Abstract

PurposeUnited States (US) and Canadian citizens attending medical school abroad often desire to return to the US for residency, and therefore must pass US licensing exams. We describe a 2-day United States Medical Licensing Examination (USMLE) step 2 clinical skills (CS) preparation course for students in the Technion American Medical School program (Haifa, Israel) between 2012 and 2016.MethodsStudents completed pre- and post-course questionnaires. The paired t-test was used to measure students’ perceptions of knowledge, preparation, confidence, and competence in CS pre- and post-course. To test for differences by gender or country of birth, analysis of variance was used. We compared USMLE step 2 CS pass rates between the 5 years prior to the course and the 5 years during which the course was offered.ResultsNinety students took the course between 2012 and 2016. Course evaluations began in 2013. Seventy-three students agreed to participate in the evaluation, and 64 completed the pre- and post-course surveys. Of the 64 students, 58% were US-born and 53% were male. Students reported statistically significant improvements in confidence and competence in all areas. No differences were found by gender or country of origin. The average pass rate for the 5 years prior to the course was 82%, and the average pass rate for the 5 years of the course was 89%.ConclusionA CS course delivered at an international medical school may help to close the gap between the pass rates of US and international medical graduates on a high-stakes licensing exam. More experience is needed to determine if this model is replicable.

Highlights

  • International medical graduates (IMGs) make up approximately 25% of current trainees in United States (US) residency programs

  • We describe the development and evalu­ ation of a United States Medical Licensing Examination (USMLE) step 2 clinical skills (CS) preparation course provided at the Tech­ nion Israel Institute of Technology School of Medicine for US and Canadian medical students in the Technion American Medical School (TEAMS) program between 2012 and 2016

  • Interactive, experiential teaching meth­ ods received the highest ratings. This is the first study to describe a successful USMLE step 2 CS preparation course conducted within the local learning environment of an international medical school

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Summary

Introduction

International medical graduates (IMGs) make up approximately 25% of current trainees in United States (US) residency programs. A substantial subset (about 38%) of IMGs are US and Canadian citi­ zens (US IMGs) who attend medical school abroad [1]. Most of these students desire to return to the US or Canada to complete resi­ dency training and practice medicine. US IMGs represent about 14% of all US residency applicants [1]. To enter graduate training in the US, IMGs must be certified by the Educational Commission for Foreign Medical Graduates. In 2015, US citizens made up 26% of all IMGs seeking certification in the US [2].

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