The United Sates Medical Licensing Examination (USMLE) is a licensure exam for Medical Test Takers in United States of America. It comprises of a series of evaluation varying in areas of competency. It has 3 steps:
Step 1: Examinees are tested based on their mastery on the basic concepts about the fundamentals of science. Application of scientific principles in different subject matters to the practice of medicine is the scope of this assessment.
Step 2: Examinees are tested based on the application of clinical knowledge and clinical skills. The Clinical Knowledge assessment ensures that principles of clinical sciences and application of patient-centered skills are provided for the safe and competent practice of medicine. On the other hand, assessment of Clinical Skills is aimed to test the examiner’s ability to gather information such as health background, conduct physical examinations and endorsing essential findings to patients and colleagues.
Step 3: Examinees are tested on their ability to manage ambulatory patients with recurrent chronic illnesses and emotional problems. This final test determines the autonomy of the examinee on to practice medicine.
One of the basic concepts that USMLE assesses is the Vascular Disorders of the Digestive System, which are Pathologic Hemorrhoids. These are the highly vascular cushions that protect the anal sphincter from increased abdominal pressure (results from sneezing and coughing) that will cause incontinence. However, it this disorder can be pathological when vascular walls, which are along the anal canal and rectum, experience excessive pressure.
Symptoms vary with the location of the hemorrhoids. Most often, patients complain of rectal bleeding, evisceration of vascular tissues on the anus, and pain during defecation. This is a vascular disorder which is the common reason for consultation for most patients. It covers broad topics such as lifestyle, diet, pregnancy, and complications. Studies proved that 50 percent of the population, ages 50 and above, both male and female are experiencing painful piles.
USMLE focuses on the treatment and independent decision making of the test taker as a physician in a given type of scenario or case. For instance, if a patient arrives at the doctor’s clinic complaining about anal itching, constipation and difficulty of passing stools related to pain. The initial management or interventions should be prioritized based on the patient’s condition. The physician should conduct a complete health history and physical examination at the time patient seeks consultation. Diagnosing prompts clinical assessment and evaluation, otherwise, the doctor is subject for malpractice.
Establishing a health history would help determine if the patient is able to apply certain healthy remedies or alternatives, such as sitz bath and adding fiber-rich foods in a meal. After completing the health history, the doctor decides the kind of treatment the patient needed. Treatment varies on the location or severity of the condition.
Usually, if symptoms are mild, it is manageable by anti-inflammatory drugs and Acetaminophen to relieve pain. Doctors would probably prescribe ointments such as Hydrocortisone, but it should not be used for more than 14 days for it can cause skin thinning, to relieve itching and discomfort. Also, physicians would treat constipation (if it is the underlying cause) and it involves changing the diet to High Fiber and Low Fat foods. Also, to avoid lifting heavy objects would be part of the treatment.
The concept of Hemorrhoids included in the USMLE covers basic knowledge of urgent and non urgent management of the condition that challenge the test taker’s autonomy in making decisions. Thus, the assessment of USMLE measures the competency and proficiency of doctors based on ethical and medical principles where it is imperative that assessment comes first before evaluation.