The Association Between USMLE Step 2 Clinical Knowledge Scores and Residency Performance: A Systematic Review and...

Area of Science:

• Medical Education Research
• Graduate Medical Training Assessment
• Standardized Testing in Medicine

Background:

• The shift in USMLE Step 1 score reporting necessitates a re-evaluation of resident selection criteria.
• USMLE Step 2 Clinical Knowledge (CK) scores may emerge as a critical metric for evaluating prospective medical residents.
• This review synthesizes evidence on the predictive validity of Step 2 CK scores for resident performance.

Approach:

• A systematic review and meta-analysis of observational studies was conducted.
• Searched MEDLINE, Web of Science, and Scopus databases for studies published in 2021.
• Included studies examining the association between Step 2 CK scores and in-training exams, board certification, core competencies, and subjective performance evaluations.

Key Points:

• A moderate positive correlation (0.52) was found between Step 2 CK scores and in-training examination (ITE) scores.
• This correlation was consistent across both surgical (0.41) and nonsurgical (0.59) specialties.
• A weak positive correlation (0.19) was observed between Step 2 CK scores and subjective resident performance measures.

Conclusions:

• USMLE Step 2 CK scores demonstrate a statistically significant moderate positive association with future examination performance.
• A statistically significant weak positive correlation exists between Step 2 CK scores and subjective resident performance assessments.
• These findings underscore the growing importance of Step 2 CK in the context of medical residency selection.