XUSOM Examination Procedures and Policies

BASIC SCIENCES EXAMINATIONS (YEARS 1 & 2)

EXAMINATION FORMAT AND GENERAL POLICIES

  1. All exams are computerized and conducted in a separate area called the Test Centre.
  2. All exams will be in the USMLE MCQ format.
  3. Every question will be allotted a time of 80 seconds as per the USMLE timing.
  4. All examinations will be taken by students on the date and time scheduled by the school and specified in the school calendar.
  5. Stipulated days of preparation leave are given for the exams (For details see below under “Scheduling policies”)
  6. Examinations in MD 1-5  include integrated quizzes, comprehensive exam and final exam in every system as well as the PDS exams for every semester
  1. Each of these exams should be a reflection of the course objective covered during the preceding duration of teaching.
  2. The three exams for every system (IQ, CQ and Final exam)  will have questions from all subjects pooled and presented to students as one single exam (or as two units of the same exam)
  3. Integrated quizzes (IQ) are conducted once in every two-three weeks in every system. These quizzes are unit-based and NOT cumulative. The quiz will not extend beyond 3 hours.
  4. Comprehensive quiz (CQ) is a cumulative quiz conducted towards the end of a system in preparation for the final exam. The comprehensive quiz will not extend beyond 4 hours
  5. Objective Structures Clinical Examination (OSCE) is conducted for one system per semester. Trained Standardized patients are utilized as the part of examination and the students are given 7 minutes for History taking and 10 to 15 min (depending on the OSCE) for Physical  examination.
  6. The final exams or system ending exams (SEE) will be NBME-CAS exams. NBME- CAS is the Customized Assessment Services (CAS) provided by the National Board of Medical Examiners (NBME).
  7. Integrated quizzes are reviewed in the classrooms by the respective faculty members after the quizzes. However, comprehensive quizzes and final exams will not be reviewed.
  1. In MD6, examinations include Kaplan diagnostic test, Subject specific NBME shelf exams, Kaplan SIM final exam, OSCE, CBSE and USMLE step 1 exam
  1. Kaplan Diagnostic Test is a preliminary “Check where you stand” test for MD6 students which may be used as a MD6 exam preparation tool
  2. Subject specific NBME shelf exams are exams based on specialties by NBME and covers eight subjects (Anatomy, Behavioral Science, Biochemistry & Genetics, ICM, Microbiology & Immunology, Pathology, Pharmacology and Physiology). Each exam will follow a series of Kaplan online lectures for that subject
  3. OSCE (Objective Structured Clinical Examination): Students are required to take an OSCE exam towards the end of the semester. This OSCE will be a comprehensive exam of all the OSCE-systems from MD1-5
  4. Kaplan SIM Final exam is a Kaplan conducted USMLE Step 1 simulated exam and will be considered as the end of Kaplan course. Students who pass this exam and the MD6 OSCE exam will be allowed to take the CBSE exam.
  5. NBME Comprehensive Basic Science Examination (CBSE) is administered at the conclusion of MD6 and serves as the MD6 semester ending exam. Students who pass both the MD 6 Kaplan SIM Final exam and CBSE exam will be allowed to sit for the USMLE Step 1.
  6. USMLE Step 1: To qualify for core clinical clerkships, students are required to pass the USMLE Step 1 exam. STUDENTS WILL NOT BE CONSIDERED ‘COMPLETED THE BASIC SCIENCES’ UNTIL THEY HAVE PASSED USMLE STEP 1. STUDENTS CAN ONLY BEGIN CLINICAL SCIENCES ROTATIONS IN THE USA AND CANADA AFTER HAVING PASSED USMLE STEP 1, UNLESS GRANTED A WAIVER BY THE PROMOTIONS COMMITTEE, THE DEAN OF BASIC SCIENCES AND THE DEAN OF CLINICAL SCIENCES.
  1. In the Clinical Science, examinations include CCSE and the Kaplan’s USMLE 2 live assessment
  1. NBME Comprehensive Clinical Science Examination (CCSE) is administered after passing the USMLE Step 1. Students who pass the CCSE score of 216 and has finished all core rotation will be allowed to take USMLE Step 2 CK.
  2. Kaplan’s USMLE 2 live assessment has to be completed by the student and pass to be allowed to take the Step 2 CS. Passing the Kaplan’s live assessment is determined by the Clinical Dean’s analysis of exam result.

