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APMLE Exam Format | APMLE Course Contents | APMLE Course Outline | APMLE Exam Syllabus | APMLE Exam Objectives

The Part I examination samples the candidates knowledge in the basic science areas of General Anatomy, including embryology, histology, genetics, and geriatrics; Lower Extremity Anatomy; Biochemistry; Physiology; Microbiology and Immunology; Pathology; and Pharmacology. A separate Candidate Information Bulletin for the Part I exam is available online at

The Part II written examination samples the candidates knowledge in the clinical areas of Medicine; Radiology; Orthopedics, Biomechanics and Sports Medicine; Anesthesia and Surgery; and Community Health, Jurisprudence, and Research. A separate Candidate Information Bulletin for the Part II written exam is available online at Performance on the Part II written examination does not impact eligibility for the Part II CSPE.

The Part II Clinical Skills Patient Encounter (Part II CSPE) assesses proficiency in podiatric clinical tasks needed to enter residency. Candidates will be expected to perform a focused physical examination including podiatric and general medicine physical exam maneuvers appropriate for each patient presentation. Podiatric and general medical knowledge, verbal and written communication, and interpersonal skills will be assessed in each exam form. Performance on the Part II CSPE does not impact eligibility for the Part II written examination.

The Part III examination is designed to determine whether a candidates knowledge and clinical skills are adequate for safe, unsupervised practice. The Part III examination samples the candidates clinical skills in evaluating, diagnosing, and treating patients. Examples of the application of knowledge may be measured through photographs, radiographs and case presentations. A separate Candidate Information Bulletin for the Part III exam is available online at

Part I and II

Podiatric Medical College Faculty submit questions (with accompanying references) to Prometric.

The pool of questions (items) are reviewed by a panel of practicing podiatric physicians and two podiatric medical school faculty in each content area.

The primary responsibility of the faculty is clarity and a current reference check.

The primary responsibility of the DPM members is what is the relationship between the item and the tasks performed by a DPM in practice=>

priority with regard importance in practice.

estimated difficulty-Is it easy, medium or hard=>

For Part I, the questions (items) also are reviewed by a content specialist in one of the basic sciences for accuracy and currency. This individual is a medical school faculty member.

Prometric assembles the test from approved questions according to the content specification.

Part III

Items are written and reviewed by panels of DPM practitioners who have been trained how to prepare effective test items. A second panel of DPMs reviews each form of the test before it is published.

Post Test Administration

Double Scoring Ensures Accuracy

At the examinee level, each computer-based test undergoes two independent scorings. Each test is first scored at the testing site and subsequently rescored when the data arrive back at Prometric. If scores do not match exactly, the examinees record is held until the results can be reconciled. Irregularities that may have occurred at the testing site are also noted and any examinees who may have experienced irregular testing conditions at the test site (such as hardware or software failures or power interruptions) receive a thorough review of their responses. Scores for these examinees are not released until all irregular conditions are given consideration and resolution processing rules are applied fairly to ensure equity in the test administration process.

Item Analysis

Each item is statistically analyzed to determine how many candidates answered correctly and whether the item discriminated between the high and low scoring candidates (the high scoring candidates answered correctly and the low scoring candidates did not). If the item is “flagged”, content experts review each of the flagged items for accuracy.

Deans Report

At the conclusion of the above analyses and after the scores are mailed to the candidates, each dean receives a report, which compares the performance for first time candidates at that school with the national examination data.

Score Reliability

Reliability refers to the consistency of test scores, the consistency with which candidates are classified as either passing or failing, and the degree to which test scores are free from errors of measurement. Errors of measurement result from factors not related to the test, factors such as fatigue or heightened attention, personal interests and other characteristics not related to the test. A persons score will not be perfectly consistent from one occasion to the next as a result of measurement error.

