What predicts performance on USMLE? Mostly you, not your medical school
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The Conclusion
This study that approached the question of what predicts USMLE performance from a different angle. They identified medical schools with institutional mean USMLE Step 1 and Step 2 CK scores > 2 standard deviations above or below predicted with the ultimate goal of identifying programs with successful or unsuccessful institutional preparation for USMLE. On an institutional level, the strongest predictor of performancewas also correlated with prior student academic performance based on undergraduate GPA and MCAT score. They identified 5 institutions with above predicted USMLE performance and 3 with below predicted performance, this study did not identify the factors that promoted their students’ success or lack of expected success on these exams. They did not disclose which schools under performed, however, University of Hawaii (Manoa), University of Missouri, and Baylor College of Medicine over performed on USMLE step 1 relative to incoming GPA/MCAT; and Emory University and University of Virginia over performed on USMLE Step 2 CK relative to incoming GPA/MCAT. This study was a small study limited to only 89 allopathic schools that had complete self reported data available from AAMC and US News and World Reports. Overall, institutional average GPA and MCAT scores correlated strongly with institutional USMLE performance.
Why does this matter?
There is already quite a bit of evidence that the best predictor of individual USMLE performance is correlated with individual undergraduate GPA and MCAT scores. The thought is that the test-taking skills you bring with you into medical school determine how you perform on the USMLE. This study sought to determine if there were institutions who performed differently on the institutional level than expected based on their average matriculant GPA and MCAT scores in order to evaluate whether there are interventions on the institutional level that can sway performance. Ultimately, the answer was still the same - if you accept students with high GPA and MCAT you will also have high USMLE scores.
Medical school applicants put a lot of stock on institutional USMLE scores, the amount of time given to study for the exam and the presence of USMLE preparation courses when they assess schools. This study reinforces the fact that the institution itself is not the strongest determinant of USMLE scores - it is ultimately how you yourself have done previously that predicts how you yourself will do on USMLE. Asking about USMLE scores and available prep may be important to you and your study needs but may not be the best marker to asses the overall quality of education at a medical school and might be more reflective of who gets admitted to that school.
