Assessments are a key feature of a robust curriculum and as such, students are frequently assessed at Duke-NUS. Each course has its own assessment structure to evaluate student performance in the course. In addition to school-administered assessments, the students sit for a number of international standardized exams.
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Each course, clerkship or elective creates a set of assessment strategies. These strategies include faculty developed assessments such as multiple -choice questions, papers, theses, projects as well as observations in simulated and real clinical experiences. Assessment is conducted throughout the program and provides an evaluation of student performance which is used to determine the passing scores. Students must pass each required course before advancing to the next level.
The Year 2 Clinical Performance Exam (Y2CPX) evaluates clinical and relational skills through the use of standardized patients (SPs). It is designed to ensure that students have achieved an expected level of proficiency upon completion of the second year. The exam is aligned with the USMLE Step 2 Clinical Skills (CS) Examination, and a passing score for the Y2 CPX is required. The Y2 CPX involves ten individual patient encounters requiring the student to perform focused history and physical examinations followed by completing a patient note. The examination incorporates materials drawn from all the required second year clerkships; Internal Medicine, Neurology, Surgery, Pediatrics, Obstetrics & Gynecology and Psychiatry.
The Year 4 CPX is a clinical skills exam that is conducted at the end of the fourth year. A passing score for the Y4 CPX is required. The Year 4 CPX has two components. The first day of testing assesses the students’ ability to elicit a patient’s history and communicate effectively with the Standardized Patients (SPs) The five patient scenarios assess students’ interpersonal skills, history taking skills and higher communication skills. After the patient encounters, the student must summarize the findings, develop a differential diagnosis and an investigation plan either in a written note or in an oral presentation to the examiner. The second day of testing assesses students’ ability to perform physical examination of Real Patients (RPs) with pathologic signs. Students rotate through five stations covering the following systems: Cardiovascular, Respiratory, Abdominal, Neurological and Endocrinological /Musculoskeletal/Vascular. This component of the Y4 CPX assesses the students’ ability to elicit signs and develop an appropriate differential diagnosis and investigation plan which will be presented to the examiners.
In addition to the assessments discussed above that are administered locally, our students take a variety of independently developed standardized exams to assess and monitor their progress.
The National Board of Medical Examiners (NBME) develops and administers a number of standardized assessments for the medical profession. At Duke-NUS, students are required to sit for a number of the NBME exams as described below. More detailed information about NBME and the examinations can be found on the NBME website.
Comprehensive Basic Science Exam (CBSE)
At the end of the first and second year, students are required to take the Comprehensive Basic Science Exam. This exam enables the students to recognize their strengths, weaknesses and gaps in their knowledge of basic science. This will allow them to create a better study plan for the higher-stakes United States Medical Licensing Exam (USMLE) to be taken later in their training. This exam also provides the school with valuable feedback on the impact of the curriculum.
Comprehensive Clinical Science Exam (CCSE)
The Comprehensive Clinical Science Exam (CCSE) provides students with a valid and reliable measure of their knowledge of the fundamentals of clinical medicine.
NBME Subject Exams
As part of each clerkship assessment in the second year, students take the NBME Subject exams, specific to the clinical clerkship that they are attached to. The results of this exam are factored into the students' final grades along with their continuous assessments and observations of performance.
The Educational Commission for Foreign Medical Graduates (ECFMG) certifies graduates of international medical schools as part of the United States medical licensing process. Through ECFMG, Duke-NUS students register for two additional standardized examinations: the USMLE Step 1 and USMLE Step 2 CK. More detailed information about ECFMG and the examinations can be found at the ECFMG website.
USMLE Step 1
The USMLE Step 1 examination assesses students’ competence in basic science concepts and the ability to apply these concepts to the practice of medicine. At Duke-NUS, students usually sit for this exam in the middle of their third year and it is required for graduation.
USMLE Step 2 CK
The USMLE Step 2 CK examination assesses student’s application of medical knowledge and skills and understanding of clinical science. Duke-NUS students must pass this exam before graduation and most take it during third year or at the beginning of fourth year.