EXAMINATION PROCEDURE TO BE FOLLOWED AT TEST CENTRE

  1. All examinations are conducted in the NBME approved test center and are on security camera and recorded.
  2. Students will receive a seat-terminal number fifteen minutes before the exam.
  3. During the examinations, students are requested to place their bags at the front or back of the examination room as directed.
  4. Electronic devices e.g. computers, PDA’s, and cell phones are not permitted in the examination room.
  5. Students will receive an access examination sheet with username and password. Students must use the username and password to login for the examination.
  6. Examinations will be proctored by faculty members allocated by the Dean, Student Affairs.
  7. Students who arrive more than 5 minutes after the commencement of the examination will not be allowed to take the examination.
  8. Students are not permitted to leave the examination room unattended once the exam has begun. Students who leave the examination room are not permitted to return, for any reason.
  9. Communication between students is NOT permitted during the course of an examination.
  10. Students found communicating with each other by whatever means, whether or not the communication is relevant to the examination, will be deemed to be using unfair means and will be required to leave the examination room. Such students may be subject to disciplinary proceedings by the Promotional Committee. The student may appeal the decision of the committee to the Dean, Basic Sciences or CAO
  11. At the conclusion of each examination all exam sheets should be submitted to the proctor in charge.

EXAMINATION SCHEDULING POLICIES:

SCHEDULING POLICIES FOR MD 1-5:

  1. Scheduling decision lies with the team comprised of coordinator (Eg. System chair, OSCE director, etc), Chair, curriculum committee and Dean, Student Affairs and shall be final and binding to students. However, Dean, Basic Science and CAO can revoke a rescheduling decision.
  2. Schedules for all exams will be intimated to students at the beginning of the system/semester in the school calendar that will be posted on the student server. However, it shall also be specified in the calendar that exam dates are subject to change as deemed necessary by the system chairs/ Deans/ CAO.
  3. The scheduled date and/or time of the integrated quiz is subject to change:
  1. If there is a clash in scheduling of examination for many courses at the same time
  2. If there is a public holiday on the scheduled date
  3. If there were unforeseen situations/accidents in the test center (technical difficulties, laptop issues, server issues, internet issues and/or weather issues have the potential to delay examination)
  4. At the discretion of Deans and CAO 
  1. Integrated quizzes:
  1. Integrated quizzes (IQ) are conducted once in two or three weeks in every system.
  2. Each system will have a minimum of one integrated quiz
  3. Integrated quizzes are unit-based and NOT cumulative. For example, if the first integrated quiz is scheduled on the Monday of week 3 of a system, it will cover all areas taught in weeks 1 and 2. The second integrated quiz will cover all areas taught after the first quiz and so on.
  4. As far as possible, integrated quizzes will be scheduled as the first school event (preferably 8 am) on the Monday of the scheduled week, to allow students enough preparation time over the weekend.
  5. If an integrated quiz cannot be conducted on the Monday of the scheduled week, the syllabus covered during exam week preceding the examination will be omitted from the exam. (Eg: If the Integrated quiz is scheduled on a Tuesday, the syllabus covered on the Monday of the same week will not be included for the integrated quiz)
  6. If multiple batches have integrated quizzes scheduled on the same day and for this reason, if one or more integrated quizzes need to be scheduled after 8 am (Eg. 10 am, 1 pm, etc), no teaching-learning sessions will be scheduled for the preceding hours of quiz, in other words, the quiz will still remain the first school event of the day.
  1. Comprehensive quizzes:
  1. A comprehensive quiz (CQ) will be conducted towards the end of most systems.
  2. Where the final exam is an in-house exam there will be no separate comprehensive exam for the system.
  3. Where the final exam is NBME- CAS exam, a comprehensive exam will be scheduled for the system a week before the NBME-CAS exam
  4. Comprehensive quizzes are cumulative and include all the contents covered in the entire system.
  5. A comprehensive exam is scheduled keeping in mind that a minimum of two days of preparation is allocated for students.
  6. Like integrated quizzes, comprehensive quizzes will be scheduled as the first school event (preferably 8 am) on the Monday of the scheduled week, to allow students enough preparation time over the weekend.
  7. If an integrated quiz of another batch falls on the same day and time as comprehensive quiz, rescheduling of the comprehensive exam will be done, since priority is given to batches with classes still running and a batch with comprehensive exam has completed the classes for the system. However, the policy of allocating a minimum of two preparation days will be complied with.
  1. Final exams (NBME-CAS): 
  1. In, nine out of the total eleven systems of MD program, students are required to take the NBME-CAS as the final exam of the system.
  2. A final exam is scheduled keeping in mind that a minimum of three days of preparation is allocated for students. Preparation leaves are allocated at the rate of one day per every running week of the system. In general, number of preparation leaves are as per the following guidelines:
  3. Immediately after the comprehensive exam, every student of the system will receive all details about the NBME exam from the system chair in his/her school email. Every student is expected to periodically check their school emails for exam updates