Determination of Passing Scores

The National Board and its test consultant, Prometric, use a widely-accepted criterion-referenced approach to determine passing scores known as the Angoff Method. The important feature of criterion-referenced standard setting is that it is based on an expected level of competence regardless of how many candidates in a particular group pass or fail. This is distinguished from a norm-referenced approach in which a set proportion of test takers fall above or below the passing score.

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Wegovy weight loss drug has heart health merits, study discovered | Resources

(CNN) - effects from a landmark clinical trial this summer suggested, for the first time, that a medication given for weight loss on my own could reduce the chance of heart attack, stroke or heart-connected death in americans with cardiovascular disease, bolstering physicians' pleasure about an already-exploding type of recent medicines.

Novo Nordisk's Wegovy, a part of the booming group of medicine referred to as GLP-1 receptor agonists, become shown to reduce these americans's risk of one more cardiovascular adventure by way of 20%, effects that have been established in a presentation of the whole dataset Saturday on the American coronary heart association convention in Philadelphia.

"imagine a future the place we're treating obesity and, in impact, treating these different obesity-related ailments" like hypertension, excessive cholesterol and kind 2 diabetes, Dr. Ania Jastreboff, director of the Yale weight problems analysis middle, who helped habits the trial, referred to at a briefing Friday. "Treating obesity naturally improves fitness consequences."

A key question about the initial effects, even though, remained not wholly answered: Is the heart benefit from Wegovy attributable to how a lot weight people lose while the usage of the drugs? Or is it as a result of Wegovy has other results as neatly?

"It continues to be doubtful to what diploma the trial findings were dependent on weight reduction, concomitant discounts in possibility elements, or different salutary mechanisms of GLP-1 receptor agonism," Dr. Amit Khera, of the school of Texas Southwestern medical center Dallas, and the countrywide Institutes of fitness's Dr. Tiffany M. Powell-Wiley wrote in an editorial that became published Saturday in the New England Journal of drugs together with the whole outcomes of the study, called choose.

then again, they delivered, "we are in a new period of treating weight problems and cardiometabolic chance with a growing armamentarium of alternate options."

The tool chest grew this week with US meals and Drug Administration approval of Zepbound for obesity, a drug from Eli Lilly as a way to compete without delay with Wegovy. each medicines have been preceded by drugs for type 2 diabetes that use the identical energetic compounds: Wegovy's sister drug is Ozempic, and each use semaglutide, while Zepbound's is Mounjaro, and both use tirzepatide. they are all taken as soon as every week as a self-administered shot.

GLP-1 receptor agonists mimic hormones that stimulate the production of insulin, promote feelings of fullness and in the reduction of urge for food. Semaglutide pursuits GLP-1, while tirzepatide targets both GLP-1 and a hormone called GIP.

The trial showed that after two years, americans using Wegovy have been much less likely to enhance diabetes or blood sugar ranges regarded "prediabetes"; lost 9.four% of their physique weight, compared with 0.9% on placebo; decreased their waist circumference by using an extra 6.6 centimeters over placebo; and had stronger discount rates in systolic blood pressure, a marker of irritation known as C-reactive protein and triglycerides.

To cardiologist Dr. Steven Nissen of the Cleveland sanatorium, who wasn't involved within the trial but is leading an identical certainly one of tirzepatide, these outcomes are all facts of the benefits of weight loss.

"should you drop extra pounds, a lot of things alternate," Nissen observed in an interview Saturday from the convention simply after the Wegovy examine presentation, which was given to a packed condominium with a couple of rows of audience participants standing at the again.

"we have, for the primary time in historical past, remedies that can definitely basically [help patients] lose adequate weight to make a change," Nissen pointed out.

Tirzepatide has shown more suitable tiers of weight reduction than semaglutide in medical trials, leading many, together with Nissen, to hope it's going to demonstrate even more advantageous cardiovascular merits.

