Do United States Medical Licensing Examination (USMLE) Scores Predict In-Training Test Performance for Emergency Medicine Residents?

Thundiyil, Josef G.; Modica, Renee; Silvestri, Salvatore; Papa, Linda

doi:10.1016/j.jemermed.2008.04.010

Cited by 74 publications

(66 citation statements)

References 15 publications

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“…Substantial literature exists on this topic, and most studies have demonstrated that USMLE scores correlate with performance during residency and future certifying examinations. 6,8,9,17,[20][21][22][23] The degree of correlation varies depending on which USMLE Step/Part is evaluated and the outcomes of interest, with the highest correlation generally between performance on the USMLE and future examinations, either during or at conclusion of training. Still, even when evaluating which measures best predict resident ratings by faculty or performance in practice, USMLE scores have consistently been the most significant and accurate variable.…”

Section: Discussionmentioning

confidence: 99%

Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

Lewis¹,

Hiatt²,

Wilkerson³

et al. 2011

Journal of Graduate Medical Education

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Background Although the primary purpose of the US Medical Licensing Examination (USMLE) is assessment for licensure, USMLE scores often are used for other purposes, more prominently resident selection. The Committee to Evaluate the USMLE Program currently is considering a number of substantial changes, including conversion to pass/fail scoring. Methods A survey was administered to third-year (MS3) and fourth-year (MS4) medical students and residents at a single institution to evaluate opinions regarding pass/fail scoring on the USMLE. Results Response rate was 59% (n = 732 of 1249). Reported score distribution for Step 1 was 30% for <220, 38% for 220–240, and 32% for >240, with no difference between MS3s, MS4s, and residents (P = .89). Score distribution for Step 2 Clinical Knowledge (CK) was similar. Only 26% of respondents agreed that Step 1 should be pass/fail; 38% agreed with pass/fail scoring for Step 2 CK. Numerical scoring on Step 1 was preferred by respondents who: (1) agreed that the examination gave an accurate estimate of knowledge (odds ratio [OR], 4.23; confidence interval [CI], 2.41–7.43; P < .001); (2) scored >240 (OR, 4.0; CI, 1.92–8.33; P < .001); and (3) felt that acquisition of knowledge might decrease if the examination were pass/fail (OR, 10.15; CI, 3.32–31.02; P < .001). For Step 2 CK, numerical scoring was preferred by respondents who: (1) believed they gained a large amount of knowledge preparing for the examination (OR, 2.63; CI, 1.52–4.76; P < .001); (2) scored >240 (OR, 4.76; CI, 2.86–8.33; P < .001); (3) felt that the amount of knowledge acquired might decrease if it were pass/fail (OR, 28.16; CI, 7.31–108.43; P < .001); and (4) believed their Step 2 CK score was important when applying for residency (OR, 2.37; CI, 1.47–3.84; P < .001). Conclusions Students and residents prefer the ongoing use of numerical scoring because they believe that scores are important in residency selection, that residency applicants are advantaged by examination scores, and that scores provide an important impetus to review and solidify medical knowledge.

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Section: Discussionmentioning

confidence: 99%

Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

Lewis¹,

Hiatt²,

Wilkerson³

et al. 2011

Journal of Graduate Medical Education

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“…Particularly strong associations have been found between USMLE scores and other exam-related measures of success, such as scores on in-training examinations in specialties such as dermatology [7], emergency medicine [8], general surgery [9], and neurology and neurosurgery [10], as well as across specialties in meta-analyses [11,12]. Other positive associations were found between USMLE scores and a resident’s likelihood of successfully passing board examinations [12,13], especially on the first attempt [14,15].…”

Section: Introductionmentioning

confidence: 99%

The association of USMLE Step 1 and Step 2 CK scores with residency match specialty and location

