Investigating Critical Disparities in USMLE Step 1 Resources: Myocardial Infarction Symptoms in Women

Area of Science:

• Medical Education
• Cardiology
• Health Disparities

Background:

• Coronary heart disease (CHD) is a leading cause of death in the United States.
• Myocardial infarction (MI) is a critical complication of CHD, with women experiencing unique symptoms and higher mortality risk.
• Underdiagnosis of MI in women is a significant concern due to atypical symptom presentation and potential gaps in medical training.

Purpose of the Study:

• To assess whether current USMLE Step 1 preparation materials adequately address the biologic sex differences in myocardial infarction (MI) presentation.
• To identify gaps in medical education regarding the recognition of MI symptoms specific to women.

Main Methods:

• A cross-sectional analysis was performed on November 13, 2023.
• Key USMLE Step 1 resources, including 'First Aid for the USMLE Step 1 2023,' were evaluated.
• Searches for terms related to women and MI were conducted to identify content on sex-specific symptom differences.

Main Results:

• None of the assessed resources, including 'First Aid for the USMLE Step 1 2023,' UWorld Question Bank, and National Board of Medical Examiners Practice Exams, included information on biologic sex-specific MI symptoms.
• A significant gap exists in educational materials concerning the unique ways MI manifests in women.

Conclusions:

• Current USMLE Step 1 resources fail to educate future physicians on recognizing MI in women, potentially impacting clinical practice.
• Medical curricula and licensing examinations must incorporate education on sex-specific MI symptoms to improve diagnosis and patient outcomes.
• Addressing this educational deficit is crucial for enhancing the quality of care and reducing mortality for women with CHD.