title: Impact of the foundations of clinical medicine course on USMLE scores.
abstract: BACKGROUND
  The synthesis of basic and clinical science knowledge during the clerkship years has failed to meet educational expectations.
  
  
  OBJECTIVE
  We hypothesized that a small-group course emphasizing the basic science underpinnings of disease, Foundations of Clinical Medicine (FCM), could be integrated into third year clerkships and would not negatively impact the United States Medical Licensure Examination (USMLE) step 2 scores.
  
  
  METHODS
  In 2001-2002, all third year students met weekly in groups of 8-12 clustered within clerkships to discuss the clinical and basic science aspects of prescribed, discipline-specific cases.
  
  
  METHODS
  Students completing USMLE step 2 between 1999 and 2004 (n = 743).
  
  
  METHODS
  Course evaluations were compared with the overall institutional average. Bivariate analyses compared the mean USMLE steps 1 and 2 scores across pre- and post-FCM student cohorts. We used multiple linear regression to assess the association between USMLE step 2 scores and FCM cohort controlling for potential confounders.
  
  
  RESULTS
  Students' average course evaluation score rose from 66 to 77 (2001-2004) compared to an institutional average of 73. The unadjusted mean USMLE step 1 score was higher for the post-FCM cohort (212.9 vs 207.5, respectively, p < .001) and associated with step 2 scores (estimated coefficient = 0.70, p < .001). Post-FCM cohort (2002-2004; n = 361) mean step 2 scores topped pre-FCM (1999-2001; n = 382) scores (215.9 vs 207.7, respectively, p < .001). FCM cohort remained a significant predictor of higher step 2 scores after adjustment for USMLE step 1 and demographic characteristics (estimated coefficient = 4.3, p = .002).
  
  
  CONCLUSIONS
  A curriculum integrating clinical and basic sciences during third year clerkships is feasible and associated with improvement in standardized testing.
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA. brownfe@musc.edu
authors.forename: Elisha L
authors.initials: EL
authors.lastname: Brownfield
authors.forename: Amy V
authors.initials: AV
authors.lastname: Blue
authors.forename: Caroline K
authors.initials: CK
authors.lastname: Powell
authors.forename: Mark E
authors.initials: ME
authors.lastname: Geesey
authors.forename: William P
authors.initials: WP
authors.lastname: Moran
mesh_terms: D000328:Adult; D002982:Clinical Clerkship; D015510:Clinical Medicine / Q000193:education*; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008007:Licensure, Medical; D008297:Male; D012586:Science / Q000193:education*