ArticleBMC medical education2025
Improving USMLE Step 1 outcomes in academically vulnerable students through a targeted, competency-based curriculum.
Article in BMC medical education, 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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Abstract
introductionFailing the United States Medical Licensing Exam (USMLE) Step 1 can have significant and lasting negative consequences on medical student well-being, academic performance and time to graduation. Although academic predictors can identify students at higher risk for Step 1 failure, there is limited evidence on how to best support these students in achieving first-attempt success and maintaining on-time graduation. Time-variable progression is one feature of competency-based medical education, but simply extending the dedicated study period is not associated with improved Step 1 outcomes.
methodsBeginning in 2019, the University of Washington School of Medicine offered a 10-week Comprehensive Basic Sciences Review (CBSR) course to students identified as having an elevated risk for Step 1 failure. This optional curricular intervention precedes the dedicated study period for these students. Program effectiveness was evaluated by comparing Step 1 scores and on-time graduation rates of 50 students who took CBSR in 2019-2021 with 50 academically propensity-matched controls.
resultsCBSR students scored significantly higher on Step 1 (mean of 212.7 vs. 202.1, P < 0.001) than their academically-matched controls. Rates of on-time graduation were similar between the two groups (65.3% [32/49]) for CBSR students, compared to (60.0% [30/50] for the control group). DISCUSSION: This proactive, optional curriculum is associated with significantly higher Step 1 scores for at-risk students than their propensity-matched controls, without negatively affecting on-time graduation.
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