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Do USMLE steps, and ITE score predict the American Board of Internal Medicine Certifying Exam results?

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BMC Medical Educationvolume 20, Article number: 79 (2020) Cite this article

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Abstract

Background

To evaluate if United States Medical Licensing Examination (USMLE) Step 1, USMLE Step 2 CK, USMLE Step 3, and residency third-year in-service training exam (ITE) scores predict the results of American Board of Internal Medicine Certifying Exam (ABIM-CE).

Methods

We performed a retrospective review of USMLE Step 1, USMLE Step 2 CK, USMLE Step 3, third-year residency ITE scores and ABIM-CE results of IM residents at our residency program from 2004 through 2017. Statistical analysis was perfrormed using Pearson correlation coefficient, and logistic regression to assess the relationship between USMLE Step 1, USMLE Step 2CK, USMLE Step 3, 3rd year ITE scores and ABIM-CE results. We used Multivariate logistic regression to predict pass or fail results in ABIM-CE based on USMLE and third-year ITE test scores controlling for other covariates.

Results

Among 114 Internal Medicine MD residents included in the study, 92% (n = 105) passed the ABIM-CE. The OR of passing ABIM-CE was 2.70 (95% CI = 1.38–5.29), 2.31 (95% CI = 1.33–4.01), and 1.63 (95% CI = 0.81–3.29) with a ten-point increase in USMLE Step 1, USMLE Step 2 CK and USMLE Step 3 scores respectively. The OR of ABIM-CE passing chance was 2.96 (95% CI = 0.95–9.20), with a ten-point increase in the average score of the above three exams. A 5 % increase in ITE percentage raised the likelihood of passing ABIM-CE (OR 2.92, 95% CI 1.15–7.38). All residents who failed ABIM-CE had Step 1 scores < 220. Among 31 residents with Step 2 CK score < 220, 20% (n = 6) failed ABIM. Similarly, 9% of residents with USMLE Step 3 score < 220 failed ABIM-CE; all residents who failed had scored < 220. The probability curve predicted that the chance of passing ABIM- CE was around 80% with USMLE scores greater than 200 and increased to almost 100% with USMLE scores of 250 or more.

Conclusion

USMLE Step 1, USMLE Step 2 CK, and third-year ITE scores can predict the chances of passing ABIM-CE. The third-year ITE score has a higher preditive value compared to USMLE Step 1 and USMLE Step 2 scores. USMLE Step 1 scores more predictive of ABIM-CE results compared to USMLE Step 2CK scores. Thus, residency programs can identify internal medicine residents at risk of failing ABIM-CE and formulate interventions at an early stage during residency training. Measures such as enrolling them in question banks or board review courses can be helpful in improving their chances of passing ABIM-CE.

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Background

The assessment of a resident's competency during training is a complex process. Residency programs perform a twice yearly evaluation of the six core competencies identified by Accreditation Council for Graduate Medical Education (ACGME) to improve the overall performance of the residents [1]. American Board of Internal Medicine (ABIM) uses various factors to test the skills of the physicians and their ability to deliver high-quality care. The factors include fulfillment of the graduate medical education training requirements, demonstration of clinical competence in patient care, and passing the American Board of Internal Medicine Certifying Exam (ABIM-CE) [2]. ABIM-CE is administered once every year for residents who complete their training. ABIM-CE results are important for both the residents and their residency programs. In order for the residency programs to maintain their ACGME accreditation, ACGME requires a 80% pass rate in ABIM-CE from the first-time takers of the exam in the latest three-year period [3].

Various tools are used by IM residency programs to select candidates likely to perform well in ABIM-CE to maintain ABIM-CE success rate. United States Medical Licensing Examination (USMLE) scores are commonly used by residency programs to screen residency applicants [4,5,6]. During the residency training, the annual in-service training exam (ITE) serves as a tool to assess the medical knowledge of the residents. A national standardized ITE was developed for various specialties, including IM, to provide feedback to the residents and the training program [7]. By assessing the knowledge gap (the deficit in the knowledge that can be improved to achieve better scores), ITE exams allow the residents to understand the areas in need for improvement. Also, the ITE exam score is used by the training programs to evaluate the residents readiness for ABIM-CE and the residents ability pass ABIM-CE [7].

Previously, several studies have reported variable degrees of correlation between USMLE and ITE scores [5, 6, 8, 9]. A few studies reported an association between USMLE scores and IM-ITE performance [10, 11]. A modest correlation between failing USMLE Step 1 and scoring at the bottom quartile in ITE scores with risk of failing ABIM-CE was reported by Kay et al. [12]. In our study, we analyze whether USMLE Step 1, USMLE Step 2 CK, USMLE Step 3, and residency third year ITE scores correlated with the results of ABIM-CE.

