTRATIONS *
- 2015-2016 STEP 2 CLINICAL SKILLS (CS) ADMINISTRATIONS *
18 Annual Report on USMLE to Medical Licensing Authorities in the U.S. | 2017
USMLE program in some capacity. These individuals represent 58 different medical and osteopathic licensing boards throughout the United States.
The USMLE recommends that state medical boards require the dates of passing Step 1, Step 2, and Step 3 to occur within a seven-year period. The program, however, recommends that state medical boards consider additional time for individuals completing a dual degree program (MD/PhD; DO/PhD). Additionally, the USMLE program imposes a limit of no more than six attempts to pass each of the Step or Step Components. Additional attempts are allowed only at the written request of a state medical board.
Most state medical boards utilizing the USMLE impose both time and attempt limits on the USMLE as part of their requirements for obtaining an initial medical license. Currently, 40 out of 53 medical boards impose some limit on the number of attempts at the USMLE; 45 out of 53 medical boards impose a time limitation for the completion of the USMLE sequence. For a complete listing, please visit:
www.fsmb.org/licensure/usmle-step-3/state_specific .
Specific requirements for taking and retaking USMLE are provided in the FAQs on the USMLE website
www.usmle.org/frequently-asked-questions/ .
at www.usmle.org/bulletin/eligibility/ .
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The USMLE program publishes aggregate performance data for all Steps since the program’s inception. These data include examinee volume and passing percentages categorized by first-taker and repeater examinees; US/Canadian and international students/graduates; allopathic and osteopathic examinees. These performance data are available at the USMLE website at www.usmle.org/performance-data/ .
Passing rates and examinee counts for 2015-2016 are provided for each Step in this report’s Appendix. Research Agenda Each year, the USMLE Composite Committee reviews and endorses a research agenda for the program. The committee endorsed the following research themes and/or topics for the program for 2017-2018: enhancements to the USMLE; relating scores and pass/fail outcomes to external measures; determining strategies for providing meaningful performance feedback to examinees and stakeholders; and USMLE security procedures.
Below is a list of program-related publications by USMLE staff in 2015. A more extensive listing (2009-2016) is available on the USMLE website at http://usmle.org/data-research/ .
Educational and Psychological Measurement. 2016; Oct 10. [Epub ahead of print]
Margolis MJ, Mee JM, Clauser BE, Winward M, Clauser JC. Effect of content knowledge on Angoff-style standard setting judgments. Educational Measurement: Issues and Practice. 2016;35(1):29-37.
Cuddy MM, Winward ML, Johnston MM, Lipner RS, Clauser BE. Evaluating validity evidence for USMLE Step 2 Clinical Skills data gathering and data interpretation scores: Does performance predict history-taking and physical examination ratings for first-year internal medicine residents? Academic Medicine. 2016;91:133-139.
Prober CG, Kolars JC, First LR, Melnick DE. A plea to reassess the role of United States Medical Licensing Examination Step 1 scores in residency selection. Academic Medicine. 2016;91:12-15.
Raymond MR, Ling Y, Grabovsky I. Investigating the performance of second language medical students on lengthy clinical vignettes. Evaluation & the Health Professions. 2016; Oct 19. [Epub ahead of print]
Katsufrakis PJ, Uhler TA, Jones LD. The residency application process: pursuing improved outcomes through better understanding of the issues. Academic Medicine. 2016;91:1483-1487.
20 Annual Report on USMLE to Medical Licensing Authorities in the U.S. | 2017
The USMLE system for setting standards is established by the USMLE Composite Committee, which includes representatives of the ECFMG, FSMB, NBME and the public. The system specifies the kinds of data to be gathered and how the data are to be gathered, the frequency of reviewing the standards and adjusting them, and assigns the judgment task to the Management Committee. The Management Committee, jointly appointed by the FSMB and NBME, must use the procedures defined by the Composite Committee, but is free to set the standard and revise the standard as it deems necessary. The decision of the Management Committee is final; no superior governing committee is authorized to alter its decision. The Management Committee includes those with educational, licensing, and clinical practice perspectives, as well as a representative from the public.
