Relationship between students’ perceptions of the adequacy of M1 and M2 curricula and their performance on USMLE step 1 examination

BACKGROUND: Performance on United States Medical Licensing Exam® (USMLE®) Step 1 examination (Step 1) is an important milestone for medical students. It is necessary for their graduation, and selection to interview for the National Resident Match Program®. Success on Step 1 examination requires content alignment, and continuous evaluation and improvement of preclinical curriculum. The purpose of this research was to observe the association between students’ perceptions of deficits in the curriculum based on core disciplines and organ systems in relation to students’ performance in those disciplines and systems on USMLE® Step 1 examination. METHODS: An anonymous survey with closed-ended and open-ended questions was sent to 174 medical students, the class of 2018 (77), and 2019 (97) within 2–3 weeks of taking Step 1 examination. Students’ feedback as well as students’ performance on Step 1 examination were organized into disciplines and organ systems to allow for more specific curriculum analyses. The closed-ended questions provide three selections (yes, no and not sure) regarding students’ agreement to the adequacy of M1 and M2 curricula to prepare students for Step 1 examination. Students’ responses on the closed-ended questions were reviewed in conjunction with their Step 1 performance. The open-ended feedback was qualitatively analyzed for emergent themes or similarity with closed-ended questions in identifying any shortcoming of the curriculum. RESULTS: The data show an apparent relationship between students’ evaluations and students’ performance on Step 1 examinations. A high percentage of students’ disagreement of the curriculum adequacy was also reflected in a lower performance on Step 1 examination. Additionally, the themes that emerged from the qualitative analysis have confirmed the areas of curricular deficiency. CONCLUSION: The data collected from this research provides insight into the degree of usefulness of students’ evaluations as a way of assessing curriculum deficits in preparing students for their Step 1 examination.