The Senior Clinical Competency Examination (SCCX) is a comprehensive 14-patient multidisciplinary clinical practice examination.  Its purpose is to provide students and faculty with a standardized measure of student competence and readiness for post-graduate (residency) training.  An important secondary purpose is to provide feedback about the effectiveness of the curriculum.  SCCX results will be reported to the Student Progress Committee (SPC), with recommendations for determination of Pass or Fail.  Students who fail the Patient Satisfaction component of the SCCX will take the 1-week Enhancing Communication in the Physician/Patient Relationship elective course at an individually-determined time.  Students who fail the main clinical component of the SCCX will be required to take the mandated 4-week Clinical Reasoning elective course that will be given October 27 through November 21, 2008. 

The CCX Committee, composed primarily of faculty from the clinical departments, selects SCCX case problems from Appendix A (Must See objectives) of the SIU School of Medicine Objectives for Graduation.  The SIUSOM Objectives, along with the Honor Code and other information, can be found on the CCX Assessment website (http://www.siumed.edu/oec/html/year_41.html).  SCCX cases are selected to cover the range of experiences and expectations you've been exposed to during the first three years of medical school.  Each SCCX case is based upon a real patient, developed by a team of faculty authors, and approved by the CCX Committee before it is used. 

The SCCX will take two full days to complete and will include seven cases each day, each beginning with a standardized patient (SP) encounter.  The SPs will complete H&P checklists and Patient Satisfaction rating scales, and will write comments about your interpersonal and communication skills.  In the first ten cases, a 20-minute SP encounter will be followed by a 35-minute CCX computer station in which you will list findings, hypotheses, labs, diagnosis, problem list, and management for the patient.  Some cases will include imaging studies for you to interpret.  The last four cases will be administered in the USMLE, Step 2 Clinical Skills format of 15-minute SP encounters followed by 10-minute patient notes.  In the patient notes you will list history findings, physical exam findings, differential diagnoses and diagnostic work-up.  (See the CCX_Assessments website referenced above for the form we will use.)  In order to most closely simulate USMLE conditions, students will be split into two groups and each group will complete all four cases within a two-hour period. 

Since we are attempting to evaluate your preparedness for residency, the best approach for a successful SCCX is to work up the SPs as if they were your actual patients.  If you want extra practice using the CCX program, the J_Keller CCX case will be available on the computers in the OEC Computer Lab at 801 N. Rutledge (just type in a name:  no records will be kept.)

Our curriculum has prepared you for the SCCX, but we recommend that you invest additional preparation time in the following areas: 

• You should be competent in all components of the Head to Toe History and Physical Exam.  These skills will be essential for successful performance on the SCCX. 

• You should know what questions to ask and what physical exam is needed for all complaints listed in the Objectives for Graduation, Appendix A.

• You should be able to generate a thorough differential diagnosis and write basic management orders for all complaints listed in Appendix A.

• You will generate problem lists for many SCCX Cases, so you should understand their construction and use. 

The SCCX will be administered six times over a three-week period (July 22 to August 8), with 12 students in each group.  The school expects that you will maintain strict confidentiality about the exam.  The SCCX is a secure examination and is protected by the SIU School of Medicine Secure Examination Policy.  Sharing information about or having unauthorized knowledge about the exam (or its cases) constitutes a violation of that policy and will be considered a serious breach of professional conduct that will be immediately dealt with in accordance with school policies.  You will sign an oath of confidentiality before you begin the SCCX. 

SCCX group assignments are attached.  If you want to be reassigned you need to find a student willing to switch with you and BOTH of you must e-mail Linda to request reassignment.  We will accept schedule changes until July 1. 

You may take the SCCX during an elective course of 2 or more weeks with the permission (in writing or via e-mail) of the course director (submit this to Cherie Forsyth), but you may not take the SCCX during the Neurology Clerkship.  Those completing deferred clerkships during the SCCX will take it at the time designated by their clerkship director.

If your class requests it, a special advance orientation session can be held in early July to discuss SCCX expectations in more detail.  The class officers can contact Linda Morrison to arrange it.  Otherwise this memo, along with information posted on the CCX Assessment website will suffice to help you prepare for the SCCX.  Please review the SCCX instructions posted on the CCX Assessments website before you come to take your examination. 

The first day of your exam will begin with a short orientation session at 7:45 AM in the Atrium Conference Room (801-2).  This is where you will get your daily schedule.  You will have 40 minutes each exam day for lunch, and you will be finished around 5:00 both days of the SCCX. 

If you have questions, you may contact:

• Dr. Nelson at enelson@siumed.edu

• Linda Morrison at lmorrison@siumed.edu or 545-4970

C:      Erik Constance, MD, Associate Dean for Student Affairs

Cherie Forsyth, Year 3 and Year 4 Registrar

Debra Klamen, MD, MPH, Associate Dean for Education and Curriculum

Tracy Lower, MD, Year 4 Director

Nancy McCann-Stone, Year 4 Coordinator