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Thanks for all the thoughtful responses so far!

This question builds off of something mentioned by Dr. Goroll. There is some thought that Step 2 CS has increased clinical skills training and evaluation in medical schools, leading the way of this beneficial trend. Yet compared to what my parents were taught, or even what my sister was taught in 2000-2004, these days clinical skills seem to me to be de-emphasized by curricula. In 2004, when Step 2 CS was introduced, 84% of medical schools had mandatory standardized patient skills exams similar to CS; in 2014, the number increased -- but to only 92%. To me, this looks like the trend towards SP exams as well under way prior to the implementation of CS.

If, however, NBME/USMLE are guiding changes in curricula by determining what gets tested and how, are there downsides or risks that come with that? How do you balance potential risks with the benefit of uniform minimum competency?