Methods

Study sample and characteristics

All residents enrolled in our IM residency training program from 2004 through 2017 were included. The collected data included gender; type of degree (MD versus DO); medical school country (American Medical Graduate [AMG] versus International Medical Graduate [IMG]); scores in USMLE Step 1, USMLE Step 2 CK, USMLE Step 3, 3rd year ITE results; gap (number of years) between graduation from medical school and start of residency (referred to as ‘the gap’); and ABIM-CE results (Pass versus Fail). The number of osteopathic residents (DO) was considerably less than allopathic residents (MD), and they had taken COMLEX exams instead of USMLE Steps so DO residents were excluded. Also, the MD residents without complete data were excluded. Thus, after excluding DO residents (n = 18) and MD residents with incomplete data (n = 9), the remaining MD residents were included in the analysis.

Scores of ITE from the third year of residency, the exam closest to ABIM-CE in the timeline, were used in our analysis because third-year ITE scores reflect the readiness of the residents to take ABIM-CE.

Statistical analysis

We presented all continuous data as mean (SD), and categorical data as N(%), Statistical analyses were based on scaled scores. We used the Pearson correlation coefficient to assess the correlation between USMLE Step 1, USMLE Step 2 CK, USMLE Step 3, and third-year ITE scores. We performed logistic regression to evaluate the relationship between various scores separately and pass or fail results in ABIM-CE. Also, we performed multivariate logistic regression to examine the relationship between the scores and the ABIM-CE results controlling for other confounding variables such as gender, medical school country, the gap between medical school and residency program. Significance was set at p < 0.05. We used SAS 9.4 software (SAS Institute Inc., Cary, North Carolina) to perform statistical analysis.

Ethics approval

We received an exemption from the approval of Michigan State University Human Research Protection Program – MSU institutional board review (IRB# × 16-029e). We did not obtain consent from individual graduates, the data is de-identified, and the ethics committee approved this procedure.

Results

We included a total of 114 MD residents in the study; 92% (n = 105) passed the ABIM-CE. Table 1 shows the characteristics of the residents, along with their mean scores in different exams. Table 2 shows the mean USMLE Step 1, USMLE Step 2CK, USMLE Step 3 and 3rd year ITE scores of based on ABIM-CE results.

Full size table

Full size table

All residents (n = 9) who failed ABIM-CE scored < 220 in USMLE Step 1 which was 25% of total residents with USMLE Step 1 score of < 220 (n = 35). Among 31 residents with USMLE Step 2 CK score < 220, 20% (n = 6) failed ABIM whereas only 10% (n = 3) with USMLE Step 2 CK score > 220 failed ABIM-CE. Similarly, 9% of residents with USMLE Step 3 score < 220 failed ABIM-CE; all residents who failed had scored < 220.

First, logistic regressions were employed to predict ABIM-CE passing with USMLE Step 1, USMLE Step 2 CK, USMLE Step 3, and ITE tests separately controlling for gender, country of the medical school, and 1 year of the gap between medical school and the start of residency. There was a significant correlation of passing ABIM-CE with 10 points increase in USMLE Step 1 (Odds ratio [OR] 2.70; 95% Confidence Interval [CI] 1.38–5.29) and 10 points increase in Step 2 CK (2.31; 95% CI 1.33–4.01). However, a 10 points increase in Step 3 (OR 1.63; 95% CI 0.81–3.29) did not significantly predict passing ABIM-CE. A 5% increase in ITE percentage increased the likelihood of passing ABIM-CE (OR 3.89, 95% CI 1.68–8.98).

Next, we calculated the average of USMLE Step scores and predicted the ABIM-CE pass result using the average Step scores. Table 3 shows the results from the analysis of maximum likelihood estimates. A 10 points increase in average Step scores will lead to a higher chance of passing ABIM-CE tests (OR = 2.96, 95% CI = 0.95–9.20)) but not significantly at α = 0.05 level. There was no relationship between ABIM-CE results and gender, the country of medical school (American medical graduate = AMG vs. International medical graduate = IMG). The increase in the gap (1 year) was not significantly associated with the chances of passing ABIM-CE (OR 0.82; 95% CI 0.364–1.06) (Table 3).

Full size table

The probability curve (with third year-ITE percentage and the gap set at mean values) predicted that the chance of passing ABIM- CE was around 80% with USMLE scores higher than 200 and ABIM-CE passing chance increased to almost 100% with USMLE scores of 240 or higher (Fig. 1). A ROC (receiver-operating characteristic) curve was computed to assess the accuracy of the model’s ability to predict passing the ABIM-CE. The area under the ROC curve was 0.945 (Fig. 2), which indicates that the probability of our model will rank a randomly chosen “pass the board” higher than “not pass the board” is 0.945.

