Changes in clinical skills education resulting from the introduction of the USMLE™ step 2 clinical skills (CS) examination

Background: Step 2 Clinical Skills (CS) was recently introduced into the United States Medical Licensing Examination (USMLE™) to ensure that successful candidates for licensure possess the clinical skills to provide safe and effective patient care. Aims: To explore if medical schools had changed the objectives, content, or emphasis in their pre-clinical curriculum in response to its implementation. Methods: In April 2005, the Clerkship Directors in Internal Medicine (CDIM) sent an electronic survey to a single member from each medical school with a CDIM member. The survey instrument included 26 pre-clinical curricular questions with nine questions specifically addressing changes in response to implementation of the Step 2 CS. Results: Forty-five percent of respondents reported changes to the Introduction to Clinical Medicine (ICM) course objectives while 39% and 40% reported changes in content and emphasis. Seventy-four percent felt their students were adequately prepared for the Step 2 CS and 18% were unsure. Conclusions: Over a third of medical schools are implementing changes to the objectives, content, and/or emphasis of their curriculum, at least partially in response to the institution of Step 2 CS.