The InCUS Experience and Upcoming Timeline
Nicole Taylor:
Hello and welcome to US MLE Connection. A podcast to keep you in the know
about all things USMLE. My guests today are Dave Johnson, Senior Vice
President of Assessment Services at Federation of State Medical Boards, and Dr.
Michael Brown,
Vice President of Licensure at National Board of Medical
Examiners. Our topic today is the InCUS experience and upcoming timeline. My
name is Nicole. Thank you for listening.
Nicole Taylor:
Hi Dave. Hi Mike. Thanks so much for joining me.
Michael Barone:
T
hanks for having us.
Dave Johnson:
Good morning.
Nicole Taylor:
So where are we in the post
InCUS timeline?
Michael Barone:
Well Nicole, we’re about five weeks outside of the conference right now. You
could imagine that the conference created a lot of insi
ghts and viewpoints. We
had multiple groups sharing their points of view and recommendations for ways
to move forward. Our plan right now is to convene the five members of the
InCUS planning group, the Federation of State Medical Boards, and the National
B
oard of Medical Examiners, the American Medical Association, the Association
of American Medical Colleges, and our close partner in the USMLE program, the
Educational Commission for Foreign Medical Graduates, to work through that
material, write some confe
rence proceedings, and begin to craft the preliminary
recommendations. We’re hoping to have that work finished up by early June
and we plan to post that document or the preliminary recommendations on the
InCUS website.
Nicole Taylor:
Great.
Dave Johnson:
N
icole, I would just add that we anticipate that that period of public
commentary would run about six weeks and we’re going to try to collect
comments through a web format. This should allow us to work through
incorporating additional viewpoints and informa
tion in crafting any final
recommendations. These will be vetted through the stakeholder groups that
Mike described and we anticipate that any approved recommendations will
finally be posted probably in the fall of this year. These timelines are definitely
approximations since the details, both in the scope and complexity of any of the
recommendations potentially that come out of InCUS, can really impact the
projected timeline. These are just what I’ve mentioned, an approximation of the
timeline at this poi
nt.
Nicole Taylor:
Okay, great. That makes sense. You spoke a bit about the views and information
shared by the attendees. I’m wondering, did they provide recommendations?
And over the course of InCUS, did the viewpoints that they have change?
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Michael Baro
ne:
Well, InCUS was designed to bring together groups that had never really talked
to one another. So we had representatives of state medical boards speaking
with medical students about critical issues like physician and trainee wellness.
We had residency
program directors from community
based hospitals talking to
CEOs of large medical education organizations.
Michael Barone:
I mention that only because there was a preconception of what the US MLE
program, or the broader system might do, in advance of InCUS
. And my only
response to that would be we would have never brought these people together
if we had preconceptions. This is a complex problem. We knew that we had to
have all the voices in the room. And everybody provided input.
Michael Barone:
We ended th
e conference with what we call the village fair format, where
various ways forward were posted on boards throughout the room and people
were invited to go to various places in the room and just provide their ideas for
options of ways forward, both pertaini
ng to USMLE score reporting and also
pertaining to things like residency application and residency selection.
Nicole Taylor:
Thank you.
Nicole Taylor:
Dave. I’d love to hear your perspective.
Dave Johnson:
Some of these stakeholder groups are those that do
n’t necessarily come into
contact on a regular basis. One of the first objectives at this meeting really was
connection. We were trying to bring these folks together and then we went
through an activity, for example, that paired them, in which they took a
few
minutes to interview each other and then share out what they had learned.
Dave Johnson:
I mean this really was designed to set the tone that it was important for
everyone to be listening to one another. As a lot of the individuals here came
with divers
e experiences and are not necessarily defined by their specific role or
sort of the stake they have in the ground depending on the community they had
come from.
Nicole Taylor:
So how did you get people with such busy schedules in one room?