Predicted probability curve for passing ABIM-CE

Full size image

ROC curve

Full size image

We repeated the analysis using standardized USMLE step scores and standardized ITE test scores with mean at zero and standard deviation (SD) at 1. One SD increase in USMLE Step 1 lead to a significantly higher chance of passing ABIM-CE (OR = 6.41, 95% CI 1.84–22.46) and one SD increase in USMLE Step 2 CK lead to a significantly higher chance of passing ABIM-CE (OR = 5.62, 95% CI 1.80–17.60). However, a 1 SD increase in USMLE Step 3 is not significantly associated with passing ABIM-CE (OR = 1.89, 95% CI 0.76–4.68). Table 4 shows the results with a 1 SD increase in average USMLE score and ITE percentage increase after controlling for demographics. Our analysis also found that a 1 SD increase in the ITE test leads to a higher chance of passing ABIM (OR = 5.0, 95% CI 1.24–20.25). The results indicate that one SD change in the ITE test has the most significant effect on increasing the chance of passing the ABIM-CE.

Full size table

Discussion

Our analysis showed that USMLE Step 1, USMLE Step 2 CK, USMLE Step 3, and third-year ITE scores have a predictive value in determining the chances of passing ABIM-CE. Among them, ITE percentage is the most predictive, followed by USMLE Step 1, USMLE Step 2 CK, and USMLE step 3 in the descending order.

Residency programs use USMLE scores as one of the initial screening tools to select their potential candidates from residency applicants. USMLE comprises of three steps - USMLE Step 1, USMLE Step 2, and USMLE Step 3, to evaluate the appropriate use of medical knowledge in patient care by the examinees. The USMLE Step 2 exam consists of two sections: USMLE Step 2 CK (Clinical Knowledge) and USMLE Step 2 CS (Clinical Skills). Currently, USMLE Step 1, USMLE Step 2 CK, and USMLE Step 3 are MCQ based exams and they reports score in a three-digit format [13]. USMLE Step 2 CS tests their clinical skills, and reports only pass or fail [13]. Previously, USMLE reported scores in percentile format. However, in 1999, the percentile-based system was eliminated in favor of a three-digit and two-digit scaled scoring system. USMLE removed the two-digit score from the score report in April 2013.

USMLE exam scores range anywhere from 1 to 300, and most examinees score between 140 to 260. USMLE Step 1 passing score is 194; the national mean approximately 229 (sd = 20) [13]. According to the National Resident Matching Program (NRMP), the mean score for US allopathic candidates matching into residency programs in 2016 was 233.2 (sd = 17.4) [13]. For the 2013–2014 and 2014–2015 academic years, the mean USMLE Step 2CK score is 240 (sd = 18) for first-time takers from the medical schools in the United States and Canada. The minimum passing score for students taking USMLE Step 2 CK after July 1, 2014, is 209 and was 209, at least until May 2018 [13]. The minimum USMLE Step 3 passing score will be raised to 198 from 196 from the beginning of January 1, 2020 [13].

USMLE Step 1 score was included in a predictive tool to rank applicants after the residency interview, the other factors in the tool were medical school quality, overall medical school performance, and performance in junior medicine clerkship [14]. However, there is limited data to prove that USMLE scores have a strong correlation with the performance in ABIM-CE [12]. The results from our study showed that the USMLE Steps scores can predict the ABIM-CE results, USMLE step 1 score more predictive than USMLE Step 2 CK scores. The chance of failing ABIM-CE is higher with USMLE Scores below 220, more so with USMLE Step 1 than USMLE Step 2 CK or USMLE Step 3. Kay et al. reported a modest correlation between USMLE Step 1 and ABIM-CE scores [13]. There are reports of consistent results showing a correlation between USMLE scores and the results of the certification examination in various specialties and subspecialties [15,16,17,18,19]. Higher USMLE Step 1, USMLE Step 2 CK, and composite scores were also associated with better performance on Emergency Medicine boards, with USMLE Step 2 scores being the strongest predictor [18]. Lower USMLE Step 1 score was previously found to be predictive of failing certifying exams in surgery and pediatrics [19, 20]. 

Performance in ITE is another tool used to predict the ABIM-CE results. ITE scores are expected to improve from the first year to the third year in IM residency training programs [13]. Previous ITE scores are strongly associated with subsequent ITE than USMLE scores [10]. ITE scores are useful for residency programs to recognize residents needing assistance or interventions from the program to increase their chances to pass the ABIM-CE. Since the third year-ITE is the exam closest to the ABIM-CE, the results of the third year ITE can be used to gauge the readiness of a resident to take ABIM-CE. In our study, third year-ITE percent had a positive correlation with ABIM-CE passing chance, the correlation was even better than USMLE scores. Similarly, a previous study by Kay et al. had found a modest correlation between ITE and ABIM-CE scores [13]. Also, reports suggest that residents scoring in the bottom quartile on their ITE were at increased risk of failing boards while those scoring in the top quartile of the ITE had a 100% pass rate [13]. In the past, a few other studies examined the association between ABIM-CE results and ITE scores with similar results [10, 21,22,23]. Babott et al. reported that second-year ITE scores of more than 61% predicted a 100% pass rate in ABIM-CE with 41% sensitivity and 100% specificity [7]. Brateanu and colleagues developed a nomogram to predict the ABIM-CE performance, which included the ITE scores of each year and the number of overnight calls in the last 6 months of residency [15], and their analysis reported that the third year-ITE was the most important predictor of chances to pass ABIM-CE. Univariate analysis showed a good correlation of USMLE results with ABIM-CE; however, multivariate regression did not show a statistically significant correlation between USMLE and ABIM-CE results.

