Abstract
The Liaison Committee on Medical Education has introduced new norms for United States Medical Licensing Examination (USMLE) performance. Improving USMLE outcomes is a complex intervention that requires careful deliberation of tradeoffs, the coordination of many people and systems, and the marshalling of significant resources, so it is important that any increased attention to USMLE processes is approached strategically through a continuous quality improvement lens. We explore the potential implications of these new standards and present a self-reflection tool, inspired by the Ishikawa method, designed to help schools guide their USMLE-related initiatives by systematically considering possible root causes of below-target USMLE performance.