Hospitals, Policy

Why is a move to ‘standardize’ patient encounters infuriating medical students?

Unnecessary testing is a waste of time and resources for physician-trainees who are increasingly thrown under the bus by the non-practicing bureaucratic elite.

patient encounterThere are few times when medical academics sound more foolish than when they’re caught with their hands in the regulatory cookie jar.

Take, for instance, this response to the recent pushback by medical students against the National Board of Medical Examiners’ Step 2 CS requirement.  For those unfamiliar, this is an attempt for the NBME to “standardize” the patient encounter while collecting $1,250 at one of only five specialized testing centers in the US for the pleasure.  Their excuse for such a requirement?

“… most medical school faculty don’t have time to observe third- and fourth-year students doing a complete physical exam, so it’s important to test those skills as part of the licensing process.

“It’s really just a part of what we do to become physicians and to demonstrate to the public that we have earned their trust — that they can put their faith in us and feel comfortable with it,” Kastufrakis said.

The exam also serves as a sort of quality assurance test for medical schools, to make sure they’re teaching patient care skills, said Dr. Lia S. Logio, president of the Association of Program Directors in Internal Medicine. “I think everyone coming to my residency program should pass it, and pass it on the first attempt,” Logio said.”

Medical school faculty don’t have the time? Seriously? That’s their job. If medical school faculty, working 9 months a year while planning their research projects and next grant application, don’t have the time to evaluate the medical students that fund their salaries sufficiently, then perhaps they need to look inward rather than asking medical students to submit themselves to this money grab.

Medical school is already incredibly expensive (private schools here in Chicago enjoy a tuition and fees of over $54,000/year). Certification and licensure fees are many more thousands on top of that (again and again and again).  Unnecessary testing is a waste of time and resources for physician-trainees who are increasingly thrown under the bus by the non-practicing bureaucratic elite.

The whole process needs serious reassessment. Otherwise, our best and brightest will understand all too soon what they’re up against and that won’t be good for the “public” at all.

I suggest the NBME stop Step 2 CS and adjust their budget accordingly.

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Addendum: Interesting that the NMBE made $136 million in 2014  from testing fees, 50% of which went to salaries.

Photo: Flickr user Francisco Orsolo