Once students have successfully completed their basic sciences courses and have met the promotion requirements for the clinical phase they have a choice of pathways for their clinical placements.
Students who aim to match to a US residency program and complete all or part of their clinical training in the USA must sit a placement examination (CBSE), be certified with ECFMG and pass the USMLE Step 1 examination within their timeline requirements. Note that placement at certain hospitals in the USA is limited by the requirement to pass the USMLE Step 1.
For students that wish to train in the USA but do not intend to match into a US residency they must also sit the CBSE, be certified with the ECFMG and pass Step 1 examination for maximum US placement options. Alternatively, they can sign an attestation that they do not plan to enter a US residency nor take the USMLE Step 1 but instead choose to complete their clinical training in the US at a non-Step requiring site for their 3rd and 4th years.
After successfully completing all 5 terms of basic sciences, the CBSE and the Step 1 USMLE must be taken prior to year 3 core rotations when timeline allows.
For students who have no available timeline, and for students who cannot pass the CBSE at the end of basic sciences within their timeline limit, they must then sit and pass the CBSE/USMLE Step 1 at the end of year 3, after core rotations at a US hospital that does not require Step 1 licensure for placement. However, in this case promotion to year 4 electives requires those students to sit and pass the CBSE and Step 1 USMLE.
For students who intend to complete training in the UK and do not intend to match to a US residency program, there is no CBSE and Step 1 USMLE requirement.
For those students who do not intend to match to a US residency, they can sign an attestation that they will not be sitting the USMLE exam and complete their clinical training in the USA without a requirement for CBSE or Step 1. The clinical training must be completed at hospitals that do not require a USMLE Step 1 score for placement.
Any student who wishes to take the Step 1 after graduating, and enter a US residency, must still fulfill the requirements of SGUSOM and in order to get certified with ECFMG will need to provide the school with evidence they have taken and passed the CBSE and can provide a score report to the university. Once validated the school can certify the student with ECFMG which will allow a Step 1 date to be arranged.
The lifetime maximum attempts that the NBME allows for the CBSE is 5 for any student. The maximum number of attempts for CBSE prior to clinical placement is dependent upon timeline and the table below shows the maximum attempts allowed prior to clinical placement. The CBSE must be taken on the published scheduled windows and failure to complete on that date for any reason will be counted as an attempt. The passing grade for the CBSE is determined by SGU SOM based on CBSE performance analytics and its correlation with Step 1 passing rates. SGU reserves the right to review and adjust the passing grade with each iteration of the examination to stay in line with changes in these metrics.
Currently, students cannot elect to be placed prior to their CBSE maximum mandated attempts upon CBSE failure.
The CBSE is offered at prometric sites only, and a very limited number of places are available in Grenada for students that can demonstrate that they have no access to a Prometric site, i.e. their citizenship status does not allow access to Prometric centers with CBSE access. Students will need to contact DOS and provide documentation in this case if they intend to sit that examination in Grenada.
The CBSE is offered in February, April, June, August, October and December. The schedule for dates can be found on the Office of the University Registrar (OUR) portal page, under the student information tab, which contains scheduling information for courses, terms and CBSE examinations. The CBSE results are made available to SGUSOM from the NBME 5 business days after the examination window closing date. SOM aims to process, grade and post results within 48 hours of receiving them. They are accessible through the document download center on self-service banner. Results will also be populated to the NBME portal directly (https://www.mynbme.org/s/login/) and students can access their results through their own accounts with NBME. The NBME publish results 2/3 days after being made available to the SGUSOM.
Students are encouraged to engage with the AADS team throughout all phases of the curriculum but are strongly encouraged to engage with AADS in term 5 and beyond for advice relating to CBSE preparation and the USMLE Step 1 licensure examination.
For any student who has not completed the program in the standard timeline, they are encouraged to engage with AADS and be clear on their timeline requirements.
More information on the CBSE can be found at the following site Comprehensive Basic Science Subject Exam - Content Outline | NBME
For students that intend to split their 3rd year training time between the UK and USA but who intend to ultimately match to a US residency program, they should complete the CBSE/Step 1 USMLE requirements prior to starting clinical placement when timeline allows (i.e. no more than 2 delays, see table). In this case, if a student is unable to pass the CBSE/Step 1 within the required timeline/attempts shown in the table CBSE attempts and timeline delays they will have to do all of their year 3 rotations in the UK or in a US site that does not require Step 1 depending on their term 5 pathway choice, and then complete their CBSE/Step 1 USMLE requirements at the end of year 3.
