Clinical skills exam not yet ready for prime time

LETTER — Posted June 21, 2004

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Regarding "Medical students to begin taking clinical skills test" (Article, June 7):

As a physician with more than 26 years of clinical practice behind me, a faculty member at the Medical College of Pennsylvania (now the Drexel University College of Medicine) and a member of the bar in the Commonwealth of Pennsylvania, I have taken numerous tests, including several licensing examinations.

Nevertheless, when my son, now completing his third year at Columbia P&S, told me of the mandatory nature of the clinical skills examination, its limited availability, and its excessive fee, I was aghast. While the examination might have merit, its administration was obviously entered into with little thought on the part of those in the NBME whose obligation it was to plan it.

Given the exorbitant fee for the examination, its availability in only a handful of locations nationally, its questionable benefit in measuring anything of value, and its relatively subjective and potentially discriminatory nature (both economically and culturally), I would urge the NBME to re-examine its decision to require this portion of the examination for licensure. Moreover, I would not be surprised if litigation developed between the NBME and those students who are unable to afford the examination, unable to afford the travel or simply unable to schedule the examination in time.

My advice -- "Primum non nocere." Wait until you have it right before making such an examination mandatory, or be ready for the potentially disastrous consequences.

Eric E. Shore, DO, Bala Cynwyd, Pa.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/06/21/edlt0621.htm.

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