Duration of the system

Minimum preparation leave for final exam

3-5 weeks

3 days

5-7 weeks

4 days

> 7 weeks

5 days

  1. Objective Structured Clinical Examination (OSCE): 

OSCE is administered as a part of the final exam for selective systems (One system per semester) and is a part of the final grade of that Organ System.

  1. is a one-time exam at the end of a system.
  2. is scheduled at a frequency of a minimum of one exam for every semester
  3. may be scheduled before or after the comprehensive exam of the system and if absolutely necessary, after the NBME CAS for the system
  4. dates are intimated to students at least two weeks in advance
  5. is scheduled keeping in mind that a minimum of one day of advance preparation is allocated to students
  1. Exams under Patient, Doctor, Society (PDS): 
  1. Exams under PDS include CASL (Critical appraisal of scientific literature) and epidemiology exams.
  2. CASL exam is a one-time final exam at the end of every semester and will follow a single CASL lecture session also scheduled at the end of the semester
  3. Epidemiology exam is a one-time final exam at the end of every semester and will follow a series of lecture sessions with in-built practice quizzes that will contribute to the final score

SCHEDULING POLICIES FOR MD6

  1. The Kaplan Diagnostic Test: This will be held within the first week of commencement of the Live Lectures.
  2. Subject specific NBME shelf exams: Scheduling of subject specific NBME shelf exams including Introduction to Clinical Sciences will be done by the MD6 system chair in consultation with Dean, Basic Sciences or CAO
  3. MD6 OSCE exams: The dates of MD6 OSCE will be scheduled depending on availability of SPs, towards the end of the semester, and announced to students two weeks in advance.
  4. NBME CBSE:
  1. The first attempt for the CBSE is given at the conclusion of MD6. Students with a score 55% and above in the Kaplan Simulated exam will be given an immediate chance to take the CBSE in the school test center.
  2. Students will be allowed 3 attempts to pass this CBSE. Those who fail first time must take second test within 4 weeks of the first attempt. On failing the second attempt, the third attempt must be taken within 4 weeks of the second attempt.
  1. USMLE Step 1 Exam.
  1. XUSOM will not process a request from any student to write USMLE Step 1, without a passing score on file with the Registrar’s Office in New York.
  2. Students are required to take the USMLE Step 1 Exam within 6 months of passing the CBSE.
  3. Students who do not take the USMLE Step 1 Exam in the above mentioned time period will be required to repeat CBSE and subject to administrative withdrawal.

EXAMINATION RESCHEDULING POLICIES (for all semesters):

  1. An exam date is subject to change based on several influencing factors including logistic issues, scheduling requirement of other student batches, technical issues in the test center, to name a few.
  2. Nobody will be allowed to take the examinations EARLIER than scheduled for whatever reasons.
  3. Rescheduling decision lies with the team comprised of coordinator (Eg. System chair, OSCE director, etc), Chair, curriculum committee and Dean, Student Affairs and shall be final and binding to students. However, Dean, Basic Science and CAO can revoke a rescheduling decision.

