With the recent announcement of the much awaited Pathway 6 Mini-CEX instructions, , IMGs (International medical students)/graduates who do not qualify for Pathway 1-5 or have failed Step 2 CS are yet again thrown into the dilemma of an unknown territory by ECFMG.
Here are the challenges
1. IMGs need to identify 3-6 physicians who are eligible as per ECFMG Clinical Evaluators criteria. Many US physicians are not familiar with Mini-CEX evaluations let our physicians from other countries!
2. IMGs need to request these busy unknown physicians to carve out their time of at least one hour to evaluate them over a real patient and communicate to ECFMG their performance and be able to answer any questions they may have as follow up from ECFMG.
3. Since physicians from any country can give this Mini-CEX evaluation, it questions the standardization for evaluation across IMGs from different countries with different levels of training along with observer bias of different physicians (Begs to question how this Pathway 6 would compare with IMGs who took a standardized Step 2 CS exam with standardized patients and passed and will be in the same pool for Match 2022 competing for the same residency programs!)
4. Students are not only challenged with real cases but they are expected to present the case with a diagnosis, workup but treatment plan discussion as well, which was not part of the Step 2 CS exam. There was no mention of a patient note which was integral part of the Step 2 CS ICE component which many IMGs failed previously as per ECFMG data.
5. The complexity includes obtaining permission/consent from the patient and from authorities where the physicians may work with no compensation.
6. The announcement came at the very crucial bottleneck juncture in a student’s journey towards applying for Match 2022, just barely before the time when the candidates have to submit their application starting September 1, 2021 which in itself is a tedious process and the portal is not yet open for physician evaluators at the time of writing this blog (August 1,2021)
7. Neither the physicians nor the hospital can be compensated for precious time spent in evaluating a random student who is not a relative /kith or kin especially with all these busy practitioners battling covid-19 with restrictions in hospitals that are currently overloaded with patients from the delta variant.
The journey to residency is a difficult road for IMGs and this Pathway 6 MiniCEX evaluation process just makes it more harder for IMGs. They don’t get a say in the matter as usual but just have to go through the motions - the OET and Pathway 6 and play it by the random rules laid before them. Especially for students who have already failed Step 2 CS , with their low confidence levels to tackle yet another new challenge must be daunting but as they say “When the going gets tough the tough get going”. Good luck with getting you dream residency!
Need help with Pathway 6 Mini-CEX. Email firstname.lastname@example.org It would be a privilege to help ease the journey to residency a bit for IMGs from our end! You can do it! We can help. –Target USMLE, www.targetusmle.com #mini-cex #pathway6 #nrmp2022 #match2022 #failedstep2cs