Gauer

Jackson

2017

Medical Education Online

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Background: For future physicians, residency programs offer necessary extended training in specific medical specialties. Medical schools benefit from an understanding of factors that lead their students to match into certain residency specialties. One such factor, often used during the residency application process, is scores on the USA Medical Licensing Exam (USMLE). Objectives: To determine the relationship between USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores and students’ residency specialty match, and the association between both USMLE scores and state of legal residency (Minnesota) at the time of admission with students staying in-state or leaving the state for residency program. Design: USMLE scores and residency match data were analyzed from five graduating classes of students at the University of Minnesota Medical School (N = 1054). Results: A MANOVA found significant differences (p < 0.001) between residency specialties and both USMLE Step 1 and Step 2 CK scores, as well as the combination of the two. Students who matched in Dermatology had the highest mean USMLE scores overall, while students who matched in Family Medicine had the lowest mean scores. Students who went out of state for residency had significantly higher Step 1 scores (p = 0.027) than students who stayed in-state for residency, while there was no significant difference between the groups for Step 2 scores. A significant positive association was found between a student who applied as a legal resident of Minnesota and whether the student stayed in Minnesota for their residency program. Conclusions: Residency specialty match was significantly associated with USMLE Step 1 and USMLE Step 2 CK scores, as was staying in-state or leaving the state for residency. Students who were legal residents of the state at the time of application were more likely to stay in-state for residency, regardless of USMLE score. Abbreviations: CK: Clinical knowledge; COMLEX: Comprehensive Osteopathic Medical Licensing Examination; GME: Graduate medical education; NRMP: National Resident Matching Program; UME: Undergraduate medical education; USMLE: United States Medical Licensing Examination

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“…Step 1 scores have been shown to correlate with intraining examination scores in Internal Medicine (Perez and Greer 2009), Emergency Medicine (Thundiyil et al 2010), Orthopedic Surgery (Carmichael et al 2005), and Obstetrics and Gynecology (Armstrong et al 2007). There also was reportedly a low correlation between Step 1 and in-training exams in orthopedic surgery (Klein et al 2004;Carmichael et al 2005), several studies showing a correlation between Step 1 and intraining examination scores reported stronger in-training examination correlations with…”

Section: Introductionmentioning

confidence: 99%

“…Step 2CK (clinical knowledge) than with Step 1 scores (Perez and Greer 2009;Thundiyil et al 2010;Black et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Academic and professional career outcomes of medical school graduates who failed USMLE Step 1 on the first attempt

McDougle

Mavis

Jeffe

et al. 2012

Adv in Health Sci Educ

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This study sought to determine the academic and professional outcomes of medical school graduates who failed the United States Licensing Examination Step 1 on the first attempt. This retrospective cohort study was based on pooled data from 2,003 graduates of six Midwestern medical schools in the classes of 1997-2002. Demographic, academic, and career characteristics of graduates who failed Step 1 on the first attempt were compared to graduates who initially passed. Fifty medical school graduates (2.5 %) initially failed Step 1. Compared to graduates who initially passed Step 1, a higher proportion of graduates who initially failed Step 1 became primary care physicians (26/49 [53 %] vs. 766/1,870 [40.9 %]), were more likely at graduation to report intent to practice in underserved areas (28/50 [56 %] vs. 419/1,939 [ 21.6 %]), and more likely to take 5 or more years to graduate (11/50 [22.0 %] vs. 79/1,953 [4.0 %]). The relative risk of first attempt Step 1 failure for medical school graduates was 13.4 for African Americans, 7.4 for Latinos, 3.6 for matriculants >22 years of age, 3.2 for women, and 2.3 for first generation college graduates. The relative risk of not being specialty board certified for those graduates who initially failed Step 1 was 2.2. Our observations regarding characteristics of graduates in our study cohort who initially failed Step 1 can inform efforts by medical schools to identify and assist students who are at particular risk of failing Step 1.

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Do United States Medical Licensing Examination (USMLE) Scores Predict In-Training Test Performance for Emergency Medicine Residents?

Cited by 74 publications

References 15 publications

Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

The association of USMLE Step 1 and Step 2 CK scores with residency match specialty and location

Academic and professional career outcomes of medical school graduates who failed USMLE Step 1 on the first attempt

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