The predictive value of ITE scores with the performance in certifying exams has been reported in other specialties as well [19, 24,25,26]. A study in Emergency Medicine showed that third year-ITE scores were most predictive of the score in the certification exam [25]. Similarly, a low score in ITE at any time during residency increased the chances of failing a certification exam in surgery [19].

Passing in ABIM-CE is of utmost importance to residents [27], and their residency training programs as well. ACGME requires a first-attempt examinee pass rate of at least 80% for continued accreditation of a residency program. Hence, residency programs put a great deal of effort to choose residents with strong clinical skills and ones likely to perform well in ABIM-CE. Residency programs hold practice exams, teaching sessions, recommend mandatory usage of Question banks, and encourage enrollment in Board Review Courses to enhance the ABIM-CE passing rates.

A majority of the IMGs, unlike AMGs, tend to complete their USMLE Step exams after completion of their medical school curriculum. During their preparation for USMLE exams, IMGs pursue observerships to familiarize themselves with the United States medical system and to improve their clinical skills. Several candidates interested in pursuing an academic career spend time doing research, and a few enroll in  master’s programs after completion of medical school and prior to applying for residency. Thus, IMG applicants  generally have a gap of 1 to 3 years between the completion of medical school and beginning residency. Brateanu et al. reported a weak positive correlation between the length of the gap and the performance in ABIM-CE [16]. Another study on IMGs by Kanna and colleagues showed that the gap between medical school and residency was not significant in predicting ITE scores [28]. Similarly, our study did not show any association of 1-year gap between medical school and starting residency with the chances of passing ABIM-CE . Also, gender differences and place of medical school (AMG vs. IMG) were not associated with ABIM-CE results.

Our study has a few limitations. First, this is a single-center study performed using data from previous residents at a small training program. Second, there is no tool to calculate the equivalence of COMLEX to USMLE, so we did not include osteopathic residents in our analysis and we could not compare ABIM-CE results of osteopathic residents with allopathic residents. Third, there is minimal variation in the ABIM-CE pass rates over the last few years since nearly all of the candidates in our sample passed ABIM-CE. Finally, starting from January 1, 2022, USMLE plans to report USMLE Step 1 as pass or fail instead of the current three digit scoring. After the implementation of the pass or fail to report USMLE Step 1 results, we need to determine if USMLE Step 1 results or the number of attempts to pass the exam has any effect on the results of ABIM-CE. 

We need to consider the predictive ability of USMLE Step 1, USMLE Step 2CK and 3rd year ITE scores in identifying residents at risk for failing ABIM-CE to implement early interventions or remediations plans to enhance their chances of passing ABIM-CE. Some of the remediation plans include enrolling in board review courses, attending conferences, or self-study courses, however, their efficacy in helping residents pass the ABIM-CE is unclear [29]. Although there are reports of improved ABIM-CE results with a directed reading program and individual education plan, although literature regarding the efficacy of these strategies is limited [30, 31]. At our program, we identified residents with scores < 35 percentile in the PGY3 ITE exam, and encouraged them to enroll in board review courses or use one of the available Question bank's which yielded a 100% ABIM-CE pass rate over the past few couple of years. Few residents reported that joining group discussions or studying with a partner was beneficial in addition to enrolling in board review courses or using Question banks. Furthermore, several other unexplained factors may determine whether a resident passes or fails the ABIM-CE.

Conclusion

The third-year ITE score is more predictive of ABIM-CE results compared to USMLE Step 1 and USMLE Step 2CK scores. Both USMLE Step 1 and Step 2 CK scores > 220 are independent predictors of success in passing ABIM-CE as well, but USMLE Step 1 score is more predictive compared to USMLE Step 2CK score. Thus, programs can identify internal medicine residents at risk of failing ABIM-CE and implement measures, such as enrolling them in question banks or board review courses to improve their chances of passing ABIM-CE.

Availability of data and materials

We have provided the raw data as a supplemental file.

Abbreviations

American Board of Internal Medicine

American Board of Internal Medicine Certifying Exam

The Comprehensive Osteopathic Medical Licensing Examination

Internal Medicine

In training exams

Receiver-operating characteristic

United States Medical Licensing Examination

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Acknowledgments

Not applicable.

Funding

We did not receive any research funding for this project.

