The Problem

In the midst of a global pandemic we as medical students are being asked to descend upon urban COVID-19 hotbeds such as Atlanta, Chicago, Houston, Los Angeles, and Philadelphia for the USMLE Step 2 CS or even worse, just Chicago and Philadelphia for the COMLEX Level 2 PE. We'll come from all over the country to be condensed in the same building, risk spreading a virus gripping our entire reality, and then go back to where we came from while it incubates inside of us. We could be the harbingers of a second wave of COVID-19 in a cruel and ironic public health nightmare. All for an exam that 46%/58% of program directors don't even require (Step 2 CS/Level 2 PE) according to the 2018 NRMP program director survey.

As if that wasn't enough, we are being forced to reschedule written board exams with no say in the matter after paying exorbitant sums of money to sit for a date that we planned months in advance for with little notice. Students plan their studying to sit for a very particular day, just to have the rug ripped out from beneath them. DO students who are forced to sit for both the COMLEX and the USMLE (due to requirements for their specialty of choice) have it worst, as they pay more than $6000 for these exams, and they still have a 50/50 shot of being moved around without any control of their own calendar. As student consumers we deserve better, but there is only one big player, Prometric, that we all have to work through. And they've stopped fielding our calls.

The Proposed Solution

Medical schools around the country administer examinations all the time. We take nationally administered COMAT exams as osteopathic students leading up to the Level 2 PE and our MD colleagues take comparable shelf exams to track their progress leading up to the Step 2 CK. These are done in-house at our medical schools without issue monthly. In light of COVID-19 we've even taken some of those exams unproctored at home. Integrity is expected of physicians every day in practice and we've stepped up in these unprecedented times to display it as we continue our education.

These shelf exams are proctored written exams just like the Level/Step 1 exams and the Level/Step 2 exams. Medical schools are more than capable of administering those aforementioned board exams in house, as well as OSCE style exams like the Level 2 PE/Step 2 CS.

As a student, consumer, and informed aspiring healthcare professional, I implore the NBME and the NBOME to consider and do the following:

• Written Exams
  • Allow medical schools to proctor the Level/Step 1 exams and the Level 2 CE/Step 2 CK for their students who are displaced from written testing environments at Prometric in house in a controlled, proctored, testing environment.
• Clinical Exams
  • Allow medical schools to administer a Level 2 PE/Step 2 CS equivalent in the form of an OSCE exam for this application cycle in the interest of public health and logistical requirements for NRMP application, should they have the standardized patient resources to do so and the facilities to record encounters to send to the NBME/NBOME for quality control.
  • Extend deadlines for Level 2 PE/Step 2 CS to ensure that students are able to graduate even if they have been displaced from an exam spot that would have allowed them adequate time to remediate if needed.
  • Permit students to bring their own PPE and use it during the exam without penalty to their patient satisfaction scores. 

Thank you for your attention to this petition. I hope that we as future healthcare professionals and current healthcare professionals alike can get behind these reasonable requests to #FlattenTheCurve and keep the classes of 2021 and 2022 on track to graduate and continue onward to graduate medical education in spite of all of the challenges that COVID-19 has placed in our path. Please share this with your friends, classmates, and colleagues. We need to gather all the support we can get!