Current policy requires that the Management Committee review the effectiveness of Step standards at least annually. A comprehensive review and possible adjustment of the standard must be undertaken approximately every four years. In addition, when there are any major changes to the design or format of the Step examination, the Management Committee is asked to establish new passing requirements for the redesigned components. USMLE believes that there must be an opportunity for review and adjustment of standards in order to reflect the realities of change in the content of medicine, the nature of the test, the characteristics of examinees, and the expectations of stakeholders. Such review of the standard is essential to assure that the judgment inherent in defining the standard reflects current conditions, not those that were pertinent in the past. Mandated Data Sources Informing the Judgment Process USMLE policy mandates the use of four categories of data in making judgments about standards. These are:
• Content-referenced judgments of experts. Content experts provide their opinions, based upon review of content and examinee performance, on the appropriate requirements for passing the examination. •
the stakeholder is exposed, that should pass the examination. •
Cohort performance trends. Trends in examinee performance over a long period of time and the effect of repeated attempts at the examinations on the failure rate in a defined cohort of examinees. •
Confidence intervals in the region of the cut-score. Estimates of numbers of misclassified examinees based on historical distributions of examinee performance and the measurement error in the scale area under consideration for the cut-score.
The Management Committee meets to consider the collected data. As part of this process the committee reviews all of the data collection processes and considers the combined data as part of the decision-making process. Typically, the question posed of the committee is whether the externally collected data, performance trends, and score reliability data suggest that the current standards need to be changed. The committee can allow the standards to remain the same or can vote to make a change. If the latter occurs then the committee identifies the new performance requirements.
21 Annual Report on USMLE to Medical Licensing Authorities in the U.S. | 2017
USMLE policy requires that standards be implemented on the first day of the month following the decision of the Management Committee. Information regarding the timing of the standard setting process and its outcomes is posted on the USMLE website.
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Multiple avenues for obtaining additional information on the USMLE exist: •
www.usmle.org ) provides the most current information on the program. •
www.fsmb.org ) contains information specific to USMLE Step 3. •
www.nbme.org ) contains information specific to registering for USMLE Steps 1, 2CK and 2CK for students and graduates of U.S. and Canadian medical schools. •
ECFMG website at ( www.ecfmg.org) provides information on ECFMG certification and registering for USMLE Steps 1, 2CK and 2CK for students and graduates of international medical schools seeking information.
•
from the main page of the USMLE website ( www.usmle.org ).
•
NBME Examiner – the official newsletter of the NBME & provides additional information on USMLE; the current and archived issues can be found under the Publications tab at
www.nbme.org .
•
by the FSMB, the Journal occasionally provides informational articles summarizing major aspects of the USMLE program . Topics covered include Step 2 Clinical Skills, the development of multiple-choice questions for test content, research, and processes for maintaining program security. The following articles are available at
http://jmr.fsmb.org/archives/ or upon request from the FSMB: o
“Implementing Strategic Changes to the USMLE.” Journal of Medical Regulation. Vol. 100, No. 3, 2014. o
“An Assessment of USMLE Examinees Found to Have Engaged in Irregular Behavior, 1992-2006.” Journal of Medical Regulation. Vol. 95, No. 4, 2010. o
“Developing Content for the United States Medical Licensing Examination.” Journal of Medical Licensure and Discipline. Vol. 95, No. 2, 2009. o
“Maintaining the Integrity of the Unites States Medical Licensing Examination.” Journal of Medical Licensure and Discipline. Vol. 92, No. 3, 2006. o
“The Introduction of Clinical Skills Assessment into the United States Medical Licensing Examination (USMLE): A Description of the USMLE Step 2 Clinical Skills (CS).”
o
“The United States Licensing Examination.” The Journal of Medical Licensure and Discipline. Vol. 91, No. 1, 2005. 23 Annual Report on USMLE to Medical Licensing Authorities in the U.S. | 2017
The following individuals are key contacts for state medical boards on matters involving the USMLE.
