A Comparative Trial of the Clinical Evaluation Exercise

The American Board of Internal Medicine (ABIM) has ultimate responsibility for certifying trainees in internal medicine. Before 1972, the certification process included a mandatory oral examination after the successful completion of a written examination. Every candidate examined two patients and was then evaluated at the bedside by an examiner selected by the ABIM. For a variety of reasons, certification examinations were changed to a completely written format in 1972.¹ The burden of certifying bedside skills of trainees became the responsibility of the director and the staff of the training program. The ABIM was appropriately concerned that formal observations of house officers' nonwritten skills actually occur.² Since 1973, regular site visits to training programs have been made to encourage a systematic approach to the evaluation of bedside clinical skills.³ Recently, this encouragement has become more explicit. The ABIM has circulated what it considers to be an ideal format