Are USMLE Scores Valid Measures for Chief Resident Selection?

Area of Science:

• Medical Education
• Graduate Medical Education
• Physician Training

Background:

• The United States Medical Licensing Examination (USMLE) Steps 1 and 2 scores are frequently utilized for critical medical career decisions, including residency placement.
• However, the validity of these scores for predicting future performance, such as selection for chief residency, remains inadequately supported by evidence.

Purpose of the Study:

• To investigate the relationship between USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores and the selection of chief residents (CRs) versus non-chief residents (non-CRs).
• To assess the predictive validity of USMLE scores for leadership roles within residency programs.

Main Methods:

• A retrospective cohort study analyzed USMLE Step 1 and Step 2 CK scores from 2015 to 2020.
• Data from 13 programs at a US academic medical center compared scores of 1334 non-CRs with 211 CRs.

Main Results:

• No statistically significant differences were observed in average USMLE Step 1 scores between non-CRs (239.81 ± 14.35) and CRs (240.86 ± 14.31; P = .32).
• Similarly, no significant differences were found in average USMLE Step 2 CK scores between non-CRs (251.06 ± 13.80) and CRs (252.51 ± 14.21; P = .16).

Conclusions:

• USMLE Step 1 and Step 2 CK scores showed no correlation with chief resident selection across various specialties over a six-year period.
• The findings suggest that relying on USMLE scores to identify potential chief residents is not advisable.