National Board of Medical Examiners explained

National Board of Medical Examiners
Type:Nonprofit educational
Location:3750 Market Street, Philadelphia, Pennsylvania, U.S. (headquarters)
Leader Title:President & CEO
Leader Name:Peter J. Katsufrakis, MD, MBA

The National Board of Medical Examiners (NBME), founded in 1915, is a United States non-profit which develops and manages assessments student physicians. Known for its role in developing the United States Medical Licensing Examination (USMLE) in partnership with the Federation of State Medical Boards (FSMB), USMLE examinations for medical students and residents are used by medical licensing authorities in the U.S. to help determine qualifications to grant and recognize medical licenses.[1] NBME also creates assessments and materials that are used by medical students, medical educators, practicing physicians, and for state testing of physicians already holding licenses.[2] [3]

NBME's stated mission is to "protect the health of the public through state of the art assessment of health professionals" and emphasizes that "while NBME's mission is centered on assessment of physicians, this mission encompasses the spectrum of health professionals along the continuum of education, training and practice and includes research in evaluation as well as development of assessment instruments".NBME is headquartered on and adjacent to the University City Science Center research campus in Philadelphia, Pennsylvania.[4]

History

The NBME was founded in Philadelphia in 1915, with the goal of creating a voluntary medical licensing exam that would be accepted by U.S. states and territories in lieu of their own exams, allowing physicians to practice across state lines.[5] Use of NBME Certifying Examinations ("Part" exams) grew in the years following its founding and in the years leading up to World War II. Prior to the war, states still administered their own exams, and operated agreements to license doctors passed by other state exams through membership in the Federation of State Medical Boards (FSMB).[6] But by 1943, 45 of the 48 states accepted NBME exams for licensure along with their state exams.[5] After the war, states continued to use the results of an NBME exam to decide whether to award medical licenses. This system meant students from different states would sit the same exam.[6] By 1992, 49 of the 50 US states accepted NBME exams for licensure along with their state exams.

The United States Medical Licensing Examination (USMLE), introduced in 1992, is a multi-part professional exam sponsored by the Federation of State Medical Boards (FSMB) and NBME. Medical students attending U.S. institutions are required to pass USMLE Step 1 and Step 2 Clinical Knowledge to enter into residency training where they treat patients under supervision.[7] [8] [9] Graduates of international medical schools seeking a medical residency in the United States generally take Step 1 and Step 2 CK after obtaining an MD or equivalent degree.[10] USMLE Step 3 must be passed before a Doctor of Medicine can apply to obtain a license to practice unsupervised medicine in the United States.[11] Because medical licenses are awarded by states, the process can vary depending on the state in which an MD or DO holder is seeking licensure. Some states cap the number times the USMLE Step exams can be taken or provide a time limit for completing the sequence of licensing exams.[12]

To assist examinees, NBME maintains a web portal that provides access to self-assessment test forms to help medical students practice for upcoming exams such as the USMLE Step 1, USMLE Step 2 CK, NBME Subject Exams, and the International Foundations of Medicine (IFOM) exams.[13] Beginning in 2021, most self-assessments became available in test forms that provide detailed answer explanations for both correct and incorrect answers.[14] As of March 24, 2021, NBME assessment form numbers 25, 26, 27, 28, 29, and 30 replaced retired form numbers 18 through 24.[13]

Other NBME Exams Used in Medical Education

Current Leadership (as of 2021)

Controversies

In 2018, NBME President Peter Katsufrakis and FSMB President Humayun Chaudhry co-authored an invited commentary titled Improving Residency Selection Requires Close Study and Better Understanding of Stakeholder Needs. Their article was in response to a previously published article on the "climate" medical students experienced around Step 1 of the USMLE and use of exam results in residency selection.[19] In one line of the article, Katsufrakis and Chaudhry theorized that pass/fail score reporting for the USMLE Step 1 exam that required less study time could result in a less knowledgeable population of physicians if students used the gained time to binge-watch Netflix or using social media platforms such as Instagram.[20] [21]

Beginning mid-March 2020, testing centers operated by Prometric were closed based on local health and safety guidelines due to the COVID-19 pandemic. Prometric center administrations for NBME-developed assessments such as USMLE, Health Professionals, and NBME Subject Examinations were suspended completely for several months.[22] [23] USMLE waived fees associated with extending testing eligibility periods and changing testing locations.[24] [25] Prometric resumed test administration for "essential services" clients at reduced capacity, which included NBME assessments, in May 2020. The medical community criticized Prometric for the mishandling of testing centers operations during the pandemic, creating "chaos", further "disadvantages", "harm", "bias" and "inequity". Prometric issued an apology to NBME for mishandling communication with students around exam scheduling during the pandemic.

