![]() 6 Furthermore, Step 1 is designed to be more reliable close to the pass/fail cut point and less reliable further from the cut point. ![]() ![]() 5 The standard error of difference for Step 1 is 8 points, meaning 2 scores must differ by at least 16 points for us to be confident they are truly different. But importantly, Step 1 was very specifically not designed to compare residency applicants. If Step 1 does not predict clinical performance, and even middling scores predict high board passage rates, why do PDs value high Step 1 scores? It is a convenient way to compare applicants, Katsufrakis and Chaudhry explain. 4 But students who score near or above the mean have extremely high board passage rates. What does Step 1 predict? Step 1 scores significantly below the mean predict increased likelihood of failing specialty board exams. ![]() 1 However, multiple studies have demonstrated that Step 1 scores are not correlated with clinical skills during residency or program directors’ (PDs’) ratings of residents. Katsufrakis and Chaudhry state that, to their knowledge, no study has ever been done to answer the question of whether the United States Medical Licensing Examination (USMLE) Step 1 scores predict success in residency. ![]()
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