USMLE Examination & Clinical Skills Competence Assessment Requirements Policy

I. PURPOSE

To provide guidelines for students regarding requirements for United States Medical Licensing Examination (USMLE) Examinations and the Clinical Skills Competency Assessment. 

II. POLICY

It is the policy of New York Medical College School of Medicine (NYMC SOM) that all students pass the USMLE Step 1 and Step 2 Clinical Knowledge (CK) examinations to graduate from the M.D. Program. In addition, all students must achieve minimal competency benchmarks on the Phase 2 Clinical Skills Competency Assessment (CSCA)

III. SCOPE

This policy applies to all medical students, members of the Student Advancement, Promotions, and Review Committee, and faculty scoring the CSCA.

IV. DEFINITIONS 

AUA Match: Urology and Specialty Match
CaRMS: Canadian Match
CSCA: Clinical Skills Competency Assessment - the CSCA is a summative, internal clinical skills assessment that certifies a student’s ability to successfully demonstrate milestones related to the following graduation competencies: Interpersonal Communication Skills, Medical Knowledge, Patient Care, Practice-Based Learning & Improvement, and Professionalism 
SAPRC: Student Advancement, Promotions, and Review Committee
SF Match: Residency and Fellowship Match Services
USMLE: United States Medical Licensing Examinations  

V. PROCEDURES 

A. USMLE Examinations  

1. Any student who fails a USMLE Step 1 or receives a failing score on Step 2 CK will be presented to the SAPRC for deliberation regarding academic action.
2. The NYMC SOM will verify students to sit for each USMLE examination no more than three (3) times. Three (3) failures on any one of the USMLE examinations may be a dismissible action by the SAPRC.  
3. The USMLE Step 1 examination: cannot be attempted prior to successful completion of the Phase 1 curriculum in its entirety, including all remediation requirements, if applicable, and CBSE recommendations as outlined in Policy on Comprehensive Basic Science Examination. Taking this examination is a requirement for entering into Phase 2 of the M.D. Program. 

a. All students are required to take USMLE Step 1 prior to the start of the Transition to Clerkship course.
b. Should a student fail to meet benchmarks established by the Office of Student Affairs (OSA) and the Office of Academic Excellence (OAE) and which benchmarks can be found in Policy on the Requirements for Comprehensive Basic Science Examination the student may request a deferral of this deadline by doing the following, as appropriate:

i. If a student is not meeting the established benchmarks set by OSA and OAE one week prior to the Step 1 deadline date, the student must meet with a Student Affairs dean to discuss deferring the exam and the start of clerkships; or 
ii. If the exam and the start of clerkships are deferred, the student must still participate in and complete the Transition to Clerkship course; or
iii. If the exam is deferred, a passing score for USMLE Step 1 must be received before the student can start Phase 2 (the clerkship phase) of the curriculum; or 
iv. If more than one clerkship is deferred, the student will be placed on an administrative Leave of Absence (LOA) 

• • • • • Students who are placed on LOA will have their schedules dropped until they pass USMLE Step 1.   
        • Students on LOA must take USMLE Step 1 no later than November 15th of that calendar year.  
        • Students who do not take USMLE Step 1 within that timeframe will be referred to the SAPRC for review and deliberation, which may include actions up to and including dismissal.

v. Students who return from LOA after passing USMLE Step 1 will have new clerkship schedules based on availability or 
vi. Deferral of USMLE Step 1 may affect and delay the timeline of both residency application and graduation. 

4. The USMLE Step 2 CK examination cannot be attempted prior to successful completion of the Phase 2 curriculum in its entirety, including remediation requirements, if applicable. 

a. Taking this examination is a requirement for entering into Phase 3 of the M.D. Program. Students must take the USMLE Step 2CK examination no later than eight weeks after the completion of the Transition to Phase 3 course. 
b. Passing this examination is a requirement for both certification and participation in the National Resident Matching Program® (NRMP®), Military Match, SF Match, AUA Match, and/or CaRMS Match and for graduation. 
c. Exceptions to this requirement may be considered by formal written request and must be approved by the Dean of Students.  d. Any deferral of USMLE Step 2 CK may affect and delay the timeline of both residency application and graduation. 

B. Phase 2 Clinical Skills Competency Assessment (CSCA)

1. The CSCA examination is a multi-station standardized patient exam, administered during Phase 2 of the M.D. Program.  
2. Students who do not achieve the minimal competency benchmarks of -1.8 standard deviation in all stations on the CSCA examination will be subject to individualized remediation programs. Students must achieve the minimum competency benchmarks in each assessed category.

a. Failure to achieve the minimal competency benchmarks  in skills related to data gathering physical exam and interpersonal communicating skills will be managed by a clinical skills mentor. 
b. Failure to achieve the minimal competency benchmark in skill related to clinical reasoning, therapeutic plan, and/or data interpretation domains will be managed by a clinician mentor. 
c. Mentors will meet with the student once per week while they are on rotation in the first months of Phase 3. 

3. If a student is unsuccessful after formal remediation is completed, the student may be subject to additional actions, up to and including dismissal by the SAPRC. 

VI. EFFECTIVE DATE

This policy is effective immediately. 

VII. POLICY MANAGEMENT

Executive Stakeholder: Dean, School of Medicine
Oversight Office: Office of Undergraduate Medical Education, Office of Student Affairs

VIII. REFERENCES 

LCME 10.3 Policies Regarding Student Selection/Progress and Their Dissemination: The faculty of a medical school establish criteria for student selection and develop and implement effective policies and procedures regarding, and make decisions about, medical student application, selection, admission, assessment, promotion, graduation, and any disciplinary action. The medical school makes available to all interested parties its criteria, standards, policies, and procedures regarding these matters.