Also in 2020, the medical community criticized NBME's refusal to accelerate USMLE Step 1 score reporting to pass/fail before 2022 and called for an emergency committee (that included student representatives) who could address these issues in a timely manner without financial or other conflicts of interest.[26]

The National Board of Medical Examiners (NBME) which is responsible for creating and publishing board exams for medical students around the United States conforms to the use of DSM-5 criteria despite the known problems with an unquestioning checklist approach to diagnosis and treatment based on the DSM that have been outlined by critics.[27] Not all providers rely on the DSM-5 for planning treatment as the ICD's mental disorder diagnoses are used around the world[28] and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.[29] [30] [31] [32]

See also

Notes and References

  1. Statistics of Land-grant Colleges and Universities (1921) United States Office of Education
  2. Web site: National Board of Medical Examiners® (NBME®). 2021-07-13. 2021-07-13. https://web.archive.org/web/20210713183011/https://globalphiladelphia.org/organizations/national-board-medical-examiners%C2%AE-nbme%C2%AE. live.
  3. Web site: About NBME | NBME. 2020-06-03. 2020-06-03. https://web.archive.org/web/20200603010617/https://www.nbme.org/about-nbme. live.
  4. News: Kostelni. Natalie. 2007-11-23. Medical examiners to expand HQ. Philadelphia Business Journal. 2009-05-16.
  5. Web site: 100 years later, medical licensing exam still a herculean task. 2021-07-13. 2021-07-13. https://web.archive.org/web/20210713223525/https://whyy.org/segments/100-years-of-medical-boards/. live.
  6. Ludmerer, Kenneth M. Time to heal: American medical education from the turn of the century to the era of managed care (1999), Oxford University Press US, 1999. p. 197-198.
  7. Web site: Step 1 | USMLE. 2021-07-13. 2021-08-12. https://web.archive.org/web/20210812163911/https://usmle.org/step-1/. live.
  8. Web site: Step 2 CK | USMLE.
  9. Web site: Doctor of medicine profession (MD): MedlinePlus Medical Encyclopedia . 2021-07-13 . 2016-10-09 . https://web.archive.org/web/20161009184412/https://medlineplus.gov/ency/article/001936.htm . live .
  10. Web site: Pathway to Medical Licensure in the U.S . 11 July 2024 . 25 February 2024 . https://web.archive.org/web/20240225212755/https://www.fsmb.org/siteassets/usmle-step3/pdfs/pathway-to-licensure.pdf . live .
  11. Melnick. Donald E.. December 2006. From Defending the Walls to Improving Global Medical Education: Fifty Years of Collaboration between the ECFMG and the NBME. Academic Medicine. Association of American Medical Colleges. 81. 12 Suppl. S30-S35, Volume 81 - Issue 12. 10.1097/01.ACM.0000243462.05719.e1. 17086043. free.
  12. Web site: FSMB | State Specific Requirements for Initial Medical Licensure. 2021-07-13. 2020-07-23. https://web.archive.org/web/20200723173402/https://www.fsmb.org/step-3/state-licensure/. live.
  13. Web site: NBME Self-Assessments | NBME. 2021-07-13. 2021-07-13. https://web.archive.org/web/20210713222815/https://www.nbme.org/examinees/self-assessments. live.
  14. Web site: Additional Answer Explanations Planned for NBME® Self-Assessments in 2020 and 2021 | NBME. 2021-07-13. 2021-07-13. https://web.archive.org/web/20210713222814/https://www.nbme.org/news/additional-answer-explanations-planned-nbmer-self-assessments-2020-and-2021. live.
  15. Web site: AMA Backs More Healthcare Economics Education for Med Students. 2021-07-16. 2021-07-16. https://web.archive.org/web/20210716181929/https://www.medscape.com/viewarticle/921603. live.
  16. Web site: Request Rejected. 2021-07-16. 2021-07-16. https://web.archive.org/web/20210716181929/https://www.nbme.org/sites/default/files/2020-01/Whats_New_HSS.pdf. live.
  17. Web site: NBME Announces New Members and Officers Elected to Its Board of Directors. 30 March 2021. 16 July 2021. 11 July 2024. https://web.archive.org/web/20240711043648/https://finance.yahoo.com/news/nbme-announces-members-officers-elected-190000565.html?guce_referrer=aHR0cHM6Ly93d3cuZ29...&guccounter=2&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAKQKI1AeBOaS2ditc50Cr6KM5gj9jXOo4dnGvMK872bzpgMtodRNrkcN8ko_YmFU9pwsubtDbn_MaTdc1WIIjIs3g6lgANiCaFM6qVe1OX3QIkovobHVR6FarcjY6AtaDRlwIT_6YSV5P5ElufxmP9v1hac19EFzlpOdsdKyntQZ. live.