Author information

Affiliations

  1. Department of Medicine, Michigan State University, 788 Service Road, Room B301 Clinical Center, East Lansing, MI, 48824, USA

    Supratik Rayamajhi, Ling Wang, Manoj P. Rai & Shiva Shrotriya

  2. Division of Oncology and Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Prajwal Dhakal

  3. Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA

    Prajwal Dhakal

Contributions

SR and PD were involved in the conception and design of the study; intellectual content, literature search, data acquisition. LW performed data analysis and statistical analysis. SR and PD prepared the first draft of the manuscript. SS and MPR contributed to the literature search, manuscript editing, and review. MPR, SR, and LW performed a revision of the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Manoj P. Rai.

Ethics declarations

Ethics approval and consent to participate

We received an exemption from the approval of Michigan State University Human Research Protection Program – MSU institutional board review (IRB# × 16-029e). We obtained consent from all participants, and the ethics committee approved this procedure.

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Not applicable.

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The authors declare that they have no competing interests.

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Rayamajhi, S., Dhakal, P., Wang, L. et al. Do USMLE steps, and ITE score predict the American Board of Internal Medicine Certifying Exam results?. BMC Med Educ20, 79 (2020). https://doi.org/10.1186/s12909-020-1974-3

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Keywords

  • USMLE Step 1, USMLE Step 2CK, USMLE Step 3, 3rd year in-training exam results
  • American board of internal medicine certifying exam (ABIM-CE)
Sours: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-020-1974-3

Performance Data

USMLE Administration, Minimum Passing Scores, and Performance

Continuous test administration of the USMLE is available to all examinees. For Step 1, Step 2 Clinical Knowledge (CK), and Step 3, which are the computer-based testing (CBT) components of the USMLE program, test scheduling and delivery are provided by Prometric. These CBT examinations are currently administered at more than 345 US/Canadian Prometric test centers and approximately 110 international Prometric test centers. Additional test centers are located at six medical schools in the United States. The Step 1 and Step 2 CK examinations are administered worldwide; the Step 3 examination is administered only in the United States.

For each of the Step examinations, once the registration process is completed, applicants make their own appointment to take the examination at a location and time most convenient to their schedule. Examination results are processed continuously, and scores are reported weekly. Most examinees taking the computer-based Step examinations receive their scores approximately three to four weeks after their test date. Individual score reports are made available to examinees via a secure website.

A pass or fail result is provided, as a USMLE recommendation, for each examinee. Passing results are based on achievement of specified levels of proficiency established prior to administration of examinations. Statistical procedures are employed to insure that for each Step, the level of proficiency required to pass remains uniform across forms of the examination. As noted in the USMLE Bulletin of Information, the score required to meet the recommended level of proficiency is reviewed periodically and may be adjusted without prior notice. Notice of adjustments is posted in the USMLE Announcements. The USMLE Score Interpretation Guidelines provides score interpretation information for Step 1, Step CK and Step 3 examinations.

Step 1

Step 1 Administrations

Examinees from US/Canadian Schools 2017 Number Tested2017 Percent Passing2018* Number Tested2018* Percent Passing
MD Degree 21,382 94% 21,611 95%
1st Takers20,35396%20,67096%
Repeaters**1,02967%94167%
DO Degree 3,835 95% 4,136 96%
1st Takers3,78695%4,09296%
Repeaters**4976%4473%
Total 25,217 94% 25,747 94%

* Represents data for examinees tested in 2018 and reported through January 30, 2019.
** 'Repeaters' represents examinations given, not number of examinees.

Examinees from Non-US/Canadian Schools 2017 Number Tested2017 Percent Passing2018* Number Tested2018* Percent Passing
1st Takers14,90078%14,33280%
Repeaters**2,30341%2,11144%
Total 17,203 73% 16,443 75%

* Represents data for examinees tested in 2018 and reported through January 30, 2019.
** 'Repeaters' represents examinations given, not number of examinees.

Step 2 CK

Step 2 CK Administrations

Examinees from US/Canadian Schools2016-2017 Number Tested2016-2017 Percent Passing2017-2018* Number Tested2017-2018* Percent Passing
MD Degree 21,071 95% 22,367 96%
1st Takers20,14096%21,53197%
Repeaters**93166%83666%
DO Degree 2,581 94% 3,076 94%
1st Takers2,54795%3,03895%
Repeaters**3468%3874%
Total 23,652 95% 25,443 96%

* Data for Step 2 CK are provided for examinees tested during the period of July 1 to June 30.
** 'Repeaters' represents examinations given, not number of examinees.

Examinees from US/Canadian Schools2016-2017 Number Tested2016-2017 Percent Passing2017-2018* Number Tested2017-2018* Percent Passing
1st Takers11,94981%11,46983%
Repeaters**2,34250%2,14452%
Total 14,291 76% 13,613 78%

* Data for Step 2 CK are provided for examinees tested during the period of July 1 to June 30.
** 'Repeaters' represents examinations given, not number of examinees.

