The Archives

Checking the references: the evidence in support of Step 1

  • We’re told that Step 1 scores predict measures of physician quality? But do they? Let’s check the references.

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

  • Do students from “lower tier” medical schools benefit from a scored USMLE? Or would they be better off by playing a different game altogether?

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

  • Under-represented minorities in medicine score lower on Step 1. So why do NBME executives think it’s a cure for bias?

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

  • Are rising Step 1 scores just “score creep” – or a sign of improving physician quality?

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

  • How is the standard for Step 1 set? Find out how the sausages get made.

A two-step plan for a better USMLE Step 1

  • If you turned Step 1 over to me, here’s what I’m gonna do.

A non-MBA’s guide to NBME revenue in 9 simple charts

  • The NBME has a financial conflict of interest in maintaining a scored test. Here’s why.

A MCQ exam on the USMLE

  • I’ve studied the business of the NBME. Ready to take the exam?

The new USMLE score report

  • Since January 2019, USMLE score reports have looked different. What changed – and why?

On pi and Step 1 Mania

  • What would happen if we asked medical students to memorize digits of pi?

The intellectual opportunity cost of USMLE Step 1

  • Students spend a lot of time studying for Step 1. What else could we do with that time?

The etiology of application fever

  • Medical students are submitting more residency applications than ever before. Why? Who benefits?

Symbiosis: the USMLE, ERAS, and medical education

  • Step 1 Mania and Application Fever need each other.

The mythology of USMLE Step 1 scores and board certification

  • Do Step 1 scores predict success on the boards? Yes… but maybe not in the way you expect.

The InCUS is coming – are we ready?

  • The Invitational Conference on USMLE Scoring (InCUS) is nigh.

InCUS wrap

  • What happened at InCUS? Who knows. Attendees have been asked to stay silent.

What’s on USMLE Step 1?

  • Physicians who took Step 1 more than 5 years ago honestly have no clue what’s on the exam. Want to remind yourself what’s really tested on Step 1?

Stonewalled: A brief update on InCUS, the NBME, and financial COI

  • I asked the NBME whether attendees received financial compensation. The answer? Silence.

What can the NFL Draft teach us about residency selection?

  • Getting into residency programs is competitive… but nowhere near as competitive as the NFL. What can we learn from the metrics used to select NFL players?

Step 1 Mania: The Case for #USMLEPassFail

  • Links to a video podcast of a Grand Rounds presentation with an overview of the case for a pass/fail USMLE.

Another MCQ Test on the USMLE

  • Most of us probably don’t appropriately interpret USMLE Step 1 scores. Do you?

As more essays are posted, I’ll continue to update this page.