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One Small Step for Step 1.

Publication ,  Journal Article
Andolsek, KM
Published in: Acad Med
March 2019

Step 1 of the United States Medical Licensing Examination (USMLE) is a multiple-choice exam primarily measuring knowledge about foundational sciences and organ systems. The test was psychometrically designed as pass/fail for licensing boards to decide whether physician candidates meet minimum standards they deem necessary to obtain the medical licensure necessary to practice. With an increasing number of applicants to review, Step 1 scores are commonly used by residency program directors to screen applicants, even though the exam was not intended for this purpose. Elsewhere in this issue, Chen and colleagues describe the "Step 1 climate" that has evolved in undergraduate medical education, affecting learning, diversity, and well-being.Addressing issues related to Step 1 is a challenge. Various stakeholders frequently spend more time demonizing one another rather than listening, addressing what lies under their respective control, and working collaboratively toward better long-term solutions. In this Invited Commentary, the author suggests how different constituencies can act now to improve this situation while aspirational future solutions are developed.One suggestion is to report Step 1 and Step 2 Clinical Knowledge scores as pass/fail and Step 2 Clinical Skills scores numerically. Any changes must be carefully implemented in a way that is mindful of the kind of unintended consequences that have befallen Step 1. The upcoming invitational conference on USMLE scoring (InCUS) will bring together representatives from all stakeholders. Until there is large-scale reform, all stakeholders should commit to taking (at least) one small step toward fixing Step 1 today.

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Published In

Acad Med

DOI

EISSN

1938-808X

Publication Date

March 2019

Volume

94

Issue

3

Start / End Page

309 / 313

Location

United States

Related Subject Headings

  • United States
  • Licensure, Medical
  • Internship and Residency
  • Humans
  • General & Internal Medicine
  • Educational Measurement
  • Education, Medical, Undergraduate
  • Climate
  • 4203 Health services and systems
  • 3901 Curriculum and pedagogy
 

Citation

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Andolsek, K. M. (2019). One Small Step for Step 1. Acad Med, 94(3), 309–313. https://doi.org/10.1097/ACM.0000000000002560
Andolsek, Kathryn M. “One Small Step for Step 1.Acad Med 94, no. 3 (March 2019): 309–13. https://doi.org/10.1097/ACM.0000000000002560.
Andolsek KM. One Small Step for Step 1. Acad Med. 2019 Mar;94(3):309–13.
Andolsek, Kathryn M. “One Small Step for Step 1.Acad Med, vol. 94, no. 3, Mar. 2019, pp. 309–13. Pubmed, doi:10.1097/ACM.0000000000002560.
Andolsek KM. One Small Step for Step 1. Acad Med. 2019 Mar;94(3):309–313.

Published In

Acad Med

DOI

EISSN

1938-808X

Publication Date

March 2019

Volume

94

Issue

3

Start / End Page

309 / 313

Location

United States

Related Subject Headings

  • United States
  • Licensure, Medical
  • Internship and Residency
  • Humans
  • General & Internal Medicine
  • Educational Measurement
  • Education, Medical, Undergraduate
  • Climate
  • 4203 Health services and systems
  • 3901 Curriculum and pedagogy