Associations between United States Medical Licensing Examination (USMLE) and Internal Medicine In-Training Examination (IM-ITE) scores.

BACKGROUND

Little is known about the associations of previous standardized examination scores with scores on subsequent standardized examinations used to assess medical knowledge in internal medicine residencies.

OBJECTIVE

To examine associations of previous standardized test scores on subsequent standardized test scores.

DESIGN

Retrospective cohort study.

PARTICIPANTS

One hundred ninety-five internal medicine residents.

METHODS

Bivariate associations of United States Medical Licensing Examination (USMLE) Steps and Internal Medicine In-Training Examination (IM-ITE) scores were determined. Random effects analysis adjusting for repeated administrations of the IM-ITE and other variables known or hypothesized to affect IM-ITE score allowed for discrimination of associations of individual USMLE Step scores on IM-ITE scores.

RESULTS

In bivariate associations, USMLE scores explained 17% to 27% of the variance in IME-ITE scores, and previous IM-ITE scores explained 66% of the variance in subsequent IM-ITE scores. Regression coefficients (95% CI) for adjusted associations of each USMLE Step with IM-ITE scores were USMLE-1 0.19 (0.12, 0.27), USMLE-2 0.23 (0.17, 0.30), and USMLE-3 0.19 (0.09, 0.29).

CONCLUSIONS

No single USMLE Step is more strongly associated with IM-ITE scores than the others. Because previous IM-ITE scores are strongly associated with subsequent IM-ITE scores, appropriate modeling, such as random effects methods, should be used to account for previous IM-ITE administrations in studies for which IM-ITE score is an outcome.