J Grad Med Educ. 2020 Aug;12(4):441-446. doi: 10.4300/JGME-D-19-00782.1.
The US Medical Licensing Examination (USMLE) Step 1 and Step 2 scores are often used to inform a variety of secondary medical career decisions, such as residency selection, despite the lack of validity evidence supporting their use in these contexts.
We compared USMLE scores between non-chief residents (non-CRs) and chief residents (CRs), selected based on performance during training, at a US academic medical center that sponsors a variety of graduate medical education programs.
This was a retrospective cohort study of residents' USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores from 2015 to 2020. The authors used archived data to compare USMLE Step 1 and Step 2 CK scores between non-CR residents in each of the eligible programs and their CRs during the 6-year study period.
Thirteen programs enrolled a total of 1334 non-CRs and 211 CRs over the study period. There were no significant differences overall between non-CRs and CRs average USMLE Step 1 (239.81 ± 14.35 versus 240.86 ± 14.31; = .32) or Step 2 scores (251.06 ± 13.80 versus 252.51 ± 14.21; = .16).
There was no link between USMLE Step 1 and Step 2 CK scores and CR selection across multiple clinical specialties over a 6-year period. Reliance on USMLE Step 1 and 2 scores to predict success in residency as measured by CR selection is not recommended.
美国医师执照考试（USMLE）的第 1 步和第 2 步成绩通常被用于告知各种二级医疗职业决策，例如住院医师的选择，尽管缺乏支持在这些情况下使用这些成绩的有效性证据。
我们比较了美国学术医疗中心的不同培训表现的非首席住院医师（非 CR）和首席住院医师（CR）的 USMLE 第 1 步和第 2 步临床知识（CK）成绩，该医疗中心提供多种研究生医学教育项目。
这是一项回顾性队列研究，涉及 2015 年至 2020 年期间参加 USMLE 第 1 步和第 2 步 CK 考试的住院医师的数据。作者使用存档数据比较了合格项目中每个非 CR 住院医师和他们在 6 年研究期间的 CR 的 USMLE 第 1 步和第 2 步 CK 成绩。
13 个项目在研究期间共招收了 1334 名非 CR 和 211 名 CR。总体而言，非 CR 和 CR 的平均 USMLE 第 1 步（239.81 ± 14.35 与 240.86 ± 14.31； =.32）或第 2 步成绩（251.06 ± 13.80 与 252.51 ± 14.21； =.16）之间没有显著差异。
在 6 年期间的多个临床专业中，USMLE 第 1 步和第 2 步 CK 成绩与 CR 选择之间没有联系。不建议依赖 USMLE 第 1 步和第 2 步成绩来预测以 CR 选择为衡量标准的住院医师培训中的成功。
