Skills test moving forward; pilot studies prove effective

An assessment test of medical students' clinical skills by the National Board of Medical Examiners is set to start in 2004, but cost and venues are still under discussion.

By Jay Greene, AMNews staff. Oct. 8, 2001.

Medical students and schools across the nation are gearing up for the start of a clinical skills assessment examination likely to begin the summer of 2004.

Public demand that physicians possess greater clinical skills led the National Board of Medical Examiners and the Federation of State Medical Boards in 1999 to approve a plan to require the test for licensure.

The licensing boards also felt lack of clinical skills, including poor communication between patient and doctor, can contribute to medical errors.

"There are two sets of competencies that doctors must have -- cognitive and clinical skills," said Peter Scoles, MD, NBME's senior vice president of assessment programs. "We do well testing cognitive skills, but we needed a way to test clinical skills."

No one objects to the need for standardized clinical training, but students and school officials are concerned about the projected per test cost of $1,000. Another concern is the limited number of regional testing locations. Preliminary plans call for the test to be offered at four to six fixed sites, Dr. Scoles said.

The NBME also is studying the possibility of rotating locations at medical schools. Those schools wishing to participate most likely would be required to absorb an additional $600 to $700 per test in administrative costs above the $1,000 student fee.

"This test will just add to the overall cost of medical education, which ranges between $80,000 to $120,000," said Dwight Johnson, the AMA's medical student section representative to the NBME. "We are pushing for students not having to travel by car any more than 450 miles." [...]