Michael Barone:
When we invited these individuals, they were eager to come. They’re folks who
are passionate about medical students, passionate about assessment, and the
transition to residency. We asked them to come with their points of view. Many
of them have written ab
out their points of view in various publications or
presented this nationally. They volunteered their time to do so.
Nicole Taylor:
You know, I imagine with all of the various stakeholders at InCUS and the
complexity of what they were discussing, it seems
that gaining consensus
might’ve been difficult. I’m curious about whether or not there were areas
where people naturally agreed.
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Dave Johnson:
Well, actually Nicole, there were. We were pleased by this. There was consensus
on several very fundamental point
s. One being that the current system for
transitioning medical school graduates into GME appears to be flawed and I
think many of the attendees actually might’ve even used a little stronger
language to say outright broken.
Dave Johnson:
A second area in wh
ich I think there was consensus was that unilateral changes
made by USMLE alone is not going to fix an overall system by which the medical
graduates transition into GME. And a third point, which I thought there was very
fundamental agreement, was that chan
ges, both systemic and those specific to
USMLE, do need to be explored. They need to be identified and implemented.
But on a reasonable timeline that is not overly disruptive.
Nicole Taylor:
So Dave, I have a followup question. As you say that the system
is flawed, what
would you say to people who would logically follow with that, "Well you’re just
passing the buck"?
Dave Johnson:
Well, I think the very fact that we were convening this invitational conference
just really begins to push back against that ki
nd of critique. We reached out to a
diverse group of individuals, as Mike has said already. There was no
preconceived notion in terms of where we were going to come out from this
conference. And we, in good faith, have done a lot of listening to what peopl
e
have said.
Dave Johnson:
I’m very pleased as this summary document from the conference is being
formulated and I’m looking forward to the point in which we’ve got some of this
out there with recommendations, both those specific to USMLE and the broader
s
ystem. For the wider community, be able to provide us some input. I think
that’s probably in some ways the most fundamental way we can show the good
faith on our part to move this issue forward in a positive and constructive way.
Nicole Taylor:
Great. Than
k you.
Michael Barone:
Nicole, can I make a couple of comments? This sense of disruption that Dave
mentioned or the tolerance for disruption. It was clear that an abrupt change to
the system may not be in everybody’s best interest. But countered by a sense
of
urgency here that we did need to commit to action as a program and as a
community and implement some change.
Nicole Taylor:
So it sounds like there was a lot of information gained. After the steps you
talked about earlier, what are you looking forward
to in the fall?
Michael Barone:
I’m looking forward to the recommendation period of public commentary. So
we’ll draft recommendations as we’re doing now. They’ll naturally be presented
to various internal groups and then we’ll have a period of public comme
ntary
where organizations, individuals could comment on those.
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Michael Barone:
Naturally, we think we’re going to get a lot of commentary. We’ll take some
time to digest that, formulate it into some more formal recommendations, and
then present those not
only to the USMLE’s governance structure, which would
include members of medical regulation, medical education. We have learners on
USMLE governance as well. But also the parent boards of the organizations. Not
only the ones that are involved in USMLE prog
ram. We imagined some
recommendations may need to go ahead of the boards of the other
organizations as well.
Michael Barone:
All of that will happen this year and we’re hopeful that we can commit to some
timelines for change by the end of the year as Dave
said earlier. Executing those
changes probably late year into 2020.
Nicole Taylor:
Dave, where can they find more information about the timeline?
Dave Johnson:
Nicole, we have a great deal of information actually on the USMLE website. We
have carved out a
specific area for InCUS, the Invitational Conference on USMLE
scoring. You’ll find a wide variety of information, timelines, you’ll find some
review of key literature and research, you’ll find essentially a quick overview of
pros and cons when people were
talking about specific solutions such as pass,
fail scoring for USMLE. So there’s a lot of materials available that we encourage
everyone to check out.
Nicole Taylor:
Thank you so much, both of you for coming on the podcast today.
Michael Barone:
Thanks Ni
cole.
Dave Johnson:
Thank you, Nicole.