  18. Web site: Our People | NBME. www.nbme.org. 2020-06-03. 2020-06-03. https://web.archive.org/web/20200603010546/https://www.nbme.org/about-nbme/our-people. live.
  19. 30570495. 2019. Katsufrakis. P. J.. Chaudhry. H. J.. Improving Residency Selection Requires Close Study and Better Understanding of Stakeholder Needs. Academic Medicine: Journal of the Association of American Medical Colleges. 94. 3. 305–308. 10.1097/ACM.0000000000002559. 58564397. free.
  20. Web site: Dear NBME and FSMB, I watch HGTV more than Netflix: A Response to the Invited Commentary on USMLE Step 1. 30 December 2018. 3 June 2020. 11 July 2024. https://web.archive.org/web/20240711043649/https://in-housestaff.org/dear-nbme-and-fsmb-i-watch-hgtv-more-than-netflix-a-response-to-the-invited-commentary-on-usmle-step-1-1274. live.
  21. Web site: Step 1 vs. Netflix and Instagram. opmed.doximity.com. 2020-06-03. 2022-08-12. https://web.archive.org/web/20220812161223/https://opmed.doximity.com/articles/step-1-vs-netflix-and-instagram. live.
  22. Web site: 2 June 2020 . Delays, miscommunications add even more stress to USMLE Step exams . 19 June 2020 . 21 June 2020 . https://web.archive.org/web/20200621214303/https://www.ama-assn.org/residents-students/usmle/delays-miscommunications-add-even-more-stress-usmle-step-exams . live .
  23. Web site: 11 May 2020 . Medical Licensing Examinations in the COVID-19 Era . 23 December 2021 . 11 July 2024 . https://web.archive.org/web/20240711043650/https://www.medpagetoday.com/publichealthpolicy/medicaleducation/86427 . live .
  24. Web site: 24 March 2020 . 4 questions medical students are asking on the COVID-19 pandemic . 13 July 2021 . 13 July 2021 . https://web.archive.org/web/20210713184828/https://www.ama-assn.org/delivering-care/public-health/4-questions-medical-students-are-asking-covid-19-pandemic . live .
  25. Web site: Free NBME Self-Assessments Available Through September 30, 2020 | NBME. June 18, 2024. www.nbme.org. July 13, 2021. July 13, 2021. https://web.archive.org/web/20210713183325/https://www.nbme.org/news/free-nbme-self-assessments-available-through-september-30-2020. live.
  26. Web site: USMLE Testing Chaos May Harm Current and Future Doctors. Medscape. 2020-06-19. 2024-07-11. https://web.archive.org/web/20240711043651/https://www.medscape.com/viewarticle/932366. live.
  27. Wakefield JC . Epidemiology and Psychiatric Sciences . DSM-5, psychiatric epidemiology and the false positives problem . 24 . 3 . 188–196 . Cambridge University Press . June 2015 . 2045-7960 . 10.1017/S2045796015000116 . 25675983 . 6998664 .
  28. First M, Rebello T, Keeley J, Bhargava R, Dai Y, Kulygina M, Matsumoto C, Robles R, Stona A, Reed G . Do mental health professionals use diagnostic classifications the way we think they do? A global survey. World Psychiatry. en. 17. 2. 187–195. 29856559. June 2018 . 10.1002/wps.20525. 5980454 .
  29. Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JP, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JP, Geddes JR . Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis . Lancet . 7 April 2018 . 391 . 10128 . 1357–1366 . 10.1016/S0140-6736(17)32802-7 . 29477251 . 5889788 .
  30. Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D . International Clinical Psychopharmacology . Efficacy of treatments for anxiety disorders: a meta-analysis . 30 . 4 . 183–192 . July 2015 . 0268-1315 . 10.1097/YIC.0000000000000078. 25932596 . 24088074 .
  31. Schneider-Thoma J, Chalkou K, Dörries C, Bighelli I, Ceraso A, Huhn M, Siafis S, Davis JM, Cipriani A, Furukawa TA, Salanti G, Leucht S . Lancet . Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis . 399 . 10327 . 26 February 2022 . 824–836 . 0140-6736 . 10.1016/S0140-6736(21)01997-8 . 35219395 . 247087411 . 1 May 2023 . free . 2 May 2023 . https://web.archive.org/web/20230502052504/https://pubmed.ncbi.nlm.nih.gov/35219395/ . live .
  32. Gartlehner G, Crotty K, Kennedy S, Edlund MJ, Ali R, Siddiqui M, Fortman R, Wines R, Persad E, Viswanathan M . CNS Drugs . Pharmacological Treatments for Borderline Personality Disorder: A Systematic Review and Meta-Analysis . 35 . 10 . 1053–1067 . October 2021 . 1172-7047 . 10.1007/s40263-021-00855-4. 34495494 . 8478737 .

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