Step 2 CS

Step 2 CS Administrations

Examinees from US/Canadian Schools2016-2017 Number Tested2016-2017 Percent Passing2017-2018* Number Tested2017-2018* Percent Passing
MD Degree 21,064 96% 21,543 94%
1st Takers20,28596%20,43895%
Repeaters**77990%1,10587%
DO Degree 46 96% 64 86%
1st Takers4596%5985%
Repeaters**15100
Total 21,110 96% 21,607 94%

* Data for Step CS are provided for examinees tested during the period of July 1 through June 30.
** 'Repeaters' represents examinations given, not number of examinees.
† Performance data not reported for categories containing fewer than 5 examinees.

Examinees from US/Canadian Schools2016-2017 Number Tested2016-2017 Percent Passing2017-2018* Number Tested2017-2018* Percent Passing
1st Takers11,79082%11,22375%
Repeaters**1,96872%2,11461%
Total 13,758 81% 13,337 73%

* Data for Step CS are provided for examinees tested during the period of July 1 through June 30.
** 'Repeaters' represents examinations given, not number of examinees.
† Performance data not reported for categories containing fewer than 5 examinees.

Step 2 CS Administrations 2017 - 2018 First Taker Passing Rates* for Subcomponents: Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS), Spoken English Proficiency (SEP)

Breakdown2016-2017 ICE2016-2017 CIS2016-2017 SEP2017-2018 ICE2017-2018 CIS2017-2018 SEP
All US/Canadian Schools97%99%>99%**96%98%>99%**
All Non-US/Canadian Schools85%95%99%81%94%93%

* Data for Step 2 CS are provided for examinees tested during the period of July 1 to June 30.
** >99% is used to signify those passing rates that would otherwise round up to 100%.

Step 3

Step 3 Administrations

Examinees from US/Canadian Schools2017 Number Tested2017 Percent Passing2018* Number Tested2018* Percent Passing
MD Degree 20,094 97% 20,595 97%
1st Takers19,40598%19,94898%
Repeaters**68973%64773%
DO Degree 13 100% 23 96%
1st Takers13100%2396%
Repeaters**0N/A0N/A
Total 20,107 97% 20,618 97%

* Represents data for examinees who tested in 2018 and reported through January 30, 2019.
** 'Repeaters' represents examinations given, not number of examinees.
† Performance data not reported for categories containing fewer than 5 examinees.
N/A - not applicable.

Examinees from US/Canadian Schools2017 Number Tested2017 Percent Passing2018* Number Tested2018* Percent Passing
1st Takers8,22688%8,91390%
Repeaters**1,43960%1,41959%
Total 9,665 84% 10,332 86%

* Represents data for examinees who tested in 2018 and reported through January 30, 2019.
** 'Repeaters' represents examinations given, not number of examinees.
† Performance data not reported for categories containing fewer than 5 examinees.
N/A - not applicable.

