The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance

Consequence in Competency-Based Education: Individualize, but Do Not Compromise

“…3 In this issue, Fitz et al investigated the predictive relationship between curricular structure, internal medicine clerkship characteristics, and National Board of Medical Examiners (NBME) subject exam scores on USMLE Step 2 CK performance. 4 While previous studies have similarly shown an association of the USMLE Step 1 and NBME subject examinations with Step 2 performance, 5 this study reported that neither the total number of clerkship NBME subject exams taken nor internal medicine clerkship-specific characteristics (e.g., length, start date) were significant predictors of Step 2 CK performance. While these findings provide some reassurance that schools do not need to necessarily offer or require NBME subject exams to prepare students for Step 2, the lack of a significant relationship between program-specific variables (i.e., NBME subject exam procedures and curricular structure) and high-stakes summative assessment performance creates more questions than answers.…”