The movement to end Step 2 CS

If you hadn’t heard, there is growing movement to end Step 2 CS (because it’s a stupid, expensive, and ultimately ineffective test). You can read about the background and sign the petition here. There’s also a fun additional JAMA editorial.

  • 20,190 MD (ignoring DOs who mostly don’t take it and IMGs, for whom the test was originally designed) students took the test in 2014-15, of which 96% passed. So 807 failed.
  • 817 MDs took a repeat and 86% passed (presumably 10 of these were third attempts or re-attempts from the previous year).
  • So 114 US MDs were caught by the Step 2 CS hurdle, at the maximum.

So that’s a terrible value proposition: offloading an expensive test offered in a handful of locations to students drowning in debt and short on time in order to catch a relative handful of people in a deficiency that is largely contrived. But what happened to those 114, of which half failed for communication skills and half failed for poor [fake] “clinical” skills? How many students are actually prevented from continuing their careers? And for students that fail and then pass (the vast majority), is there any evidence whatsoever that this process has improved their skills?1

I am very curious about the former question. I strongly suspect the latter is completely absent.

The irony is that there are plenty of bad physicians, but none of this testing is well suited to unmasking and dealing with real world deficiencies. The even sadder wrinkle is that there are also clearly physicians in the US who have insufficient English skills to practice medicine properly, so Step 2 CS isn’t even doing what it was originally designed to do well.

If I were an MS1, I’d be praying this momentum snowballs and I could save myself the hassle and additional debt.

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