Sours: https://www.usmle.org/performance-data
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I started studying for Step 1 on April 1st 2020 (during obligated quarantine). One reminder: med students are excellent test-takers. As you can see, many of these average scores are well above the mean USMLE Step 1 score of 237.27(standard deviation: 8) for US allopathic seniors in 2020. Pass your USMLE Step 2 CS on the first attempt to show you have not decreased in ability; Consider taking your USMLE Step 3; If you believe there were extenuating circumstances that caused you Step 2 CK score to be impacted, you can potentially, briefly explain the situation in your Personal Statement Posted by 4 days ago. UW. Thank you for the efforts you are making.” ... ®2020 CCSCases is a … The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®) have announced several … While the USMLE program does not disclose how the three-digit score is calculated, Step 1 scores theoretically range from 1 to 300, most examinees score in the range of 140 to 260, the passing score is 194 and the national mean and standard deviation are approximately 229 and 20, respectively. Once the test concludes, exam data will be sent to the NBME. This is why the NBME should be more transparent about the way that 3 digit scores … Again, your CCScases software was instrumental in helping instill in me the confidence I needed to feel prepared. The NBME will declare USMLE Step 3 results and issue score cards. Step 1 Score (2) Studying (7) Testing (12) Uncategorized (2) USMLE Board Preparation (11) USMLE News (1) Recent Posts. Specific information on USMLE Step 1 and the current minimum passing score is available on the USMLE web site at www.usmle.org. Search. Average Step 1 Scores by Specialty for the 2018 Match. 0 comments. The USMLE does not publish percentile rankings with individual scores and only provides this kind of … Oct 6, 2020. deleted699098. Although it is not the best score out there, I am seriously proud of it and I hope that whoever is still studying for Step 1 can benefit from this. The average score in 2018 was 230 with a standard deviation of 19. Search engine: XenForo Search; Threadloom Search ... Will a high step 3 score help with getting a residency. Though Step 3 is the least “high-stakes” exam of the 3, it at least deserves a portion of the same preparation and work. ... Because students put so much emphasis on getting a high USMLE Step 1 score… In response to public outcry, in February 2020, the USMLE program announced a plan to change Step 1 score reporting to a pass/fail system in an effort "to reduce overemphasis on Step 1 performance while allowing licensing authorities to continue the original intention to use the test to determine medical license eligibility. " DANBY. However, in some cases there may be a delay, which is why candidates are suggested to wait for at least eight weeks to receive their score report notification. ... Oct 3, 2020; Replies 3 Views 763. Element 10.4: GME Placement Rates Today I received my step 1 score: 248 (predicted at 246 +/-10). Step 5: Pass your first exam. The other reason is that, much like Step 2 differs from Step 1 (with both CS and CK), Step 3 has some new components that will be less familiar . Despite the reputation of the USMLE Step 1 as one of the world’s most difficult exams, US and Canadian candidates secured a 94% pass rate in 2018. Make a plan. 11 comments. 1200100727 2/3/2020 Number of Exams for First Time Takers Family Medicine Graduation Year Residents Who Completed Training Taken Passed Failed Take % Pass % Program Average National Average 2015 1 1 1 0 100.00% 100.00% N/C 503 2016 3 3 1 2 100.00% 33.33% 410 528 2017 4 4 3 1 100.00% 75.00% 433 542 2018 6 6 6 0 100.00% 100.00% 555 544 It felt easier than the assessment, and I took the assessment 3 weeks prior my test, so I really don't know how much I could have improved, I hope a lot. M-STEP: What can students expect? In February 2020, the United States Medical Licensing Exam (USMLE) announced that Step 1 is going to change over from a numerical score to a pass/fail designation. A 5 % increase in ITE percentage raised the likelihood of passing ABIM-CE (OR 2.92, 95% CI 1.15-7.38). The COM must publish to the public the COMLEX-USA Level 1, Level 2 CE, Level 2 PE, and Level 3 first time pass rate for all students in each class at the COM. USMLE Scores 2020 - For Step 1, Step 2CK and Step 3, the USMLE 2020 scores are released within three to four weeks of the test date. Step 3 Score Delay. Step 1 is the first of a three-part series from the USMLE and is given during the second year of medical school. Just wondering if first aid is good for step 3 as well. DANBY; Nov 26, 2020; Replies 4 Views 786. For example, the average MCAT score is roughly 500, with a standard deviation of 10.5. 0. Video . No More Numerical Scores for USMLE Step 1 Exam — New pass/fail policy aims to reduce overemphasis on test performance by Judy George, Senior Staff Writer, MedPage Today February 14, 2020 This is a pretty major change in the world of medical education, and one that has a lot of people scratching their heads if not down-right panicking. Which NBME Practice Exam Forms Should You Take for Your USMLE Step 1, Step 2, Step 3 and Clerkship Updated; Minimum Passing Score Raised for the USMLE Step 1 Examination; Step 1/Level 1 Study Tips for Your Learning Style If you purchase before 3PM Central, your Study Guide can arrive in as little as 3 business days (depending on the shipping method that you choose at checkout). Click on the article to learn more about the endeavors and accomplishments of the 2016, 2017, 2018, and 2019 SCORE Program and participants. A familiarity with the interface is crucial to help you improve your score on … While scoring high on Step 1 can help ensure you match into your desired residency later on, there are many other factors that will also contribute to getting there. D. A. Score Rechecks. 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Sours: https://eproceeding.undiksha.ac.id/cache/certificat-de-tacxwqi/step-3-passing-score-2020-483d40
USMLE Step 3 Reaction [How Hard Was It]

USMLE Step 3

Step 3 is the final exam in the USMLE series of examinations. It is part of the licensing requirements for Doctors of Medicine (M.D.), including international medical graduates aiming to practice medicine in the United States. Generally, it is a pre-requisite of the majority of the state licensing boards.

Most of the USMLE Step 3 exam (75 percent) consists of multiple choice questions, while the remaining 25 percent are clinical case simulations. A full description of the content of the exam can be found on the USMLE website.[1] USMLE Step 3 exams are delivered online but administered only at Prometric testing centers, which emphasize identity verification and security. Examinees must provide official photo identification and fingerprints as well as pass both metal detector and physical inspection every time they wish to enter the examination room. Materials allowed within the exam room are extremely limited and most require prior approval, including medical equipment. Examinees are on video surveillance during the examination. The test is available throughout the year to the examinees.

Since 2014 USMLE Step 3 can be taken on two non-consecutive days, instead of two consecutive days.[2]

Examination content[edit]

USMLE Step 3 examination tests on general topics that are required to understand and practice concepts of general medicine/ family medicine.

The following components are tested:

Normal conditions and disease categories (normal growth and development, basic concepts, and general principles)

Clinical encounter frame (initial work up, continuing care, urgent intervention)

Physician task (applying scientific concepts, formulating a diagnosis based on history, physical exam, and lab findings, and managing the patient).

