The effect of rescheduling National Board of Medical Examiners subject examinations on United States Medical Licensing Examination Step 2 Clinical Knowledge performance

Abstract

Brian Rutledge, Gerald Clark, Jessica Bailey, Lou A Woodward

Historically, the University of Mississippi School of Medicine administered all National Board of Medical Examiners subject examinations at the end of the third year of the medical curriculum, just before the comprehensive United States Medical Licensing Examination Step 2 Clinical Knowledge examination. Due in part to grading and accreditation concerns, subject examinations were moved in a phased fashion from the end of the year to the end of the clerkship associated with each subject examination; this research aims to determine the effect of this rescheduling. Multiple hierarchical regression was performed on Step 2 Clinical Knowledge examination scores by whether the subject examination was given at end-of-clerkship or end-of-year, while controlling for covariates known to affect examination performance. This analysis found that performance on the Step 2 Clinical Knowledge examination is not significantly affected by the scheduling of subject examinations. The benefits gained from moving the subject examinations from end-of-year to end-of-clerkship, such as timely feedback and compliance with accreditation standards, do not appear to come at the cost of decreased performance on the Step 2 Clinical Knowledge examination.