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Cited by 40

The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.

The Associations Between United States Medical Licensing Examination Performance and Outcomes of Patient Care

Norcini, John, Grabovsky, Irina, Barone, Michael A, Anderson, M Brownell, Pandian, Ravi S, Mechaber, Alex J·2024·Academic Medicine
DOI 10.1097/acm.0000000000005480
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Abstract

Purpose: The United States Medical Licensing Examination (USMLE) comprises a series of assessments required for the licensure of U.S. MD-trained graduates as well as those who are trained internationally. Demonstration of a relationship between these examinations and outcomes of care is desirable for a process seeking to provide patients with safe and effective health care. Method: This was a retrospective cohort study of 196,881 hospitalizations in Pennsylvania over a 3-year period (January 1, 2017 to December 31, 2019) for 5 primary diagnoses: heart failure, acute myocardial infarction, stroke, pneumonia, or chronic obstructive pulmonary disease. The 1,765 attending physicians for these hospitalizations self-identified as family physicians or general internists. A converted score based on USMLE Step 1, Step 2 Clinical Knowledge, and Step 3 scores was available, and the outcome measures were in-hospital mortality and log length of stay (LOS). The research team controlled for characteristics of patients, hospitals, and physicians. Results: For in-hospital mortality, the adjusted odds ratio was 0.94 (95% confidence interval [CI] = 0.90, 0.99; P < .02). Each standard deviation increase in the converted score was associated with a 5.51% reduction in the odds of in-hospital mortality. For log LOS, the adjusted estimate was 0.99 (95% CI = 0.98, 0.99; P < .001). Each standard deviation increase in the converted score was associated with a 1.34% reduction in log LOS. Conclusions: Better provider USMLE performance was associated with lower in-hospital mortality and shorter log LOS for patients, although the magnitude of the latter is unlikely to be of practical significance. These findings add to the body of evidence that examines the validity of the USMLE licensure program.

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Cites

Research works printed but not linked: 3

  1. Barone, Summary report and preliminary recommendations from the Invitational Conference on USMLE Scoring (InCUS), March 11–12, 2019
  2. Moore, 2021, Introduction to the Practice of Statistics
  3. Kane, 2006, Educational Measurement, 17

Cited by

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Metadata

Authors
Norcini, J., Grabovsky, I., Barone, M. A., Anderson, M. B., Pandian, R. S., & Mechaber, A. J.
Venue
Academic Medicine
Publisher
Oxford University Press (OUP)
Published
2023-10-09
Volume
99
Issue
3
Pages
325-330
ISSN
  • 1040-2446
  • 1938-808X
DOI
10.1097/acm.0000000000005480
Cited by
40
References
18
Language
en
Update notices
correction (2024-11-01)
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