All third-year students participate in a day-long Clinical Assessment Program designed to evaluate their mastery of the skills of the clinical transaction. Students are excused from their clerkships for the one day during the Spring on which they are assigned to attend the Clinical Assessment (held at a facility at the Mount Sinai Medical School). Using standardized patient methods, each student performs a focused medical evaluation on seven patients. The patients present with symptoms of medical, psychiatric, pediatric, surgical, gynecological, or neurological diseases, and they are seen in such settings as the Emergency Room, the CCU, a private doctor's office, or a walk-in clinic. In fact, to achieve standardization, all patients are actors who have been coached to portray reliably the clinical aspects of each case.

After the interaction, the student completes questions about the differential diagnosis, tests to be ordered, and given the results of the tests - test interpretation and clinical management. Meanwhile, the patient fills out information about the student's history-taking skill, performance of the physical examination, and communication skills. The entire proceedings are videotaped for review later by the student and a faculty member. Students generate scores throughout the day on the individual cases as well as the individual skills assessed.

Since the installment of the NBME Clinical Skills Exam in the required Board exams, this exercise has taken on more importance for P&S students. This is the only practice students will receive in taking formal standardized patient examinations, and it should be regarded as valuable preparation for the Step 2 CS exam.

The results of this assessment are not used as a pass/fail exam (as they are in other schools), nor are the results part of the student academic record in the Dean's Office or the Dean's Letter or transcript. Rather, P&S believes that the chief dividend is obtained when the student reviews his or her videotape to learn what kind of doctor he or she is becoming, and to receive guided feedback about ways in which to improve clinical performance. Accordingly, once the entire class has completed the assessment, each student must sign up for an hour-long one-on-one review of his or her videotape with a P&S faculty member who has been trained to give feedback on this clinical performance.

Participation in the Clinical Assessment Program is a requirement for promotion to the fourth year, and all Clerkship Directors release students from their clerkship duties on their assigned day. Students who fail to attend the Clinical Assessment on their scheduled day will be required to attend at a later date and to pay the not inconsiderable cost of the assessment themselves.