The Wegovy examine, subsidized with the aid of Novo Nordisk, enrolled 17,604 people whose body mass index become 27 or greater, placing them within the overweight class, and who had heart problems, meaning a previous heart assault or stroke or signs of peripheral artery ailment - clogged arteries within the palms or legs.

Importantly, contributors didn't have a historical past of diabetes; a outdated trial had proven that treating individuals with diabetes with a GLP-1 drug, Ozempic, reduced their cardiovascular risk.

The Wegovy trial confirmed that 569 of eight,803 americans taking the drug had a heart attack or stroke or died from coronary heart-related causes, or 6.5%. it really is in comparison with 701 of 8,801 people on a placebo, or eight%. The change in these charges is what quantities to the 20% improvement suggested in August.

The advantage became seen on properly of drug treatments like statins to lower cholesterol, which 90% of the trial contributors have been taking, and other medicine regarded the average of look after coronary heart patients.

"The ameliorations in costs between the two treatment agencies begun to emerge very early after initiation of medication, within the first months," the Cleveland medical institution's Dr. A. Michael Lincoff, who led the trial, spoke of Friday.

The 20% reduction became on a mixture of three measures; when looked at one after the other, no longer all reached statistical significance. the first individual measure the researchers looked at became loss of life from cardiovascular explanations, and while it regarded Wegovy reduced the possibility via 15%, the results weren't statistically enormous, which means they do not cling as lots weight.

The biggest benefit seemed to be in preventing heart assaults, the place the risk discount turned into 28%. Strokes were reduced by using 7%. it be unclear what the statistical value of those measures turned into, as a result of researchers failed to calculate these values after the discovering on deaths failed to meet the edge. The ordinary finding of 20% possibility reduction, though, was statistically very potent.

The look at failed to uncover any new protection concerns, nonetheless it discovered that extra people stopped taking semaglutide than placebo because of adverse hobbies. essentially the most general were gastrointestinal issues like nausea, vomiting and diarrhea, and there turned into a small boost in gallbladder-linked disorders on Wegovy compared with placebo.

The amount of weight loss viewed in the trial, 9.4%, turned into lower than in different reviews of Wegovy, which showed usual weight loss nearer to fifteen%. Lincoff noted that this trial wasn't concentrated on weight administration, the place trials customarily contain changes in food regimen and recreation and "shut monitoring," but instead "fashions the manner cardiovascular disease is treated within the real world."

He additionally referred to that no longer the entire contributors received the optimum dose of Wegovy during this look at; the dose of medicine turned into adjusted according to even if they had facet effects.

On the query of whether the benefit within the trial came basically from weight reduction or from other drug consequences, Lincoff cited that the coronary heart merits grew to become apparent within the analyze sooner than the predominant modifications between Wegovy and placebo on weight loss, and he mentioned that "lighter-weight patients to birth with skilled the equal magnitude of improvement."

"I believe most of us agree with that a few of here is weight loss, but I think that that oversimplifies a extremely complex molecule, a complex receptor on multiple tissues, and that i don't feel it's as an easy as that," he talked about. "it is a part of the reason why I don't feel weight reduction itself is the surrogate; we ought to appear on the mechanism of the burden loss."

"And," Jastreboff brought, "it may well be a mixture of both."

The examine left just a few additional questions unanswered: It checked out heart possibility best in americans with present heart problems, and researchers stated it will be vital to understand no matter if the drug could improvement people who hadn't had a cardiac experience. The trial additionally had racial and gender imbalances: simplest three.eight% of contributors typical were Black, and 28% were women.

The findings are expected to boost demand for the drug, which already is in brief supply, and probably improve insurance insurance, which is spotty. Wegovy expenses $1,349 a month earlier than insurance.

And whereas "millions of additional sufferers" might improvement from the drug in line with these effects, Khera and Powell-Wiley wrote of their editorial, "semaglutide comes with a big can charge both to patients and to society at the present pricing for GLP-1 receptor agonists, which makes this treatment inaccessible for a lot of."

greater from CBS information


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