EXAMINATION GRADING AND ASSESSMENT POLICIES

GRADING AND ASSESSMENT POLICIES FOR MD1 to MD5:

  1. For all exams, the following grading policy applies:
  2. The following grid may be regarded as a general assessment policy for all system ending exams, with points to be noted listed under the grid

BELOW 70%

Fail

70%-89%

Pass

≥90%

Honors

MCQ based exams (65%)

Continuous assessment (a + b + c = 35%)

System ending NBME CAS exam = 50%

 

Quizzes = 15%

(CQ 7 or 8%, other IQs and subject quizzes 8 or 7 %)

Assessment during small group session (a %)

(Note: a = x + y + z)

Interactive assessment during lectures (b %)

Assignment (c %)

PBL/TBL sessions = x %)

 

Anatomy practical + small group lab sessions = y %

 

Clinical case presentation (CCP) = z %

b % of total marks

 

c % of total marks

  1. The dark shaded area is the component that is included in and remains constant for all system ending exams in terms of percentage of marks that contributes to the final score
  2. The light shaded area is the component that is included in all system ending exams but the percentage of marks that contributes to the final score varies from system to system
  3. The unshaded area is the component that may be included in some systems and absent in some systems
  1. The following grid for PDS may be regarded as a general assessment policy for all system ending exams

PDS components

MD1

MD2

MD3

MD4

MD5

CASL

25%

30%

50%

50%

50%

Professionalism + Medical humanities

25%

30%

50%

50%

-

Early clinical exposure- Outside XUSOM (Eg. GP score, neurologist score, hospital observership score, etc)

Early clinical exposure- Logbook

25%

-

-

-

50%

Epidemiology

25%

40%

-

-

-

GRADING AND ASSESSMENT POLICIES FOR MD6:

  1. Kaplan Diagnostic test: Those who fail to score 45% and above in the Diagnostic Test will be listed for customized monitoring for the rest of the semester.
  2. NBME subject based shelf exams: A grade of 70% is considered as a Pass for each of the eight subject based shelf exams
  3. OSCE: A grade of 70% is considered as a Pass in MD6 OSCE. Those who fail the OSCE will have to take an OSCE remake. Those who fail OSCE twice will repeat the MD6 course.
  4. Kaplan SIM Final exam:
  1. A grade of 68 is considered as a Pass in Kaplan Sim Final exam.
  2. Students with less than 68 will repeat MD6.
  3. Students who score 68 and above in the Kaplan USMLE Step 1 simulated exam will proceed to school approved Preparatory Leave (PL) for 16 weeks. Leave of Absence (LOA) period will commence after week 16 and the LOA fees will be applicable
  4. Students who score 75 and above in the Kaplan Simulated exam will be given an immediate chance to take the CBSE in the school test center
  1. NBME CBSE:
  1. A passing grade of 208 on the CBSE is required to be academically eligible for USMLE Step 1, without exception.
  2. Students have to pass the NBME CBSE in the first 12 weeks of their PL, and will be declared as PASS in MD6 semester.
  3. If a student does not score 208 or above in the first attempt, he/she will be required to remake the CBSE exam.
  4. Students in their second and third attempts of CBSE will be charged $ 550.00 as exam fee
  5. If a student does not pass CBSE after 3 attempts, he/she will be required to repeat MD6 with full attendance in Aruba or be administratively withdrawn from XUSOM.
  6. Following the repeat of MD6, the student must pass the CBSE on the first attempt, with a score of 208. Failure to score 208 will be deemed as a failure of the MD6 course and administrative withdrawal from the school.
  7. Students with four failures of CBSE will be dismissed from XUSOM for academic reasons. The student may choose to re-enroll in the basic sciences, and the Admissions Committee will determine what advanced credit the student will receive.
  1. USMLE Step 1 Examination
  1. On passing NBME CBSE, students will be allowed to register for the USMLE Step 1 Examination.
  2. Students who do not pass NBME CBSE and/or Step 1 within the 16 weeks of school approved PL will pay a LOA fee of $600.00 every month after week 16 till they pass MD6, i.e. CBSE followed by Step 1. 
  3. If the student does not pass Step 1 after 3 attempts, students is academically dismissed from XUSOM.

