Residency applicants misinterpret their United States Medical Licensing Exam Scores

Proper interpretation of the results of the United States Medical Licensing Exam (USMLE) is important for program directors, residents, and faculty who advise applicants about applying for residency positions. We suspected that applicants often misinterpreted their performance in relationship to others who took the same examination. In 2005, 54 consecutive applicants to the University of Tennessee, College of Medicine internal medicine residency program were asked to complete a brief survey about their performance on Parts 1 and 2 of the USMLE exam. When asked what percentile their Part I score represented, slightly over one in ten were unsure or did not know, and nearly three out of five wrote in their two-digit score. Of the 15 who wrote in another number, only a third were within ten percentile points of their estimated percentile. Similar results were seen for Part II. A higher percentage of international medical graduates (IMGs) than U.S. applicants responded to the percentile question with their two-digit scores (79% vs. 50% p = .08). Applicants to residency programs frequently misinterpret their performance on the USMLE compared to their peers. Unless they are high performers, those who misinterpret their two-digit scores as percentiles markedly overestimate their performance. The sponsors of the USMLE should discontinue reporting the two-digit score and consider re-instating the reporting of percentiles.