Exam performance following a structured Step 1 USMLE preparation programme

Background The United States Medical Licensing Examination (USMLE) is a three-step licensing exam that includes a series of computerized multiple-choice questions (MCQs) [1]. In order for a student to receive a license to practice medicine in the USA, that student must pass all three steps of the USMLE. Student performance in this exam - and in particular, Step 1 - is widely employed to compare medical schools both inside and outside North America. However, until now medical school curricula in Ireland are not focused on preparation for this exam - a disconnect that may negatively impact on Irish medical schools, and on those students who plan to continue to train in North America. SUMMARY OF WORK The University of Limerick Graduate Entry Medical School (GEMS) working together with leading e-learning provider Kaplan has developed a structured Step 1 USMLE preparation programme involving four supports. These include (i) course books and e-learning materials, (iii) an online diagnostic self-test , (ii) a live webinar workshop on MCQ exam taking skills and a mock day-long exam and (iv) a series of twenty four interactive weekly three-hour MCQ evening exam workshops hosted by experienced tutors. SUMMARY OF RESULTS Exam performance in the Step 1 USMLE over a seventeen month period was compared in two groups - enrolled or not enrolled in the preparation programme. A pass rate of 83% was observed in those GEMS students not enrolled (18) compared to a pass rate of 90% in those enrolled in the preparation programme (42) including one score of 252 out of a possible 300 marks - the highest score yet achieved in the School. DISCUSSION AND CONCLUSIONS Incorporating a structured USMLE preparation programme into an Irish fouryear graduate entry curriculum represents a significant logistical and resource challenge. However, these data suggest that such a programme is worthwhile in that it improves the pass rate possibly by ensuring that the student is adequately prepared for this exam.