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Predictors of performance on NBME Subject Exam in Obstetrics and Gynecology and USMLE 2

Objective: To determine if midrotation and standardized tests predict performance on the obstetrics and gynecology (OB/GYN) NBME exam as well as USMLE 2.

Study Design: A midrotation test is administered to all medical students during their OB/GYN clerkship. This IRB exempt study involved retrospective review of de-identified student data from 2003 to 2012, including basic demographics. Pearson’s correlation was used to determine the relationships among educational assessments (midterm/practical examinations in OB/GYN, MCAT, USMLE 1 and 2, NBME). Logistic regression was used to determine significant predictors of failing the NBME.

Results. Among 199 student subjects reviewed, the study population was predominately white (78%), male (69%), having an average of 3 rotations prior to OB/GYN and from West Virginia (54%). The mean NBME score was 74 (range: 53-99). There were significant positive correlations between NBME scores and midterm (R=0.23, p=0.001), USMLE 1 (R=0.43,p=0.001), and practical exam (R=0.41,p=0.001). MCAT scores and number of prior rotations did not affect NBME scores. Rather, MCAT scores correlated with USMLE 1 (R=0.35,p<0.001), but not with USMLE 2 (R=0.17,p=0.07). USMLE 2 scores correlated with midterm (R=0.40, p<0.001), practical exam (R=0.22 p=0.08) and NBME scores (R=0.55,p<0.001). Student scoring in the lower third of the midterm (<75%) trended towards failing the NBME (OR: 5.0; CI:0.93:26.3,p=0.06).

Conclusions: Students at risk of failing the NBME and USMLE 2 can be identified with midterm exam. Past performance on MCAT and USMLE 1 did not predict performance on NBME or USMLE 2 administered during clinical years. A remedial plan may improve performance.

Topics: 2014, Student, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Medical Knowledge, UME, Assessment,