Gauer Jacqueline L, Jackson J Brooks
a University of Minnesota Medical School , Minneapolis , MN , USA.
b University of Minnesota , Minneapolis , MN , USA.
Med Educ Online. 2017;22(1):1358579. doi: 10.1080/10872981.2017.1358579.
For future physicians, residency programs offer necessary extended training in specific medical specialties. Medical schools benefit from an understanding of factors that lead their students to match into certain residency specialties. One such factor, often used during the residency application process, is scores on the USA Medical Licensing Exam (USMLE).
To determine the relationship between USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores and students' residency specialty match, and the association between both USMLE scores and state of legal residency (Minnesota) at the time of admission with students staying in-state or leaving the state for residency program.
USMLE scores and residency match data were analyzed from five graduating classes of students at the University of Minnesota Medical School (N = 1054).
A MANOVA found significant differences (p < 0.001) between residency specialties and both USMLE Step 1 and Step 2 CK scores, as well as the combination of the two. Students who matched in Dermatology had the highest mean USMLE scores overall, while students who matched in Family Medicine had the lowest mean scores. Students who went out of state for residency had significantly higher Step 1 scores (p = 0.027) than students who stayed in-state for residency, while there was no significant difference between the groups for Step 2 scores. A significant positive association was found between a student who applied as a legal resident of Minnesota and whether the student stayed in Minnesota for their residency program.
Residency specialty match was significantly associated with USMLE Step 1 and USMLE Step 2 CK scores, as was staying in-state or leaving the state for residency. Students who were legal residents of the state at the time of application were more likely to stay in-state for residency, regardless of USMLE score.
CK: Clinical knowledge; COMLEX: Comprehensive Osteopathic Medical Licensing Examination; GME: Graduate medical education; NRMP: National Resident Matching Program; UME: Undergraduate medical education; USMLE: United States Medical Licensing Examination.
对于未来的医生而言，住院医师培训项目提供特定医学专业所需的延长培训。医学院校若能了解促使其学生匹配到某些住院医师专业的因素，则会从中受益。住院医师申请过程中常用的一个因素是美国医师执照考试（USMLE）的成绩。
确定USMLE第一步和第二步临床知识（CK）成绩与学生的住院医师专业匹配之间的关系，以及USMLE两项成绩与入学时合法居住州（明尼苏达州）之间的关联，即学生是留在本州还是前往其他州参加住院医师培训项目。
分析了明尼苏达大学医学院五个毕业班学生的USMLE成绩和住院医师匹配数据（N = 1054）。
一项多变量方差分析发现，不同住院医师专业与USMLE第一步和第二步CK成绩以及两者的综合成绩之间存在显著差异（p < 0.001）。匹配到皮肤科的学生总体USMLE平均成绩最高，而匹配到家庭医学专业的学生平均成绩最低。前往其他州参加住院医师培训的学生第一步成绩（p = 0.027）显著高于留在本州参加培训的学生，而两组第二步成绩之间无显著差异。在以明尼苏达州合法居民身份申请的学生与该学生是否留在明尼苏达州参加住院医师培训项目之间发现了显著的正相关关系。
住院医师专业匹配与USMLE第一步和第二步CK成绩显著相关，与留在本州或前往其他州参加住院医师培训也显著相关。申请时为本州合法居民的学生更有可能留在本州参加住院医师培训，无论其USMLE成绩如何。
CK：临床知识；COMLEX：综合整骨疗法医师执照考试；GME：毕业后医学教育；NRMP：全国住院医师匹配项目；UME：本科医学教育；USMLE：美国医师执照考试