For students that have failed the CBSE 4 times between basic sciences and clinical rotations and then fail a further 1 time at the end of third year or otherwise have reached their maximum limited of 5 CBSE attempts; they will not be able to promote to 4th year unless they sign an attestation form that they do not intend to place in a US residency. In this case if a student then changes their mind post graduation, they should contact the registrar and discuss what alternative CBSE equivalent is acceptable for ECFMG certification. For extra ordinary circumstances the SGUSOM may alternatively mandate an NBME custom examination equivalent to the CBSE for students that have failed the CBSE five times and have already graduated the SOM.
Post term 5 CBSE schedule and Clinical Placement deadlines
The table above shows the timeline post term 5 for CBSE and clinical placement for those students who aim for a US residency. The end date of basic sciences is shown in column titled “End BS Phase”, and indicates the date at which a student finishes basic sciences. All students who intend to do a US residency and all or part of 3rd year in the USA are expected to take and pass the CBSE before clinical placement, and are required to sit the CBSE on the dates indicated. Placement at non-step sites is currently not elective and only available for students who have maximized their CBSE attempts based on the table above. Any student who has been through the sequence of all available CBSE examinations between basic sciences and clinicals outlined in the table above, and who fail their last CBSE attempt, will move to immediate mandatory placement at an appropriate clinical site.
NO DELAYS: If finishing the basic sciences curriculum in 2 years with no timeline delays (no fails repeats, LOA, W, CR) then row 1 and 2 apply for Dec and May finishers respectively. The mandatory CBSE attempts are shown (CBSE1, CBSE2, CBSE3, CBSE4) and the last dates for a step 1 score to be provided to SGUSOM and clinical placement process to begin is shown in the last column. If the CBSE is passed at any attempt before the 4th and final one then Step 1 can be completed and placement initiated at any time before the deadline in the final column. If a fail is registered on the 4th attempt then placement at a non-step requiring site will proceed and the deadline is shown in the last column. The CBSE must then be completed at the end of year 3 after all core rotations and remediation is completed.
1 FT DELAY; With one full term delay, i.e. a term repeat, LOA, W, CR, in a full term of 18 weeks (i.e. term 1, 2, 4 or 5) then the CBSE dates are shown in rows 3 and 4 for Dec and May finishers respectively. In this case there is only timeline for 3 CBSE attempts before placement requirement deadlines are met. Students passing the CBSE in Feb or April (for Dec finishers) or June or Aug for May finishers will proceed to Step 1 and need a score before the final column date, otherwise they will be placed at a non Step 1 requiring site. * and ** Please note that if a student fails the third CBSE attempt in June, for Dec finishers, or Oct for May finishers, then placement will be in August and January since no Dec or July placements are possible. For those who pass CBSE and aim to have a step 1 score they should be aware of the deadline dates for step 1 indicated in the last column, i.e. July and Nov in rows 3 and 4 respectively for their placements in Aug and Jan respectively.
T3 DELAY ONLY; if a student has only delayed by 1 term and it is term 3 they will finish basic sciences in Feb or July and will have 4 CBSE attempts. The mandatory CBSE attempts are shown (CBSE1, CBSE2, CBSE3, CBSE4) and the last dates for a step 1 score to be provided to SGUSOM and clinical placement process to begin is shown in the last column. If the CBSE is passed at any attempt before the 4th and final one then Step 1 can be completed and placement initiated at any time before the deadline in the final column. If a fail is registered on the 4th attempt then placement at a non-step requiring site will proceed and the deadline is shown in the last column. The CBSE must then be completed at the end of year 3 after all core rotations and remediation is completed. *** Please note that for Dec finishers (row 7) then the step 1 deadline is Nov but placement will be in Jan since there is no December placement. Step 1 scores are required to be reported in Nov otherwise clinical placement at a non Step requiring site will proceed.
1 FT + T3 DELAY; if a student has a full term delay and a term 3 delay they will finish basic sciences in Feb or July and the rows 9 and 10 indicate the dates on which the CBSE can be taken. **** and ***** There is only timeline for a single attempt at CBSE, and step 1 scores will need to be available to SGUSOM in May or Nov for placement in Jun or Jan. Without step 1 scores placement will proceed to a non step 1 requiring site on the dates indicated in the last column.
>2 DELAYS; there will be no CBSE prior to clinical placement and student will proceed to clinical sites that do not require Step 1. Students will complete CBSE and Step 1 at the end of year 3 after completing all core rotations and remediation.
Accommodations; students that have time accommodations for SGU exams in term 5 will automatically be carried forward for time accommodations for CBSE. If your accommodations status changes during the CBSE attempts the accommodation can only be honored if the NBME exam rosters have not yet been set. If any upcoming CBSE roster has been set at the time we are alerted of accommodations status, the accommodation cannot be offered for the next immediate examination but can only be offered at any subsequent CBSE examinations.
CBSE appeal grade
Grade appeals for CBSE are a matter between the prometric center and the individual student. For any grades reported to SGU by NBME, SGU will proceed with these grades. In case of a successful appeal, SGU will update the grades once received from NBME.