- The Washington Times - Monday, June 28, 2004

Medical students now must demonstrate not only technical proficiency, but also must pass a new nationwide skills test on patient interaction and communication to become a doctor.

The Clinical Skills Exam, administered by the National Board of Medical Examiners and the Federation of State Medical Boards, is the latest addition to the Medical Licensing Exam.

The one-day test is designed to assess a doctor’s ability to interact with patients, gather information, perform physical examinations and communicate in a manner that ensures accuracy and comfort for the patient.

“Doctors have to know a lot, but they have to be able to gather information, make decisions about what that information means, and talk to patients about what they think,” said Dr. Peter Scoles, senior vice president of the National Board of Medical Examiners. “Without that, doctoring doesn’t work.”

As of June 14, the exam is mandatory for all graduate and international medical students. While many medical schools have had similar tests in place for years, this is the first standardized national test.

“The test is far more than bedside manners. What you have to be able to demonstrate to pass this test is that you can take a medical exam, take a medical history and make some reasonable diagnostic assumptions and that you can communicate with a patient,” said Carol Thomson, of Steege/Thomson Communications. The group is responsible for publicizing the test.

Each candidate sees 12 “patients” — professionals trained to represent the age range of people who visit doctors in the United States with the exception of the frail elderly and children. The test took 15 years to prepare, Mrs. Thomson said, in order to devise a reliable system, as well as to construct training programs for professionals administering the test and those who act as patients.

Five centers across the country will administer the test, for which students pay $975. The first site in Philadelphia will be joined by sites in Atlanta, Los Angeles, Houston and Chicago, with the last site opening by September.

While the cost may seem steep for students already paying medical school bills, Dr. Scoles said the fundamental issue is patient safety, not cost.

“Compared to the cost of medical errors, this is really a small price,” he said. Mrs. Thompson said more than $50 million was put into the design of the test, training, and development of test centers, which feature one-way mirrors and cameras to observe student performance throughout the exam.

Students who fail the test can try again after 60 days up to three times a year, but states may have independent limits on how many attempts a student can make and still qualify for licensing.

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