For the first time in 40 years, bedside exchanges between medical students and patients have come under mandatory review by the National Board of Medical Examiners (search).

The country's first clinical-skills assessment test began this week in Philadelphia, one of five test sites nationwide. It's a pass/fail test the licensing board says will weed out bad doctors and protect patients.

"Patients who are unhappy because they perceive their doctor isn't listening, or hasn't accurately communicated the facts, are patients who don't have good outcomes," said Laurence Gardner, chairman of the National Board of Medical Examiners (search).

But the American Medical Association (search) says the new practice won't improve patient safety. The physicians' organization is openly critical of the new licensing hurdle, saying the goal is unproven and the test is redundant.

"The place to do it is in medical schools where [students] can receive training, they can receive evaluation and most importantly — can receive a helping hand," said John Armstrong of the AMA.

Many medical students echo the AMA's complaints and balk at the additional cost of submitting to the test.

"Students are [already] anywhere between one hundred and two hundred thousand dollars in debt, and an additional one thousand to fifteen hundred for the test, plus having to fly to a test site and stay at a hotel ... it's a factor," said University of Miami med student Chad Aarons.

Despite the debate, the licensing board says the test is here to stay, giving students six chances to pass and to prove what multiple-choice tests cannot — that doctors can communicate with patience.

Go to the video box at the top of this story to watch a report by Fox News' Catherine Herridge.