Why Does Your Program Have Health Maintenance as Part of the Grading System?

Why Does Your Program Have Health Maintenance as Part of the Grading System

A frequent question that we get is why we include health maintenance as part of our grading system? Examples include: counseling (smoking cessation, safe sex, medication compliance), screening (pap smears, colonoscopy screenings), vaccines.


We get the “No one else is doing this, so you must be doing it wrong.” We have received other criticism saying that we “overly-emphasize” this topic. Just because we include this does not mean that we emphasize this to be extremely important. On our grading system, typically this would account for a very small portion of the grading for the case (like 5% of the total grade). Could you do fine on the test without doing these things? Yes. You would be fine. The most important is the physical exam, diagnostic labs, and treatment. Does the USMLE include this as part of grading on the USMLE Step 3 CCS portion of the test? Yes, see below.

Why do we include this? Because the USMLE says that it should be addressed. From the USMLE in what is graded on the CCS portion under the “What are my responsibilities? heading” : “Addressing health maintenance issues. Note: The nature of each case dictates whether or not health maintenance issues are relevant within the simulated time frame.” Health maintenance issues is defined by the USMLE as: “common screening tests for conditions amenable to prevention or detection in an asymptomatic patient or population and selection of appropriate preventive agent or technique (eg. contraception, vaccines, vitamins).” This also includes: “Education of patients on screening, health maintenance, self care.”

So, we feel that it is important to include as you may pick up some extra points on the cases which could have a small but meaningful impact on your final score.

Having said this, we know that this is a small portion of your grade. If you are in crunch time and have limited time to study. The most high yield would be to study the diagnosis tests and treatment with the most cases as you can. The health maintenance would be the cherry on top. The most bang for your buck would be with the “meat” of the CCS Portion which is to diagnose and treat. You can view all of the this on the USMLE website located here

If you would like to try out our program, you can try 2 free cases located here

Thanks for reading.