Is the Step 1 score predictive of the Step 2 score?
While the USMLE Step 1 and 2 exams cover different material, basic sciences and clinical knowledge, respectively, there are similarities between the tests as they are both written by the same governing body. A study of USMLE performance in the mid 1990s (when the exam was converted from the NBME to the USMLE) showed a strong correlation between Step 1 and 2 performance. A more recent study in 2006 similarly showed correlated results.
Interestingly, the correlation was stronger for students from medical schools with a higher average USMLE Step 1 score; this may be reflective of an environment that encourages strong study habits and drive to achieve. The correlation was also stronger at larger medical schools, possibly because some smaller schools have a more narrow curricular focus or a less diverse patient population.
Multiple studies have also demonstrated a difference in performance on the tests based on gender. While the overall pass rates between genders are similar, studies have demonstrated that male students generally outperform females on Step 1 while females perform equal to or better than males on Step 2 CK. Although controversial, some believe this may be in part because female students may have less of a basic science background upon entering medical school, leading to lower Step 1 scores; Step 2 CK includes areas that have traditionally been of more interest to female students, such as pediatrics, psychiatry, and obstetrics/gynecology, in turn leading to higher scores. Overall, there was a stronger correlation of Step 1 with Step 2 performance in males than females.
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