Predicting performance on the United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge using results from previous examinations

Abstract

Background

Finding early specific indicators of failure in the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) could be used to develop early interventions that could solve deficiencies and help at-risk students to ultimately attain a passing score. This study was aimed at determining if the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) could predict a passing score during the USMLE Step 1. We also assessed if the NBME Medicine Clinical Science Subject Examination (CSSE) or the USMLE Step 1 could predict passing scores during the USMLE Step 2 CK.

Methods

Gender and scores from 724 students who took the USMLE Step 1 were linked and analyzed with the scores of the NBME CBSE, the NBME Medicine CSSE, and the USMLE Step 2 CK using IBM-SPSS.

Results

There were significant correlations between the scores from NBME CBSE and USMLE Step 1 (r=0.73, P≤0.001), between the scores from the NBME Medicine CSSE and the USMLE Step 2 CK (r=0.572, P≤0.001), and between the scores from the USMLE Step 1 and Step 2 CK (r=0.698, P≤0.001). Students with scores <66 in the NBME CBSE were less likely to approve the USMLE Step 1 on their first attempt (P≤0.00001). There was a significant correlation (r=0.684, P≤0.0001) between a score of ≥208 in the USMLE Step 1 and passing the Step 2 CK on the first attempt.

Conclusion

A score <66 in the NBME CBSE might indicate failure during the USMLE Step 1 first take. Similarly, a score <208 in the USMLE Step 1 might predict failure in the USMLE Step 2 CK.

Keywords:

• USMLE Step 1
• USMLE Step 2 CK
• NBME CBSE
• NBME Medicine CSSE

Acknowledgments

The authors would like to thank 1) Gerónimo Maldonado-Martínez, RPT, MPH, PhD, for his advice on statistical analysis; 2) Irma L. Rivera-Colón, EdD, MS, and her staff in the Office of Evaluation for providing the investigators with the data; and 3) Karen G. Martínez, MD, MSc, for her meaningful insight about the manuscript. This project was partially supported by the National Institute on Minority Health and Health Disparities (NIMHD) and the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health under the Award Number U54MD007587 for the Puerto Rico Clinical and Translational Research Consortium. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure

The authors report no conflicts of interest in this work.