Strategies for identifying students at risk for USMLE step 1 failure.
OBJECTIVE
Failing Step 1 of the US Medical Licensing Examination (USMLE) or a delay in taking the exam can negatively affect a medical student's ability to match into a residency program. Unfortunately, identifying students at risk for failing Step 1 is challenging, but it is necessary to provide proactive educational support. The purpose of this study was to develop a strategy to identify students at risk for failing Step 1.


METHODS
Using a retrospective study design, 256 students from the class of 2008 were eligible for the study. Independent variables included Medical College Admission Test (MCAT) scores and cumulative grades from years 1--2 of medical school. The dependent variable was their score on the USMLE Step 1. Variables with a significant univariate relationship were loaded into a series of binary logistic regression models. A receiver operating characteristic (ROC) curve examined the significant variables.


RESULTS
Both year-2 standard score and the MCAT biological sciences score were significant as predictors of failure. The ROC curve provided a range of values for establishing a cutoff value for each significant variable.


CONCLUSIONS
Using internal and external predictors, it is possible to identify students at risk for failing Step 1 of the USMLE.
Faculty of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48201, USA.
Jira
J
Coumarbatch
Leah
L
Robinson
Ronald
R
Thomas
Patrick D
PD
Bridge
D004501:Education, Medical / Q000379:methods* / Q000592:standards; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D005544:Forecasting / Q000379:methods; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D016015:Logistic Models; D012372:ROC Curve; D012073:Remedial Teaching / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D013337:Students, Medical / Q000523:psychology*