RESPONDING TO THE
PROPOSED USMLE “GATEWAY” INITIATIVE:
Ruth Greenberg* and David
Wiegman, University of Louisville School of Medicine, Louisville, KY, 40202,
U.S.A.
PURPOSE: For the past year,
medical schools have been discussing the curricular and assessment implications
associated with a possible change in the current USMLE licensure system that
would eliminate Step 1 and Step 2 CK and replace them with a new “gateway”
examination at the end of third year.
Although no formal proposal has yet been presented by USMLE, medical
educators have begun to consider its curricular impact. This abstract describes the steps one medical
school has taken to promote student success in a potential end-of-third-year
examination.
METHODS: As a medical school
with a relatively “traditional” curricular structure, we were concerned about
the possible elimination of Step 1. The
Educational Policy Committee (EPC) encouraged the Dean to initiate curriculum
review. The Dean charged the EPC to make
recommendations that would respond to the proposed Gateway system. The EPC hosted a Curriculum Retreat to
solicit feedback about a core set of curricular revisions. The Retreat was well attended by stakeholders
(students, department chairs, faculty). Work groups were used to develop
recommendations, including a “funding” work group.
RESULTS: The Curriculum
Retreat was well received by attendees.
Post-retreat communications with attendees and other medical school
stakeholders created a positive attitude toward
curricular change. Recommendations and a
proposed budget were forwarded to the Dean. Recommendations included starting clinical
clerkships earlier, creating an integrated lecture series in clinical years for
all students, and restructuring some basic science courses.
CONCLUSION: Even the possibility
of change in a high-stakes licensure examination may become an effective tool
for promoting curricular review and reform.