The impact of early career specialization on licensing requirements and related educational implications

USMLE Step 2 performance and test administration date in the fourth year of medical school

PURPOSE

To determine whether the time interval between completing the third-year curriculum and test administration affects a student's USMLE Step 2 score.

METHOD

Scores for 846 students in the classes of 2000-2004 were grouped in ten time periods depending on test date. A linear regression model to predict performance on Step 2 using gender, Step 1, and grades in medicine, pediatrics and obstetrics-gynecology was developed based on the class of 1999. Analysis of covariance was used to test the effect of time on scores, adjusting for predicted performance.

RESULTS

Step 2 scores decreased significantly (p <.001) across time. Students' mean scores were four points higher than predicted in the early months and five to eight points lower near the end of the senior year.

CONCLUSIONS

Students who scheduled Step 2 early in the senior year achieved higher scores, on average, than those who waited until later in the year.