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To the Editor: Physical diagnostic skills are considered essential for the practice of medicine,¹ but several studies have noted declining clinical skills among US medical school graduates (USMGs).^2-4 We conducted a study to measure recent medical school graduates' ability to perform the abdominal examination.

Methods

We defined criterion standards for 13 specific abdominal examination skills (Table 1) in accordance with a textbook that is widely used in US medical schools to teach physical diagnosis.⁵ These skills relate to performing a general examination of the abdomen as well as examination for suspected acute appendicitis.

Table appears in full text version. Table. Performance of Abdominal Examination Maneuvers by US and International Medical Graduates*

We studied 148 first-year residents in internal medicine and pediatrics at our institutions, of whom 113 were USMGs and 35 were international medical graduates (IMGs). Subjects were asked to examine the abdomen of a young adult patient, and each examination was directly observed by . . . [Full Text of this Article]

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