UT Southwestern offers practice licensing test to hone clinical skills

Medical students across the country now must pass a new licensing test designed to gauge their skills as a physician in a clinical setting.

To help prepare students, UT Southwestern Medical School is offering its own practice version of the test. All fourth-year medical students as of 2005 must pass the Step 2 Clinical Skills Exam portion of the United States Medical Licensing Examination (USMLE) to become physicians.

“We’ve been preparing students for this for a long time,” said Dr. James Wagner, associate dean for student affairs. “We prepare them to be doctors, but with the advent of this test, we wanted to provide them with a practice exam that gives the students experience with this type of test.”                

During the practice test, students have a set amount of time to examine people trained to be patients. It’s designed to test students’ ability to take patient histories and administer physical exams.

Piloted last year, UT Southwestern’s practice exam, called the “Practice Clinical Skills Examination,” provided students with a clinical test that closely resembled the Step 2 Clinical Skills Exam. Students interacted with six “patients,” just as they would during the USMLE. The students were evaluated on their abilities not only on diagnosing ailments, but also on how they interacted with the patients.

“I took the school’s practice exam last summer and that’s the only thing I used to prepare for the exam,” said Javier Montes, a graduating fourth-year medical student who already passed the new exam. “I want to go into family medicine, and this is very similar to what my experiences will be.

“The practice test was a lot like the real test,” he said. “You walk up to the patient and talk to them just like you would in real life.”

The topics included in the practice exam were making a diagnosis, taking the patient’s history and interacting with the patient, such as talking to him or her in an understandable way as well as having a good bedside manner, he said.

During the USMLE, students must travel to testing sites where they get an eight-hour period to evaluate 11 or 12 standardized patients who are actors trained to present with a specific set of symptoms. Between June of 2004 and March of 2005, about 17,700 students took the Step 2 Clinical Skills Exam nationwide.

Dr. Wagner said that students attending UT Southwestern Medical School get plenty of clinical experience and interaction with real patients. Much of that real-life experience, he said, is spread out over their years as students. The new practice test presents the clinical encounter in a format that will help students prepare for the USMLE.

Last year about 150 students took the practice test. This summer, the test will be offered three times, and all beginning fourth-year medical students are encouraged to sign up.

“I took it last year, and we saw six patients,” said Jason Medina, a graduating fourth-year medical student. “I thought the school did a good job in terms of content. It was reflective of the real test.”

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