In 1986, The Association of American Medical Colleges (AAMC) bestowed their Special Recognition Award on Dr. Edithe J. Levit, the first woman president and CEO of a national medical association, the National Board of Medical Examiners. Dr. Levit introduced new technologies and strategies for the examination of medical students, spearheading change to improve standards. Carefully managing the needs of both medical schools and examiners, she promoted dynamic changes that included the introduction of audiovisual tools, computer-based exams, and the first self-assessment test of the American College of Physicians.
Edithe J. Miller was born in Wilkes-Barre, Pennsylvania, in 1926. She was interested in science from an early age, and majored in biology at Bucknell University. After a year as a graduate assistant in psychology, she enrolled at the Medical College of Pennsylvania, in 1948. She met Dr. Samuel Levit as a student and they married a year after her graduation in 1952. The young couple stayed in Pennsylvania to start a family and continue with their careers. Sons Harry and David were born in 1953 and 1955.
Dr. Levit was working s a Clinical Instructor and Associate in Endocrinology at the Philadelphia General Hospital, where she had completed her internship before graduation, when the two boys were born. She took on a more influential role when they were still quite young, becoming Director of Medical Education in 1957. When she left a few years later to serve as Assistant Director at the National Board of Medical Examiners, she carried on as a consultant for a number of years, in the meantime ushering in some of the most revolutionary new practices in the history of the National Board of Medical Examiners.
At the National Board of Medical Examiners, (NBME), Dr. Levit was one of the first professional full-timers. The NBME was founded in 1915 to standardize the criteria required for a license to practice medicine across all states, and to regulate and improve medical education and students. Dr. Levit joined early in the 1960s and over the decade instituted a number of creative innovations that have revolutionized the ways medical students are evaluated.
Dr. Levit was charged with the development of the major examination programs, and was instrumental in the development of patient management problems (PMPs) to test clinical competence. PMPs were first introduced in 1961, and were designed to test the observation skills of the medical student and their decision-making process during the physical examination and patient-history taking. Students selected options from a selection of multiple choice answers at several stages in a written version of an encounter with a patient. The decisions made at each stage had specific consequences, and would require the student to make more decisions based on each outcome. Real encounters with patients, and even faked ones where students watched edited films and responded, were both tried out by the NBME but were too difficult to standardize. The patient management problem was a far more effective way to test all students on the same skills, and to hold them to the same standards. The computer-based tests that have been introduced since expand on this concept, and were first identified by Levit as the way forward in medical examination. The success of computer-based testing has proven the wisdom of her vision for medical education. She also played an important role in the design of an examination for neurological surgeons in training, and self-assessment programs for practicing physicians.
Her innovative contributions were well noted, and Dr. Levit rose from Assistant to Associate Director and Secretary of the Board within those first ten years. In 1975 she was made Vice President, and in 1977 she became the first woman president and Chief Executive Officer of a national medical association when she took over the leadership of the NBME. In her retirement she was named President Emeritus and Life Member of the Board, and in 1986, she received the first ever honorary resolution from the American Medical Association's Resident Physicians Section for her commitment to the highest standards in medical education, as well as a Special Recognition Award from the Association of American Medical Colleges.
