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

Coronary heart disease (CHD) is the leading cause of death in the United States. Myocardial infarction (MI) is a major complication of CHD and often fatal. Women with MI are at risk for underdiagnosis due to unique symptoms such as fatigue, nausea, and shortness of breath. Younger women under 55 have a higher risk of death from MI compared to men. Early recognition of these symptoms is essential but may not be adequately taught in medical education.

We conducted a cross-sectional analysis on November 13, 2023. The study examined the most recommended Step 1 resources listed in First Aid for the USMLE Step 1 2023. We performed a search for terms such as "women," "female," and "myocardial infarction" to identify content on biologic sex differences in MI symptoms.

None of the evaluated resources, including First Aid for the USMLE Step 1 2023, UWorld Question Bank, and National Board of Medical Examiners Practice Exams, discussed biologic sex-specific MI symptoms.

The findings reveal a gap in medical education. USMLE Step 1 resources do not address the unique presentation of MI in women. This oversight may affect students' ability to recognize MI symptoms in clinical practice. Medical curricula and licensing exams should include this topic to better prepare students. Improving education on biologic sex-specific symptoms can lead to better care and outcomes for women with CHD.