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The USMLE organization, the single group responsible for certifying all American physicians, has added the USMLE Step 4 for all current and future medical residents.

usmle_This new Step will include 3 parts:

1) A written section similar to Step 3 but labeled Step 4CBK (Clinical and Book Knowledge) and will include a $550 registration fee and a $350 testing fee.

2) A Step 4CSK (Clinical Skills and Knowledge) that includes a $550 registration fee and a $2000 testing fee.

3) And finally a Step 4E (essay), like the MCAT, that will require students and residents to go to one of 2 convenient testing centers, located in Oklahoma City and Salt Lake City, and write an essay on anything they want, for a $7,000 testing fee (plus travel expenses).  Each test, they added, must be taken separately.

“Step 4E [essay] is really a capstone on the future physician’s medical training.  They had to write a long, critical essay when they took the MCAT, now a final essay when they leave medical education,” Sam Silver M.D. a USMLE board member said in a statement.  “Like the MCAT, the written portion will be graded differently, this time using symbols found above the numbers on a standard qwerty keyboard,  from ~ to [email protected]#$%^&*()_ and +.”

Dr. Silver also said the other parts of the test Step 4CBK will be given a number grading scale and Step 4CSK a pass/fail with a projected 99.9% of testers passing.  Giving a final 3-part combined score of 35P^, where the ^ is the essay.  Other Scores of 24P# and 22P( are possible.  When asked why have a test when everyone passes anyway, he responded: “We have Step 2 CS, which most people pass, and that is a vital step in the licensing process.”  He also reiterated that this announcement was in no way related to the ginormous debt the USMLE has accrued over the years.

Lord Lockwell
Lord Vincent Lockwell, a medival surgeon, started Gomerblog in 1388. He went for a walk in the alps to get away from the bubonic plague in what is now considered southren Germany when a tragic acident occured. The avalanche did not kill him but froze him for over 500 years. He was thawed and now continues to report on medical news.