USMLE Requires more than Optimal English Proficiency

Foreign and even US medical graduates wanting to do their residency in the United States are required to undergo a Clinical Skills Assessment (CSA) as part of licensing requirements.

Candidates conduct a day-long examination of actors playing patients by conducting a timed clinical encounter : 1) talking to the ''patient'' about his or her chief complaint - Data Gathering (DG), 2) performing a physical exam, and 3) writing a Patient Note (PN).

Excellent English Required
Besides the DG and PN, candidates are assessed on their Communication and Interpersonal Skills (CIS) and Spoken English Proficiency (SEP).

The SEP is broken down into listening effort, pronunciation, and word choice.

While statistics indicate foreign medical graduates mostly fail because of their CIS than English proficiency, the two are interwoven.

Acting patients are instructed to ask questions, request more than a superficial explanation of unfamiliar terms, and to simulate angry, moody or otherwise difficult patients.

USMLE Preparation
While a TOEFL score of 35 is usually considered adequate to possess the English proficiency needed to pass the US Medical Licensing Exam (USMLE) Step 2, the candidate needs to be understood by exercising good grammar and pronunciation in a professional context.

Therefore, it is important prospective candidates practice with a English native if possible to test rapport with a patient, role play medical scenarios, and build confidence speaking in layman's terms.

An exam prep text is a start. However, in preparation of students, instilling confidence and getting the candidate to speak naturally about ailments on a patient's level appear to be the foremost challenges.

While role playing, challenge the candidate to a calm and thorough explanation of an illness presented and offer advice on how better to speak up and address the patient directly.

From experience, medical vocabulary does not appear to be an issue, but pronunciation often is.

In sum, an English professor can coach students to interact naturally using optimal English and to develop a patient routine to be followed not only at test time, but in their residency and beyond upon a successful score.

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