Evidence map›Paper›PMID 40896362›Full record

ArticleAdvances in medical education and practice2025

Exam Sequence and Timing as Predictors of COMLEX-USA and USMLE Performance in Osteopathic Medical Students.

Maurice Blodgett, Martin Schmidt, Jennifer S Beaty, Brian Pinney, Bryan Hays

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Article in Advances in medical education and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Maurice BlodgettDepartment of Primary Care, Des Moines University, West Des Moines, IA, USA.ORCID 0009-0007-8492-003X
Martin SchmidtDepartment of Biochemistry and Nutrition, Des Moines University, West Des Moines, IA, USA.
Jennifer S BeatyDepartment of Specialty Medicine, Des Moines University, West Des Moines, IA, USA.ORCID 0000-0002-1654-5895
Brian PinneyCenter for Educational Enhancement, Des Moines University, West Des Moines, IA, USA.
Bryan HaysRegistrar's Office, Des Moines University, West Des Moines, IA, USA.ORCID 0009-0007-2674-4808

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: This study examined the impact of exam sequence and timing on the performance of osteopathic medical students on the COMLEX-USA Level 1 and Level 2 and USMLE Step 1 and Step 2 examinations. Methods: Two cohorts were analyzed: 364 osteopathic medical students who completed both COMLEX-USA Level 1 and USMLE Step 1 between 2020 and 2022 (prior to the implementation of pass/fail grading), and 734 osteopathic medical students who completed both COMLEX-USA Level 2 and USMLE Step 2 between 2021 and 2025. Student performance was evaluated based on the sequence of examinations and intervals between them. Because the scores did not follow a normal distribution, as indicated by the Shapiro-Wilk test, the Mann-Whitney Results: Osteopathic medical students who undertook the USMLE examinations first consistently achieved higher scores than those who undertook the COMLEX-USA examinations first across most academic quartiles. Shorter exam intervals (1-7 days) were associated with higher scores, whereas longer intervals (≥8 days) were correlated with significantly lower scores. The effects of exam order and timing varied across performance quartiles, with lower-performing students deriving the greatest benefit from taking the USMLE examinations first and maintaining shorter intervals between the exams. Conclusion: Strategic scheduling of exams may enhance performance on both the COMLEX-USA and USMLE examinations, particularly for lower-performing students. However, individual factors should be considered when implementing these strategies. These findings offer valuable insights for osteopathic medical students and educators in planning exam preparation and scheduling.

Indexed as

medical licensure assessmentscore outcome correlationstandardized board examinationstest preparation strategies

Identifiers

PMID40896362
PMCPMC12396519

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