Clinical encounter frames are common clinical scenarios physicians may encounter. They range from nonemergency problems, to the continuity of care, to life-threatening emergency situations encountered in emergency departments, clinics, offices, care facilities, inpatient settings, and on the telephone. Each test item, in an encounter frame, represents one of the six physician tasks. For example, initial care encounters emphasize taking a history and performing a physical examination. In contrast, continued care encounters emphasize decisions regarding prognosis and management.

Day 1 (Foundations of Independent Practice [FIP]) will continue to be divided into six 60-minute blocks. Each FIP block will have 38 to 40 multiple-choice questions (MCQs). The total number of MCQs on the FIP portion of the examination will be 233. The total testing day will be approximately 7 hours.

Day 2 (Advanced Clinical Medicine [ACM]) will continue to be divided into six 45-minute blocks of MCQs, and 13 computer-based case simulations (CCS). Each ACM MCQ block will have 30 items. The total number of MCQ items on the ACM portion of the examination will be 180. The second half of day 2 will contain the 13 CCS cases. [3]

Eligibility for USMLE Step 3[edit]

To be eligible to take the USMLE Step 3 exam, the physician must hold a medical degree, and pass the USMLE Step 1 and Step 2 Clinical Knowledge exams. International medical graduates (IMGs) must obtain certification by the Educational Commission for Foreign Medical Graduates (ECFMG). (Prior to December 2009, one could alternatively complete a "Fifth Pathway" program.) Certification in 2020 required the Occupational English Test instead of the Clinical Skills (CS)[4] The Step 2 CS may also be required. Canadian M.D. graduates are not considered IMGs.

Starting November 2014, fulfillment of specific requirements from individual medical licensing authorities will not be needed.[5]

Preparation strategies for USMLE Step 3[edit]

Typically, worldwide examinees require two to three months[citation needed] to prepare for this exam, although in the US, examinees who are American medical school graduates commonly prepare for only a few days to a few weeks.[citation needed] Physicians in post-graduate training that plan for fellowships or additional training often are advised to consider more detailed preparation.[citation needed] An examinee is tested on clinical skills, diagnostic acumen, decision making, treatment guidelines and follow up care. Most recently, some changes have been made to USMLE Step 3 multiple choice questions including increased emphasis placed on biostatistics, epidemiology, and population health, literature interpretation, medical ethics, and patient safety.[citation needed]

Since the USMLE Step 3 exam is typically taken after matching into a residency, it does not require a physician to obtain a competitive score and only need to pass to obtain their medical license. However, a competitive score may be needed if they want to apply for a fellowship.

Scoring[edit]

Beginning January 1, 2020 the recommended Step 3 minimum passing score was raised from 196 to 198.[6]

Pass rates[edit]

First-time USMLE pass rates for D.O. and M.D. students in 2020 were 91 percent and 98 percent, respectively.[7] The first-time pass rate for students from schools outside of the United States and Canada was 90 percent.[7] Trainees in fields which encompass multiple specialties, such as emergency medicine or internal medicine, tend to perform well on Step 3 regardless of when they take the exam; trainees in other fields tend to do better if they take the exam shortly after medical school.[8]

References[edit]

  1. ^"USMLE® : Test Content & Practice Materials". Retrieved 21 January 2011.
  2. ^"USMLE New Changes 2014: Step 3 Going To Be Divided Into Two Parts". Medicalopedia. 2012-04-12. Retrieved 19 November 2012.
  3. ^[1] from usmle.org, January 2016
  4. ^https://www.ecfmg.org/2017ib/fifth-pathway.html
  5. ^Changes to USMLE 2014 – 2015 from usmle.org, November 2013
  6. ^"United States Medical Licensing Examination | Announcements". www.usmle.org. Retrieved 16 December 2019.
  7. ^ ab"2020 Performance Data". USMLE. Retrieved 9 May 2021.
  8. ^Sawhill AJ, Dillon GF, Ripkey DR, Hawkins RE, Swanson DB. The Impact of Postgraduate Training and Timing on USMLE Step 3 Performance. Academic Medicine, 78 (10), October Supplement 2003, S10-S12.
Sours: https://en.wikipedia.org/wiki/USMLE_Step_3

3 score 2017 passing step

It turns out that my dad is a good specialist in this matter. Probably, he often licks his mother, the experience is obvious: he does everything confidently and very skillfully. The tension disappeared, and I relaxed: instead of stiffness, a feeling of pleasant languor appeared, calling me to fly away somewhere.

either into the sky, or somewhere else.

Step 3 TEST DAY(s) - Ep. 18

Radom is a path. Male voices. Young and old, five men are staring at me. Im a skier, this is the name of this game, when two hefty men lie next to you, and you jerk them with both hands at once, my.

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Normal. Sergei did not answer immediately, staring at the table. Very strange, to say the least. - he began quietly. At first I was worried, and then I became the same as before.



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