An Examination of the Relationship between Clinical Skills Examination Performance and Performance on USMLE Step 2

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To examine the relationship between performance on a large-scale clinical skills examination (CSE) and a high-stakes multiple-choice examination.


Two samples were used: (1) 6,372 first-taker international medical graduates (IMGs); and (2) 858 fourth-year U.S. medical students. Ninety-seven percent of IMGs and 70% of U.S. students had completed Step 2. Correlations were calculated, scatter plots produced, and regression lines estimated.


Correlations between CSE and Step 2 ranged from .16 to .38. The observed relationship between scores confirms that CSE score information is not redundant with MCQ score information. This result was consistent across samples.


Results suggest that the CSE assesses proficiencies distinct from those assessed by current USMLE components and therefore provides evidence justifying its inclusion in the medical licensure process.

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