The National Board of Medical Examiners, which designed the exam, said it will measure critical but often overlooked skills needed to produce an accurate diagnosis, including how well students listen to their patients and how artfully they question them.
"Patients would like to know that their doctors are qualified to talk with them and communicate with them, and none of that is assessed by the (written) cognitive exam," said the board's president, Dr. Donald Melnick.
Many medical schools already test students' clinical skills, but this will be the first time such a national test has been required of doctors since 1964, when a similar evaluation was abandoned amid concerns about its objectivity.
During the test, aspiring doctors will examine 10 people trained to act like they have various ailments. After each 15-minute exam, the students will get 10 minutes to record their observations. Later they must meet with senior physicians to report their findings.
The new test will be expensive: It will cost $975 and students will have to travel to test sites in Philadelphia, Atlanta, Chicago, Los Angeles or Houston.
Some groups have objected to the cost of the test and questioned its accuracy. The American Medical Association has asked that the test's implementation be delayed, saying medical schools already rigorously test clinical skills.
About 86 percent of about 850 students who took a field trial of the examination in Philadelphia and Atlanta last year passed, the National Board of Medical Examiners said.
The 20,000-student class of 2005 will be the first required to take the exam. Most will need to take the test in 2004, Melnick said. Students who fail will be allowed to repeat the exam after 60 days.
A similar test has been required since 1998 of foreign medical school graduates who wish to work as doctors in the United States.