David Johnson, MA
Michael Barone, MD Federation of State Medical Boards
National Board of Medical Examiners Sr. Vice President, Assessment Services
Vice President, Licensure Programs 400 Fuller Wiser Road
3750 Market Street Euless, Texas 76039
Philadelphia, PA 19104-3190 817-868-4081; djohnson@fsmb.org
mbarone@nbme.org
Amy Buono Office of the USMLE Secretariat 3750 Market Street Philadelphia, PA 19104-3190 215-590-9877; abuono@nbme.org
24 Annual Report on USMLE to Medical Licensing Authorities in the U.S. | 2017
The data tables below are extracted from the performance data provided on the USMLE website at http://www.usmle.org/performance-data/ . Similar data are available for all years of the USMLE program.
2016 STEP 1 ADMINISTRATIONS * Number Tested and Percent Passing
MD Degree
21,122 94% 1st Takers
20,122 96% Repeaters**
1,000 64% DO Degree
3,454 93% 1st Takers
3,398 94% Repeaters**
56 75% Total US/Canadian
24,576 94% Examinees from Non-US/Canadian Schools 1st Takers
15,031 78% Repeaters**
2,575 39% Total non-US/Canadian
17,606 72%
Notes for Table 1 * Represents data for examinees tested in 2016 and reported through February 1, 2017. ** The # tested listed for repeaters represent examinations given, not the number of examinees for the specified time period.
25 Annual Report on USMLE to Medical Licensing Authorities in the U.S. | 2017
Table 2
2015-2016 STEP 2 CLINICAL KNOWLEDGE (CK) ADMINISTRATIONS * Number Tested and Percent Passing
MD Degree
21,515 96% 1st Takers
20,535 97% Repeaters**
980 71% DO Degree
2,272 94% 1st Takers
2,228 94% Repeaters**
44 84% Total US/Canadian
23,787 95% Examinees from Non-US/Canadian Schools 1st Takers
12,720 80% Repeaters**
2,738 53% Total non-US/Canadian
15,440 75%
Notes for Table 2 * Data for Step 2 CK are provided for examinees tested during the period of July 1, 2015 to June 30, 2016.
** The # tested listed for repeaters represent examinations given, not the number of examinees for the specified time period. 26 Annual Report on USMLE to Medical Licensing Authorities in the U.S. | 2017
Table 3
2015-2016 STEP 2 CLINICAL SKILLS (CS) ADMINISTRATIONS * Number Tested and Percent Passing
MD Degree
20,662 97% 1st Takers
19,906 97% Repeaters**
716 85% DO Degree
46 91% 1st Takers
46 91% Repeaters**
0 NA
Total US/Canadian 20,668 97%
1st Takers
12,051 82% Repeaters**
2,300 71% Total non-US/Canadian
14,351 81%
Notes for Table 3 * * Data for Step 2 CS are provided for examinees tested during the period of July 1, 2015 to June 30, 2016. ** The # tested listed for repeaters represent examinations given, not the number of examinees for the specified time period.
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Table 4
2016 STEP 3 ADMINISTRATIONS * Number Tested and Percent Passing
MD Degree
19,574 96% 1st Takers
18,997 97% Repeaters**
597 70% DO Degree
21 85% 1st Takers
20 95% Repeaters**
1 § Total US/Canadian
19,595 96% Examinees from Non-US/Canadian Schools 1st Takers
8,804 86% Repeaters**
1,355 53% Total non-US/Canadian
10,159 81%
Notes for Table 4 * The table represents data for examinees tested in 2016 with scores reported by February 1, 2017. ** The # tested listed for repeaters represent examinations given, not the number of examinees for the specified time period. §
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