USMLE Update on Resuming Testing

Resuming United States Medical Licensing Examination^® (USMLE) testing remains the USMLE program's top priority. Below, please read several key updates.

Status of Prometric Testing
Testing resumed at select Prometric centers on Friday, May 1 in accordance with state and local social distancing guidelines. Although hundreds of examinees successfully tested, the overall examinee experience is not meeting expectations. The USMLE program continues to exert pressure on Prometric to rectify all issues in a timely manner. The USMLE program is working daily with Prometric and they have dedicated resources to both resume USMLE testing and address the quality of the examinee experience.

The USMLE program understands that when Prometric test centers reopened, some examinees with confirmed slots traveled to test centers only to find them closed, leading to increased confusion during an already difficult situation. The USMLE program has been disappointed with Prometric's failure to fulfill its obligations to examinees and to the USMLE program. The USMLE program has emphasized to Prometric the importance of their obligations to examinees and the harm that their failures have caused.

Examinees who have suffered direct out-of-pocket monetary losses due to Prometric's lack of communication or miscommunication regarding test center closures should submit a written claim directly to Prometric at prometric.com/contact-us.

In March 2020, in response to the suspension in testing, the USMLE program extended eligibility periods to December 2020 for all examinees who had a Step 1, Step 2 Clinical Knowledge (CK), or Step 3 scheduling permit with an unexpired eligibility period with an end date in 2020. To help alleviate some of the pressure examinees may be feeling, USMLE will further extend eligibility periods through June 2021.

Note: Eligibility period extensions will be processed approximately over the next eight to twelve weeks.

Alternate Delivery of USMLE Step 1, Step 2 CK, and Step 3
To resume testing, the USMLE program has already identified several options for proctored testing outside of Prometric centers. The USMLE program is expecting to begin testing at some medical school campuses this month. USMLE is committed to offering a broader distribution of testing at medical schools; it is working through technological challenges in order to do so. While this solution will not completely address the testing backlog, it will provide additional USMLE-specified slots within Prometric's overall capacity, which is increasing. Schools are being considered based on geographic location and a willingness to serve as a regional testing site. Because the USMLE program is not able to scale this solution to all schools, it plans to deliver other solutions as well. The USMLE program will ramp-up testing as it institutes new systems and processes.

The USMLE program continues to aggressively explore remote proctoring and expects to have progress to report on the timeline for that project in the next week.

Validity, Reliability, and Fairness
The USMLE program recognizes the burden that reduced testing capacity places on schools and examinees. As the USMLE program moves forward with solutions to alleviate this burden, it must also evaluate the fairness of any test administration method. The USMLE program needs to ensure that its test administration models allow all test takers to reliably and validly demonstrate their skills and maximize, to the extent possible, fairness, access, security, and reliability. Increasing capacity by deploying exam administrations to schools may create differential geographic access. Similarly, with respect to remote proctoring, the USMLE program recognizes that not all schools or individuals have equal access to high-speed internet, a computer that meets the technology requirements for remote proctoring, or dedicated space in which to take the test.

Given these issues of fairness and bias, the USMLE program will continue to work with organizations in the medical education and the medical regulatory community to identify temporary changes to policy and requirements such as relaxing requirements for promotion, graduation, or licensing decisions. The USMLE program is committed to continuing its focus on delivering safe testing and fair test results for examinees.

Step 2 CS
As announced previously, Step 2 Clinical Skills (CS) testing has been suspended due to the COVID-19 (coronavirus) pandemic, and the USMLE program is pursuing testing solutions to ensure the health and safety of examinees and test center staff. After careful consideration, the USMLE program has determined that it cannot resume the exam in its current format without unacceptable risk to examinees and staff.

Prior to COVID-19, the USMLE program was in the very early stages of exploring alternate formats and methods for delivery of the Step 2 CS exam, as part of overall efforts to enhance the USMLE. As a result of COVID-19, these plans have been accelerated and are focused on a testing solution that employs a telehealth model, where examinees and standardized patients would interact on-line, via a web browser. The USMLE program is aggressively assessing this solution, which will require significant redesign of the exam's content and delivery. Expediting such changes to the exam format and delivery will help result in a safe and effective assessment for all involved.

At this time, Step 2 CS testing is expected to resume after July.

Please know that the USMLE program is doing everything it can to address the challenges of this new environment quickly, and that it will continue to provide you with updates on its progress.

ECFMG Medical School Accreditation Requirement Moved to 2024

ECFMG previously announced that, starting in 2023, applicants for ECFMG Certification will be required to be a student or graduate of a medical school that is appropriately accredited. More specifically, the medical school must be accredited by an agency recognized by the World Federation for Medical Education (WFME). To date, 21 accrediting agencies have received WFME recognition, with many others in process. We are energized by the commitment to quality improvement demonstrated in response to this initiative.

At the same time, we recognize that many countries have been forced to suspend or limit their accreditation efforts due to COVID-19. As such, we are moving the implementation of the requirement to 2024. We will announce an effective date as we approach 2024; we will also continue to reassess this timeline as needed.

Further information regarding this change will be provided in the coming weeks on our website at www.ecfmg.org/accreditation.

ECFMG|FAIMER Endorses Recommendations and Resources for Medical Students, Trainees, and Physicians during COVID-19

On May 11, the Coalition for Physician Accountability, of which ECFMG|FAIMER is a member, released final reports from two work groups that examined critical issues facing medical students, residents, medical educators, and medical regulators during the COVID-19 pandemic. ECFMG|FAIMER strongly endorses the work groups' recommendations.

Medical Students in the Class of 2021: Moving Across Institutions for Post Graduate Training

The current health care crisis presents new challenges for medical students/graduates, trainees, and U.S. training programs. This work group considered three major issues in preparation for the 2020-2021 residency cycle during the COVID-19 pandemic: away rotations, in-person interviews for residency, and the timeline for the Electronic Residency Application Service^® (ERAS^®). The recommendations will provide a consistent approach to disruptions caused by the COVID-19 pandemic, greatly reducing unnecessary confusion, stress, and inequity among students, and promoting a more successful residency selection process for all.

Maintaining Quality and Safety Standards Amid COVID-19

The pandemic has created a public health emergency that is rapidly altering the provision of health care services across the country. Physicians and other clinicians have responded with offers to provide care outside of their previously licensed jurisdiction and beyond their typical scope of practice. This work group has developed guidance and resources for the deployment of physicians, physicians in training (interns, residents, and fellows), and retired or inactive physicians, to ensure the safe delivery of quality clinical care during this unprecedented emergency.

Read the full announcement and access the reports and recommendations here.