Tuesday, June 29, 2010

USMLE Step 2 CS: A waste of $1000

I recently took the clinical skills (CS) portion of step 2 of the US medical licensing exam (USMLE). It's a whole day of interviewing standardized patients (actors), writing notes, coming up with possible diagnoses and ordering lab tests. It definitely covers what every physician should know. What's upsetting though, is that it's a recently-introduced exam that costs $1295 and has a 96% pass rate (and supposedly 100% at our institution). So essentially, every medical student in the country (something like 15,000 students each year) has to take the exam so that only 600 (most of whom probably also have terrible grades and are unlikely to match into a residency program anyway) could be weeded out. We live in a culture of standardized testing. There are whole industries surrounding it (books, tutoring, computer programs, testing centers, patient actors, etc.). So, its not surprising that the company administering the medical licensing exam would like to add yet another exam for students to take. What's disappointing is that physicians in charge of medical licensing go along with it. Residency programs don't care about your Step 2 CS score and I highly doubt that there will be less dangerous physicians around because of this new exam. My cynical opinion is that someone decided that they could make an extra $20 million each year off of medical students and "convinced" those in charge of medical licensing to go along with it.

Oh well, at least I'll never have to deal with fake patients anymore.

Tuesday, June 15, 2010

Seven alternatives to evidence-based medicine

Two more days of 3rd year left... can't wait.

This article is a pretty funny (but in my experience true) description of how some doctors justify their treatment plans. My favorite:
Eloquence based medicine---The year round suntan, carnation in the button hole, silk tie, Armani suit, and tongue should all be equally smooth. Sartorial elegance and verbal eloquence are powerful substitutes for evidence.