A Predictive Model for USMLE Step 1 Scores

Abstract

PurposeThe United States Medical Licensing Examination (USMLE) Step 1 plays a pivotal role in one’s residency application. While prior literature has investigated which factors influence performance on the examination, the authors sought to include factors such as performance on a well-used question bank and financial need to develop a predictive model.Method After obtaining institutional review board approval, the authors surveyed two consecutive second-year medical school classes and correlated the data to the students’ Step 1 and National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) scores. The survey included questions such as how many days they studied per week, how many days they studied in total, which resources they used, how they performed on question banks, group studying habits, and whether they were receiving financial aid. The authors also assessed whether the students received only A letter grades during the first year of medical school. The authors used SPSS® Statistics V22.0 (IBM® Corporation, NY, USA ) and included one-way analysis of covariance (ANOVA) and multiple linear regression for statistical analysis.Results Eighty-one students completed the survey with an average Step 1 score of 240.5 and with an average study time of 39.5 days. The Step 1 Scores significantly correlated with the CBSE taken immediately preceding the dedicated study period (r=0.711, P=<0.001), UWorld Question Bank (UWorld) percentage correct (r = 0.622, P<0.001), straight As during first-year (r=0.356, P=0.001), and financial need (r=0.318, P=0.01). The scores were not correlated with age, gender, Medical College Admissions Test (MCAT), prior medical training, number of days studied, or the students’ perception of appropriate time studied. The authors developed a predictive model accounting for 62.3% of the variability. 140.625+(0.319xCBSE)-(3.817xA)+(5.845xN)+(0.452xU), where A=1 if straight As, N=1 if receiving need-based scholarship, U=UWorld percent-correct, and CBSE=the three-digit score of the CBSE taken prior to the dedicated study period.Conclusions Academic performance and financial need may predict Step 1 scores. Interestingly, the number of days studied did not have a correlation with scores, suggesting that increased length of study may not ameliorate poor grades.

Is There an Association Between Comprehensive Basic Science Examination Score and Acceptance into an Oral and Maxillofacial Surgery Residency Program?

“…8 Those variables included dental school class rank and NBDE scores. This is consistent with a survey study that evaluated which factors were valued most by program directors when evaluating applicants.…”

“…This is consistent with a previous study in which male medical students performed better on the USMLE Step 1 exam with a mean score of 220.4 (correlated to a CBSE score of approximately 78) than female students with a mean score of 214.4 (correlated to a CBSE score of approximately 76). 8 The reasons for this discrepancy and knowledge gap are unclear and should be investigated in future studies.…”

“…This is consistent with a survey study that evaluated which factors were valued most by program directors when evaluating applicants. 8 Those variables included dental school class rank and NBDE scores. Therefore, improved performance in the factors that program directors report are most important was associated with a high probability of acceptance into the UIC OMFS residency program.…”

“…3 In addition, we have observed that many dental schools do not assign students a grade point average (GPA) or class rank, removing those measures as ways to eval-uate applicants. 5 The CBSE has been found to be strongly correlated with USMLE Step 1 performance [6][7][8] and was adopted by AAOMS beginning with the 2013 American Dental Education Association Postdoctoral Application Support Service (ADEA PASS) application cycle as an objective tool to assess an applicant's knowledge base or at least an applicant's ability to prepare adequately for this exam, even though its focus remains controversial. 4 Additionally, for OMFS residency programs offering integrated training with a medical degree, an applicant's passing the USMLE is a major consideration since residents must pass this exam to progress in the program, and failure would have negative consequences for the program as well as the resident.…”

“…4 Additionally, for OMFS residency programs offering integrated training with a medical degree, an applicant's passing the USMLE is a major consideration since residents must pass this exam to progress in the program, and failure would have negative consequences for the program as well as the resident. 5 The CBSE has been found to be strongly correlated with USMLE Step 1 performance [6][7][8] and was adopted by AAOMS beginning with the 2013 American Dental Education Association Postdoctoral Application Support Service (ADEA PASS) application cycle as an objective tool to assess an applicant's knowledge base or at least an applicant's ability to prepare adequately for this exam, even though its focus remains controversial. 4 Due to the value of the CBSE score, we have observed that OMFS program directors often place major emphasis on it as a screening threshold for applicants to their programs.…”