Welcome to the In the Loop newsletter, an initiative of the Wayne State University School of Medicine’s Office of Assessment, Accreditation and Continuous Quality Improvement.

As a champion of continuous quality improvement, your School of Medicine has benefited greatly from the feedback of students and other stakeholders the last several years. This feedback has been instrumental in driving positive change.

In the Loop aims to keep you informed about these important updates and changes, and the successes we’ve achieved together.

This month’s issue of In the Loop celebrates student success with a 99% pass rate of the Step 2 CK Exam.

Christopher Steffes, M.D., is the associate dean of Clinical Medical Education for the Wayne State University School of Medicine.

Clerkship Success Reflected in Step 2 CK Success: A Story of Continuous Improvement and Achievement

The Wayne State University School of Medicine takes immense pride in its commitment to preparing students for the rigorous demands of their medical careers. The success of our students in the Step 2 Clinical Knowledge exam for the 2023-2024 cycle serves as a testament to this dedication. With a remarkable 99% pass rate and scores that are two points above the national average, the results reflect the hard work of our students and the continuous efforts of our faculty, staff and leadership in crafting a supportive and enriching academic environment. These outcomes highlight our ongoing focus on continuous improvement, innovation and the collective mission of preparing students for a seamless transition to residency.

A Multi-Faceted Approach to Success

The success we celebrate today is the result of years of thoughtful planning, strategic adjustments and a commitment to excellence in medical education. As we move forward, it is important to recognize that this achievement was made possible through a holistic, multi-pronged approach that embraced both academic rigor and personal growth. Our preparation for shelf exams, expanded study opportunities, a well-structured clerkship program and—most importantly—the tireless work of our faculty, residents and clinical educators, have all contributed to our students’ readiness for the next stage of their medical journey.

Our results underscore the impact of intentional curricular enhancements and a data-driven approach to education. The leadership has been particularly proactive in anticipating and responding to external changes in medical education, especially with the transition of the Step 1 exam to a pass/fail format. This shift made Step 2 CK even more critical as a differentiator for students applying for residency positions, and our curriculum was adjusted accordingly to ensure our students were positioned for success.

Curricular Adjustments: Responding to Changing Demands

The leadership recognized early on that the shift to a pass/fail Step 1 format would necessitate significant changes to the curriculum. As Step 2 CK became a pivotal exam in residency applications, we revised our educational structure to ensure that students were prepared and empowered to excel. Here are some of the key curricular changes that contributed to our students’ outstanding performance.

1. Transition to a Quarterly Schedule: One of the first strategic changes implemented was transitioning to a quarterly schedule. This adjustment provided students with more consistent opportunities for reflection, feedback and growth throughout the academic year. Creating shorter, more manageable periods of study and clinical work allowed students to focus on mastering core material without becoming overwhelmed.

2. Early April Start for M4 Rotations: Another critical change was moving the start of the M4 year to April. This earlier start provided students an extended period—five months instead of the previous two months—to complete M4 rotations and study for Step 2 CK. This extension allowed for a more balanced approach to clinical responsibilities and exam preparation, ensuring students had ample time to solidify their knowledge before residency application deadlines.

3. Introduction of Longitudinal Courses: Recognizing that not all students follow the same trajectory, we introduced longitudinal courses designed to offer flexibility for those who required additional time to prepare for Step 2 CK. These courses allowed students to “stack” consecutive months of study, providing them with the opportunity to fully focus on exam preparation without sacrificing clinical learning experiences. This innovative approach empowered students to take control of their educational journey and customize study plans to meet their individual needs.

4. Extension of the Internal Medicine Clerkship: With Internal Medicine constituting a sizable portion of the Step 2 CK content, we lengthened the clerkship from eight to 12 weeks. This change provided students with deeper exposure to critical content areas, strengthening their foundational knowledge in a domain that is central to the exam. The extended clerkship also allowed for more comprehensive patient care experiences, further enhancing clinical learning and application.

5. Provision of UWorld for M3 Students: Recognizing the importance of high-quality resources, we purchased UWorld for all M3 students. This comprehensive question bank is widely regarded as one of the best study tools for Step 2 CK, and providing it to our students early in their clinical years allowed them to integrate it into their learning and exam preparation. By making this resource universally available, we leveled the playing field and ensured that all students had access to the best materials to support their success.

6. Continuous Preparation During M3: While preparing for shelf exams is a critical component of M3, we emphasized the importance of continuous clinical preparation as the foundation for success on Step 2 CK. By maintaining robust and demanding clinical clerkships throughout the year, we ensured that students were constantly applying their knowledge in real-world settings, reinforcing their learning and building the skills needed to excel on the exam. This integration of clinical and academic learning created a well-rounded educational experience that equipped students to handle the challenges of Step 2 CK.

7. Strengthening the M1 and M2 Curriculum: Our focus on continuous improvement extended to the early years of medical school as well. We strengthened the M1 and M2 curriculum by expanding clinical content and ensuring that students were well-prepared to transition smoothly into clerkships. This early emphasis on clinical relevance helped students build a strong foundation that they carried into the more demanding clinical years.

The Role of Faculty and Students in Achieving Success

While the curricular changes played a significant role in our Step 2 CK success, it is important to acknowledge the dedication and perseverance of our students, as well as the unwavering support of our faculty, staff and resident physicians. Our faculty members, who are deeply committed to student success, went above and beyond to ensure students were prepared for the exam and well equipped for their future careers. Their mentorship, teaching and guidance played a pivotal role in helping students navigate the challenges of medical education.

Similarly, our students exhibited remarkable resilience, adaptability and determination. They embraced the changes to the curriculum, utilized the resources provided and dedicated themselves to their studies with an unwavering focus on their future goals. Their success on Step 2 CK is a direct reflection of their hard work and commitment to excellence.

Looking Ahead: Continuous Improvement as a Pathway to Success

As we celebrate the success of our students on the Step 2 CK exam, we remain committed to the principles of continuous improvement. We will continue to evaluate and refine our curriculum, ensuring that it meets the evolving needs of our students and the demands of the ever-changing medical field. By fostering an environment of innovation, collaboration and support, we are confident we will continue to produce graduates who are not only successful on exams but well-prepared to become leaders in the medical profession.

Let us know what you think

Many thanks to Dr. Steffes, for compiling this issue of In the Loop. We hope you enjoy this issue as well as those to come in the months ahead.

You can submit your ideas for future issues via the In the Loop Suggestion Form. You can submit general questions or comments about the School of Medicine via the Warrior Med Suggestions Program. You are free to include your name and contact information or to remain anonymous.

All issues of In the Loop can be found on the Office of Assessment, Accreditation and Continuous Quality Improvement website.

Sincerely,

Kanye L. Gardner, M.B.A., LSSBB, CMLC 
Director of Continuous Quality Improvement
Office of Assessment, Accreditation and Continuous Quality Improvement