what a crock
So I just took a board exam towards medical licensure called the “USMLE Step II, CS” (US medical licensing exam Step 2, clinical skills). The USMLE consists of 3 steps, each of which is taken at different points of medical training. Step 2 is traditionally taken at the end of medical school. Up until 4 or 5 years ago, all 3 steps of the USMLE consisted of written exams. And then, someone had the brilliant idea of introducing a clinical skills portion to Step 2. This practical exam is comprised of a rapid-fire history and physical of 12 actors pretending to have various, common medical problems, with subsequent documentation of the encounters. To imagine how ridiculous this whole process is, think about the episode of Seinfeld where Kramer pretended to have gonorrhea for medical students (see below, skip to time = 3:01).
Anyway, so this exam costs over $1000 for medical students to take. Moreover, there are only 5 centers around the US where students can take the exam, so if you don’t live nearby you also have to pay for transportation and an overnight hotel stay. The biggest waste of $1000, well more like $1400 after all is said and done, that I’ve ever seen.
The general principle behind Step II CS is reasonable: that a graduating medical student going into residency training should be able to take a basic, focused history and physical from a patient with a common medical problem, then write a note about it. Having taken the exam now, I can tell you that anyone who even performed sufficient motions to get through medical school should be able to pass this exam. And anyone who couldn’t pass this exam probably wouldn’t be going to residency anyway. Given the expense we go through with residency interviews and the subsequent move to residency, it’s such a crock of shit to have to pay so much money for such a waste of time.
Of course after my rant, watch me fail the exam. Whatever. Refer to my previous blog entry.