A critical examination of the USMLE II: does a study month improve test performance?

Students often are encouraged to elect a study month prior to taking the USMLE II. OBJECTIVE: To determine if a study month prior to the September USMLE II improves student test performance. METHODS: Student clerkship sequence was prospectively recorded for each senior at a large midwestern medical school during the 1998-99 academic year, and USMLE I and II scores were obtained. USMLE II scores were compared between students who elected a study month prior to the September testing date versus those who elected clerkships, while controlling for USMLE I test scores using multiple linear regression. RESULTS: Complete data were obtained for 167 senior year medical students. 124 (74.3%) students took the September USMLE II after electing a study month, and 43 (25.7%) students took the September USMLE II after electing clerkships. The mean score for those who elected a study month before the USMLE II test was higher than those electing clerkships (210.56 +/- 17.12 vs 208.65 +/- 20.83). However, after controlling for USMLE I scores (r(2) = 0.53; p < 0.01), the election of a study month prior to the September USMLE II was not associated with an increase in student performance (r(2) < 0.01; p = 0.73). CONCLUSIONS: These results do not support study months as a means to improve USMLE II test performance, and suggest that rotations may be equally beneficial.