POLICIES FOR RELEASE OF GRADES (For all semesters):

  1. Grades from integrated and comprehensive exams in MD 1-5 will be made available to the students by the system chair as soon as the exams are over.
  2. At the conclusion of each final examination in MD 1-5, the consolidated results will be forwarded to the Registrar and will be available within 4 days of the end of the examination period ONLY on the SMS. A student will get access to the final exam results on the SMS ONLY after he/she has completed the system feedback questionnaire survey
  3. Grades from all MD6 exams will be made available to students by the MD6 chair as soon as the same is received by the system chair from NBME/ Kaplan website
  4. Grades from USMLE step 1 will be directly accessible to the students from USMLE

EXAMINATION REMAKE POLICIES (for all semesters):

  1. Students failing to attend at the specified date and time of examinations for any reason will be treated as having failed the examination.
  2. A remake exam is scheduled by the Dean, Student affairs, if a student
  1. has failed an exam in the first or subsequent attempts as per the grading policies of the school
  2. has missed an exam with prior permission from the Dean, Student Affairs, Dean, Basic Sciences or CAO
  3. has missed an exam without prior permission and the reason for missing is deemed by the Dean, Student Affairs/ Dean, Basic Sciences/ CAO to be due to genuine reasons/ unavoidable circumstances (Eg. Family emergencies)
  4. with multiple remakes has exam conflicts
  5. is nominated by the school to attend professional events such as conferences, volunteering, etc during a scheduled exam
  6. has been permitted by the school to pursue a second degree program with another university and the exam/ graduation/ convocation for that program conflicts with the XUSOM scheduled exam
  1. A prior permission for missing an exam must be addressed to Dean, Student Affairs explaining the reasons for doing so, in writing. The decision to accept or reject the request lies with the Dean, Student Affairs and shall be final and binding to the student
  2. All missed examinations without prior intimation must be reported to the Dean, Student Affairs within 12 hours.
  3. The date for a remake will be decided by the Dean, Student Affairs. However, it is the responsibility of the student who has missed/failed an exam, to make a letter of appeal to the Promotions Committee, with accompanying documents as soon as possible and request a schedule for a remake
  4. No ‘remake-eligible’ student will be entertained to miss the remake or request for a reschedule of the remake except if there are conflicts of date and timings in case of multiple remakes
  5. In principle, all remake examinations will be different and more difficult than the regular examinations.
  6. In MD6, any student remaking a Standardized Comprehensive Basic Sciences Examination final exam will have to take all 3 exams: Exam 1 = 30%, Exam 2 = 30%, and Exam 3(SE) = 40%.

Clinical Science Examinations (YEARS 3 & 4)

METHODS OF EVALUATION

  1. Evaluation of Clinical Science involves assessment during core and elective Rotations, the Comprehensive Clinical Science Exam (CCSE) and the USMLE Step 2 Clinical Knowledge (CK) and USMLE Step 2 Clinical Science (CS) exams.
  2. Assessment at the core rotations involves:
  1. Preceptor evaluation
  2. Comprehensive exam
  3. NBME final exam
  1. Preceptor evaluation: Students are supervised by preceptors who monitor two oversights during core rotations – hospital oversight and central oversight.
  1. Hospital oversight:
  • Assessment methods include monitoring of attendance, knowledge of differential diagnosis, initial & ongoing therapies, attitude, professional behavior, patient evaluation, case presentation and summaries (written and oral), technical skills.
  • Supervising faculty and Residents complete evaluations of students, including numerical ratings and narrative comments about performance across competencies, compiled by the clerkship director working with the grading committee.
  1. Central oversight:
  • Students are responsible for maintaining an electronic log of clinical experiences in an ongoing manner for each required clerkship, in accordance with that clerkship’s requirements.
  • Failure of a student to maintain a log of required experiences and/or complete all required experiences or their equivalent by the end of the educational experiences will result in a grade of “I.”
  • All logs and evaluation forms should be submitted within 2 weeks of completion of the rotation.
  1. Students will receive feedback from supervising faculty and/or clerkship site directors midway through the rotation. This feedback must include review of the electronic log of clinical experiences as well as an assessment of the student’s performance in comparison to clerkship objectives and School of Medicine performance milestones.
  1. NBME final exam: There is a final exam required to be taken by students at the end of every core rotation.
  2. NBME (CCSE): is administered at the conclusion of all core rotations. Students who pass the CCSE will be allowed to sit for the USMLE Step 2 CK.
  3. Kaplan’s USMLE live assessment has to be completed and passed by students to be allowed to take the Step 2 CS

