A Plea to Reassess the Role of United States Medical Licensing Examination Step 1 Scores in Residency Selection.

The three-step United States Medical Licensing Examination (USMLE) was developed by the National Board of Medical Examiners and the Federation of State Medical Boards to provide medical licensing authorities a uniform evaluation system on which to base licensure. The test results appear to be a good measure of content knowledge and a reasonable predictor of performance on subsequent in-training and certification exams. Nonetheless, it is disconcerting that the test preoccupies so much of students' attention with attendant substantial costs (in time and money) and mental and emotional anguish.

Commentary: Balancing responsibility to patients and responsibility to aspiring physicians with disabilities.

In 2008, Congress amended the Americans with Disabilities Act (ADA) to relax court-imposed limitations on evidence required to warrant protection under the ADA. Since passage of the ADA in 1990, medicine has focused not on evaluating the types of accommodations that would best balance the interests of individuals with disabilities, institutions, and patients but, rather, on the question of whether individuals seeking protection under the law qualify for disability accommodations at all. The medical profession should refocus on the nature of accommodations provided to those with disabilities.

Licensing examinations in North America: is external audit valuable?

The United States and Canada both have long-standing, highly developed national systems of assessment for medical-licensure based outside the institutions of medical education. This commentary reviews those programs and explores some of the reasons for their implementation and retention for nearly a century. The North American experience may be relevant to dialog about national or European assessments for medical practice.

From defending the walls to improving global medical education: fifty years of collaboration between the ECFMG and the NBME.

The author outlines the intertwining roles of the Educational Commission for Foreign Medical Graduates (ECFMG), which is celebrating its 50th anniversary in 2006, and the National Board of Medical Examiners (NBME) in meeting needs for assessment of international medical graduates. Both organizations had early histories focused on a protective role: ensuring that only the most qualified foreign-trained doctors could train or practice in the United States. The two organizations have interacted throughout the ECFMG's 50-year history to improve the assessment of internationally trained doctors.

Physician performance and assessment and their effect on continuing medical education and continuing professional development.

This article has three key points. The first proposes and illustrates a model for planning effective continuing medical education (CME) and continuing professional development (CPD) and how assessment might fit into it. The second reviews major trends in assessment, particularly with regard to regulation and CME.