Clinical Knowledge

My USMLE Step 2 Clinical Knowledge score came back in record time. As you will recall, my score on the costly sandwich (CS) exam was PASS. Today, three weeks to the day after taking the 9 hour computer exam, I received my score report. I PASSED, and scored higher than I did on Step 1 (which I took back in 2003).

Since my score was higher than I expected, and lower than most of my peers, I've decided to share some data about how well the USMLE World practice software package prepared me and the accuracy of one practice exam score predictor, provided by medfriends.org. Those who know I'm an engineer at hear will not be suprised by the following chart.

Plotted on this graph are score estimates from sequential practice exams I took using the USMLE World software. That software grants you acces to a couple thousand practice questions and prepares exams composing of 46 questions each. I averaged the raw scores of the six most recent exams made of questions I'd never seen. That average was input into the medfriends.org tool and plotted on the date. The averages are rolling. The turnover was 4 exams (adjacent data points share from 1-3 individual scores in their average. On the scale above, the horizontal line is 184, or passing. You can see that my trend was dangerously close to that cutoff. But considering my poor showing on Step 1 back in '03, I knew I needed to buckle down.

Shown in red is my actual score - a 209. This is below the national mean, but right about where I'd hoped to be. The one data point immediately before the exam - that was the free USMLE practice exam provided by the exam company. I recommend you take it. not only, will it make you feel better, my experience was that combined with the score estimator, it was a better predictor of my actual score.

Finally, you may ask: why is he advertising such a low score? Well - there's a good chance that residency programs already know my score. If you're reading this because Google brought you here, maybe you'll appreciate seeing a self-reported score that isn't in the 240 range. If you're reading this because your my friend, thanks for being my friend!

If you haven't taken the exam yet, hang in there. Take some time to focus on the material, practice with question sets, and try to take some time off to prepare. I wouldn't, for example, recommend studying at the same time as taking a required psychiatry clerkship.

Exam Branching Diagram

To assist your complete understanding of my medical school experience, I have prepared the following flow chart detailing the way I feel before taking an exam, immediately after the exam, the grade result and what I think on my way home from the exam. Granted, we usually don't get the grades until weeks after, but I'm the blogger, so I'll present the information the way I want to.I bet you want to know how I felt after each of my clerkship exams... Even if you don't want to know, there's a reason I want to tell you:

• Pediatrics: Blue-Green-Orange-Red
• Family Medicine: Orange-Red-Blue-Blue
• Medicine: Green-Blue-Green-Orange
• Surgery: Blue-Orange-Orange-Orange
  
• Ob/Gyn: Blue/Green --> The exam is tomorrow! --> Green
  
• Psych: Ask me in September
  

The point of this little exercise is to indicate how poor I am at predicting:

1. Readiness for an exam
2. Whether I knew the answers
3. What grade I'd get on the exam
4. My mood after taking the exam

Careful readers will notice that I haven't aced many exams. Don't worry - that doesn't mean I haven't done well in medical school. Depending on the clerkship, the exam consists of a variable contribution to the final grade. And I don't REALLY hate medical school. SOmetimes I think that I do, however.