Objective predictors of intern performance

Area of Science:

• Medical Education
• Graduate Medical Training
• Physician Performance Evaluation

Background:

• Medical residency programs utilize metrics like USMLE scores, GPA, and class rank for student selection.
• The predictive validity of these metrics for intern performance remains unclear.
• This study aimed to determine if pre-admission metrics correlate with intern success.

Purpose of the Study:

• To test the hypothesis that pre-admission academic and licensing examination metrics predict intern performance.
• To evaluate the association between USMLE scores, GPA, class rank, and intern performance ratings.
• To inform residency selection processes in light of evolving USMLE scoring.

Main Methods:

• Retrospective cohort analysis of 244 interns from four graduating classes (2015-2018).
• Program Director evaluations including global assessments and ACGME competency ratings were analyzed.
• Statistical comparison of USMLE Steps 1 & 2CK scores, GPA, class rank, and competency ratings.

Main Results:

• Higher USMLE Step 1, Step 2CK scores, GPA, and class rank were significantly associated with better intern performance.
• Interns rated as average had lower academic metrics compared to above average or outstanding interns.
• Strong correlations were found between higher ACGME core competency ratings and superior intern performance.

Conclusions:

• Pre-admission metrics including USMLE scores, GPA, and class rank are predictive of intern performance.
• Residency programs can leverage these established metrics for candidate selection.
• Alternative metrics may be considered for intern selection as USMLE Step 1 shifts to a pass/fail format.