SCHEDULING AND GRADING POLICIES FOR CLINICAL ROTATIONS:

FOR CORE ROTATIONS

  1. At the end of week 3, 6 and 9, the student should request a formal feedback session from the preceptor on their progress.
  2. 2 weeks before the rotation ends the student should ensure that the Shelf Examination (NBME) has been scheduled.
  3. Final exam (NBME) has to be taken within 2 weeks of completion of every core rotation
  4. The student has two attempts to pass the Shelf Examination, after which the student must repeat the rotation, with an “incomplete” grade.
  5. Following the completion of all core rotations students will be allowed 4 weeks of study leave for step 2 CK/CS.
  6. The final grade in the clerkship represents a contribution from two major components as follows:

Preceptor evaluation (90% of the final grade): Preceptor evaluation includes two major components:

  1. Six ACGME competencies (Medical knowledge, Patient care, Communication skills, System based practice, Professionalism, Lifelong learning skills): Students are graded on a scale of 10 for each of these competencies and the total score on the six competencies contributes to 90% of the final score for the rotation
  2. Narrative evaluation: This is a non-numerical evaluation of the student on academic standing, ethical behavior and professional values in the student and is an important parameter in the final evaluation of the student
  1. NBME final exam contributes to 10% of the total grade.
  2. Evaluation of student performance should use the following grades: Fail, Pass and Honors

BELOW 70%

Fail

70%-89%

Pass

≥90%

Honors

  1. By school policy, Honors are assigned to no more than 45% of students in each core clerkship.

FOR ELECTIVE ROTATIONS

  1. For Elective Rotations, examinations are at the discretion of the preceptor, and the information obtained is used in the overall preceptor evaluation of the student.

SCHEDULING AND GRADING POLICIES FOR CCSE/STEP 2 CK/ STEP 2 CS

NBME CCSE:

  1. A passing score of 216 on the CCSE is required to be academically eligible for USMLE Step 2 CK, without exception.
  2. The first attempt for the CCSE is given at the conclusion of all core rotations.
  3. Students will be allowed 2 attempts to pass CCSE.
  4. Students who fail in the first attempt will go through a remedial plan and will be given a second attempt.
  5. Students in their second and third attempts of CCSE will be charged $ 550.00 as exam fee.
  6. A student who fails CCSE at the third attempt will be academically dismissed from Xavier University School of Medicine Aruba.

USMLE Step 2 CK:

  1. USMLE Step 2 CK needs to be taken within 4 months of passing the NBME CCSE.
  2. Students who do not take the USMLE Step 2 CK in the above-mentioned time period will be required to repeat CCSE and are subject to administrative withdrawal.
  3. Students failing first attempt will have to take remedial courses in consultation with Dean of Clinical Sciences, before being allowed second attempt.
  4. Failing second attempt will require repeating core rotations/ remedial plans as approved by the Dean of Clinical Sciences.
  5. A Student who fails the USMLE Step 2 CK three times will be academically dismissed from Xavier University.

USMLE Step 2 CS

  1. Students can appear for USMLE Step 2 CS examination after completing Internal Medicine, Family Medicine and Pediatric Core Rotations.
  2. Students have to pass the Step 2 CS review course with Kaplan’s before being allowed for Step 2 CS.
  3. USMLE Step 2 CS needs to be taken within 6 months of passing the CS assessment.
  4. Students failing first attempt will have to undergo remedial course approved by the Dean at their own expense.
  5. Second failure requires repeating core rotations/ remedial plan approved by the Deans.

A student who fails USMLE Step 2 CS three times will be academically dismissal from Xavier University School of Medicine Aruba.