April 16, 1999

Chapman lecture ends medical licensure rumors

Chapman lecture ends medical licensure rumors


Dr. L. Thompson Bowles (left) and Dean John Chapman. (photo by Mary Donaldson)

A little knowledge often goes a long way toward de-mystifying the unknown.

That was the case in Light Hall last week, as Vanderbilt University School of Medicine students got the lowdown on the United States Medical Licensing Examination (USMLE), the test required of all medical students to practice medicine in this country. Dr. John E. Chapman, dean of Vanderbilt's School of Medicine, is chairman of the composite committee that governs the USMLE.

The students learned about the history of medical licensure in this country in addition to learning the ins and outs of the current exam from a physician well versed on the topic – Dr. L. Thompson Bowles, president of the National Board of Medical Examiners, administrators of the exam.

Bowles was at Vanderbilt to deliver the Second Annual John E. Chapman Lectureship on the Ecology of Medicine and Medical Education. His lecture, "Learning Evaluation, Ups and Downs in Nashville and Other Proper Places," provided an opportunity for first- and second-year medical students to learn more about the examination they must all pass.

"Unfounded rumors about the USMLE circulate frequently and quickly become accepted as fact," Bowles said. "Quite often they are very far from fact."

The test is broken up into three parts. Step one is a one-day test covering basic science knowledge and consists of 350 multiple-choice questions. Step two is also a one-day affair consisting on 350 multiple-choice questions, but it is devoted to clinical knowledge. Step three is two days long and consists of more detailed clinical knowledge and patient care information.

The USMLE is the single pathway used by all states for medical licensure. It supplanted the FLEX examination, created in 1968 to offset the differences among individual states' licensing tests.

According to Bowles, since the USMLE was instituted, 95 percent of students pass all three steps on the first try and 99 percent pass in less than four attempts. Test takers have been polled about the exam's fairness, appropriateness of material and balance of content, and so far the response has been very positive, Bowles said.

The high percentage of success among test takers doesn't mean the exam is easy, Bowles said.

"Knowing it's required makes passing the test a priority. It is highly motivational. The information gleaned preparing for the exam is also highly useful.

"After all, a sound general medical education is the best preparation for studying a specialty," Bowles told the students.

Also at last week's event, Bowles was awarded a Vanderbilt Medal of Merit in recognition of his achievement and his service as a colleague supporting the objectives of the School of Medicine.

The lecture Bowles delivered honors Chapman, the longest tenured dean at any medical school in the United States.

It was established by Dr. Richard E. Strain Jr., who graduated from VUSM in 1975, in memory of his father, Dr. Richard E. Strain Sr. The annual lecture is devoted to subjects that address the changing role of medicine in our culture.