I. Purpose of policy
To establish the requirement that Residents must complete all three (3) steps of the USMLE or COMLEX examination series with 18 months of initial start date into an Accreditation Council for Graduate Medical Education (ACGME)-accredited graduate medical education program at Dartmouth-Hitchcock (D-H).
II. Policy scope
The policy applies to Residents and Program Directors of ACGME-accredited residency and fellowship training programs at D-H.
III. Definitions
Resident: Any physician in an ACMGE-accredited graduate medical education program including residents and fellows.
USMLE: United States Medical Licensing Examination
COMLEX: Comprehensive Osteopathic Medical Licensing Examination
IV. Policy statement
- General: Completion of the USMLE or COMLEX examination series satisfies one of the key requirements for achieving board eligibility. As such:
- Residents are strongly encouraged to take and pass USMLE Step 3 or COMLEX Level 3 during their first year of training at D-H.
- All Residents must take and pass USMLE Step 3 or COMLEX Level 3 within 18 months of their initial start date in a D-H residency program.
- Failure to take and pass USMLE Step 3 or COMLEX Level 3 on or before the third attempt within 18 months of the Resident’s initial start date in a D-H residency program will result in the Resident’s automatic resignation from the program effective at the conclusion of the academic year in which the timeframe for passing the examination has expired. Automatic resignation in these circumstances is deemed an administrative action under the GME Disciplinary Action Policy, of which there is no review opportunity pursuant to the GME Appeal of Disciplinary Action Policy.
- To address the temporarily closure of testing sites due to COVID-19, the following addendum was approved by the GMEC and applies to all residents who were active in a D-H residency program as of June 8, 2020:
- All residents must take and pass USMLE step 3 or COMLEX Level 3 within 24 months of their initial start date in a D-H residency program.
- Failure to take and pass USMLE step 3 or COMLEX Level 3 on or before the third attempt within 24 months of the Resident's initial start date in a D-H residency program will result in the Resident's automatic resignation from the program effective at the conclusion of the academic year in which the timeframe for passing the examination has expired. Automatic resignation in these circumstances is deemed an administrative action under the GME Disciplinary Action Policy, of which there is no review opportunity pursuant to the GME Appeal of Disciplinary Action Policy.
- The addendum will be revisited in June 2021 to determine if the extension from 18 to 24 months is still necessary.
- As of August 9, 2021, the following requirements are in place in response to testing sites once again operating at full capacity within NH, VT, and ME:
- All residents who were active in a D-H residency program prior to June 14, 2021 must take and pass USMLE Step 3 or COMLEX Level 3 within 24 months of their initial start date in a D-H residency program.
- Failure to take and pass USMLE Step 3 or COMLEX Level 3 on or before the third attempt within 24 months of the Resident’s initial start date in a D-H residency program will result in the Resident’s automatic resignation from the program effective at the conclusion of the academic year in which the timeframe for passing the examination has expired. Automatic resignation in these circumstances is deemed an administrative action under the GME Disciplinary Action Policy, of which there is no review opportunity pursuant to the GME Appeal of Disciplinary Action Policy.
- All residents with a D-H residency program start date of June 14, 2021 or later must take and pass USMLE Step 3 or COMLEX Level 3 within 18 months of their initial start date in a D-H residency program.
- Failure to take and pass USMLE Step 3 or COMLEX Level 3 on or before the third attempt within 18 months of the Resident’s initial start date in a D-H residency program will result in the Resident’s automatic resignation from the program effective at the conclusion of the academic year in which the timeframe for passing the examination has expired. Automatic resignation in these circumstances is deemed an administrative action under the GME Disciplinary Action Policy, of which there is no review opportunity pursuant to the GME Appeal of Disciplinary Action Policy.
- All residents who were active in a D-H residency program prior to June 14, 2021 must take and pass USMLE Step 3 or COMLEX Level 3 within 24 months of their initial start date in a D-H residency program.
- Program Responsibilities
- Programs will be responsible for monitoring satisfactory completion of this requirement for Residents. The exam report and details must be entered into the resident’s file within the residency management system, MedHub, by the program within one month of receiving the report.
- Consistent with ACGME Institutional Requirements, programs must provide written notification regarding non-renewal of the Resident Agreement of Appointment for the following academic year to any Resident who fails to meet the policy-defined deadline.
- Consistent with the Dartmouth-Hitchcock Resident Promotion Policy, this written notification must be supplied no later than 120 days prior to the end of the agreement, programs must provide the Resident with as much written notice of the intent not to renew as circumstances reasonably allow, prior to the end of the current agreement.
V. References
ACGME Institutional Requirements. (2021). Retrieved from ACGME.org.
D-H Policy ID: 11320