A Non-MBA’s Guide to NBME Revenue in 9 Simple Charts

A few weeks ago, I commented on how financial conflict of interest may prevent the NBME from considering a pass/fail USMLE Step 1. Look, I’m on record as supporting a pass/fail Step 1. But even if you don’t, the lack of transparency in the NBME’s defense of maintaining a scored test should bother you a […]

A Two-Step Plan for a Better USMLE Step 1

Lately, I’ve spent quite a bit of time highlighting problems with the USMLE Step 1. Now it’s time to talk solutions. So if you turned the test over to me, here’s what I’m going to do: 1. Make USMLE Step 1 Pass/Fail. The original intent of the USMLE was to provide a binary decision on […]

A peek inside the USMLE sausage factory: setting the Step 1 minimum passing score

Recently, I pointed out USMLE Step 1 score creep – the steady improvement in Step 1 scores over time. My ‘manuscript’ was intended to be tongue-in-cheek. The goal was to propose a conclusion so laughably preposterous that it would make you stop and think, hey, why is it that Step 1 scores should be rising? […]

Raising the bar: encouraging trends in USMLE Step 1 performance, 1997-2017

Introduction The United States Medical Licensing Examination (USMLE) Step 1 is the first test in a four-part examination that serves as a prerequisite for state licensure for all allopathic medical school graduates in the United States. The minimum passing score is set by the USMLE Management Committee, and since the USMLE began in 1992, the […]

USMLE Step 1: the “antidote to implicit bias”?

Recently, I commented on whether USMLE Step 1 scores serve to “level the playing field” for applicants from lower-tier medical schools, as is often claimed. (If you missed that, you can catch up here.) Today, I’d like to consider another claim made by the sponsors of the USMLE – that the objectivity of the Step […]

USMLE Step 1: Leveling the playing field – or perpetuating disadvantage?

Let me show you some data. I’m going to show you the Match rate and mean Step 1 score for three groups of residency applicants. These are real data, compiled from the NRMP’s Charting Outcomes in the Match reports. Ready? U.S. Allopathic Seniors: 92% match rate; Step 1 232.3 U.S. Osteopathic Seniors: 83% match rate; […]

Checking the references: the evidence in support of Step 1

Recently, the presidents/CEOs of the National Board of Medical Examiners and the Federation of State Medical Boards wrote an invited commentary in Academic Medicine. The piece was in response to an article by medical students highlighting the adverse effects of the “Step 1 Climate” in medical education. I have criticized several things about the NBME/FSMB […]