Winnie Wu BA*, Katy Garcia MA*, Sheila Chandrahas BS*, Arham Siddiqui MBA*, Regina Baronia MD, Yasin Ibrahim MD
Background: Ninety-four percent of program directors cited the USMLE Step 1 score as the most important factor in determining applicant competitiveness for residency. Thus, medical students are motivated to attain the highest possible scores. Since Step 1 recently switched to a pass/fail standard, it is important to analyze factors that predict meeting this goal.
Objective: To investigate the factors that can influence or predict performance on USMLE Step 1.
Methods: We conducted a systematic literature search on PubMed, Web of Science, Scopus and ERIC in 2019. Key words included “USMLE,” “Step-1,” “score,” “success,” and “predictors.” The search included articles published between 2005 and 2019. Studies that did not focus on Step 1 outcome or allopathic medical students in the United States were excluded.
Results: Two hundred seventy-five articles were found, 29 of which met our inclusion criteria. Analysis of these articles demonstrated that predictors of USMLE Step 1 score can be divided into unmodifiable and modifiable factors. Unmodifiable factors include gender, MCAT score, pre-clinical grades and NBME/CBSE scores. Modifiable factors include taking USMLE Step 1 within two months of completing pre-clinical courses, motivation from anxiety, multiple-choice questions completed, unique Anki cards seen, and complete passes of First Aid for the USMLE Step 1.
Conclusion: Our review suggests that although students can focus on modifiable factors to increase their score, the energy expenditure required to increase the Step 1 score by one point is unrealistic. This may have influenced the NBME’s decision to change Step 1 to a pass/fail exam.
Keywords: USMLE Step 1, performance predictors, medical school, medical student, test preparation, Step 1 modifiable predictors
Article citation: Wu W, Garcia K, Chandrahas S, Siddiqui A, Baronia R, Ibrahim Y. Predictors of Performance on USMLE Step 1. The Southwest Respiratory and Critical Care Chronicles 2021;9(39):63–72
From: The School of Medicine (WW, KG, SC, AS), Department of Psychiatry (RB, YI), Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 2/1/2021
Accepted: 4/3/2021
Reviewer: Kenneth Nugent MD
Conflicts of interest: none
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
* Wu, Garcia, Chandrahas, Siddiqui are co-first authors.