title: A national cohort study of U.S. medical school students who initially failed Step 1 of the United States Medical Licensing Examination.
abstract: OBJECTIVE
  To describe educational outcomes for a national cohort of U.S. medical students who initially failed Step 1 of the United States Medical Licensing Examination.
  
  
  METHODS
  The authors analyzed deidentified, individualized records for the 1993-2000 cohort of U.S. medical school matriculants who both initially failed Step l and were no longer in medical school as of March 2, 2009, using multivariable logistic regression to identify factors associated with attempting, and initially passing, Step 2 Clinical Knowledge (CK).
  
  
  RESULTS
  Of 6,594 students who failed Step l, 5,985 (90.8%) took Step 2CK. Women and Asian/Pacific Islander students were more likely to attempt Step 2CK; more recent matriculants and students with lower failing Step 1 scores were less likely. Of the 5,985 students who attempted Step 2CK, 4,168 (69.6%) initially passed. Women, students with higher Medical College Admission Test scores, and more recent matriculants were more likely to pass Step 2CK; Asian/Pacific Islander students, underrepresented minority students, older students, and students with lower failing Step 1 scores were less likely. Ninety percent of students in the study sample (5,952/6,594) ultimately graduated from medical school, including 99.5% (4,148/4,168) of those who initially passed, 96.7% (1,757/1,817) of those who initially failed, and 7.7% (47/609) of those who never attempted Step 2CK.
  
  
  CONCLUSIONS
  The authors identified variables associated with educational outcomes among students who failed Step l. These findings can inform medical schools' efforts to develop tailored interventions to maximize the likelihood that students will take Step 2CK and pass on the first attempt.
authors.affiliation: Washington University School of Medicine, Saint Louis, Missouri 63110, USA. andrioled@wustl.edu
authors.forename: Dorothy A
authors.initials: DA
authors.lastname: Andriole
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
mesh_terms: D000328:Adult; D044466:Asian People; D015331:Cohort Studies; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008007:Licensure, Medical / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D044468:Native Hawaiian or Pacific Islander; D012189:Retrospective Studies; D012737:Sex Factors; D013337:Students, Medical / Q000706:statistics & numerical data*; D014481:United States