PROFESSIONAL ISSUES

Delegates oppose testing of clinical skills for licensure

Supporters of the NBME exam say a national standard is needed, but opponents say medical schools are better for skill assessment.

By Bonnie Booth, AMNews staff. Jan. 6, 2003.

New Orleans -- Medical students who have been opposed to the National Board of Medical Examiners' plan to test their clinical skills as a condition of licensure won long-sought backing from the American Medical Association House of Delegates during their meeting here in December 2002.

The issue has been the target of medical student ire for several years, but even though the AMA asked the NBME to delay implementation of the test, the Association's policy was to support clinical skills assessment at the national level and to support the use of such assessments in evaluation for licensure as long as they had been demonstrated to be "valid, reliable and practical."

This time around, however, delegates approved policy changes that "recognize that clinical skills assessment is best performed using a rigorous and consistent examination administered by the medical school and should not be used in evaluation for licensure of medical school graduates."

AMA Trustee J. James Rohack, MD, said the Association was likely to ask its Council on Medical Education, which already has significant experience in the debate on the clinical skills assessment exam, to review when in the medical education continuum clinical skills are best tested.

"The AMA will continue to push for the appropriate evaluation of clinical skills during medical school," Dr. Rohack said. "We will also request that the federation delay implementation of the test, but we recognize that is up to each state."

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