Do The Licensing Examinations (USMLE Step 1 and Step 2 Clinical Knowledge) Measure Something Meaningful?

USMLE: Probably, according to this study of more than 160,000 practicing physicians who graduated from US MD-granting schools between 1994 and 2006.  The authors looked for correlations between a physician’s examination scores and their likelihood of receiving disciplinary action from a state medical board.  Overall, only 1.3% of these physicians had received such an action.  For both exams, higher scores were associated with a lower risk of receiving disciplinary action, but once Step 2 scores were included in the model, Step 1 scores had no further contribution to the effect.  The effect was moderate:  a 1 SD increase in Step 2 score (about 23 points) was associated with a 25% lower risk of receiving an action.  It would have been useful to know the reasons for actions taken and whether higher board scores reduced some classes of actions (e.g. clinical incompetence citations) more than others (e.g. professionalism citations). — Laura Willett, MD

Cuddy MM, Young A, Gelman A, Swanson DB, Johnson DA, Dillon GF, Clauser BE. Exploring the Relationships Between USMLE Performance and Disciplinary Action in Practice: A Validity Study of Score Inferences From a Licensure Examination.
Acad Med. 2017

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