High MCAT correlates well to High Step 1...Fact or Fiction?

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ParabolaMDPHd said:
Ive heard about this correlation many times and always wondered about its validity, anyone care to comment?
Click to expand...


Anecdotally, I have heard the same thing from a professor of ours. He also claimed that SAT scores actually correlated even better. Again, completely anecdotal.

More relevant, I was talking with our MSTP program director last week about Step 1 scores from people in our program. She said she has noticed the people who do best on Step 1 are the people who all along in med school have been doing well to very well. She said it is very rare to see a student just get by then pull out a superior Step 1 score. She went on to say that she feels like for MSTPers going into Internal Med and Path, not doing spectacularly isn't a huge issue, but for those students wishing to go into "botique specialties" [her words] she has seen some of them match to only their penultimate or last choice.

Just fyi since I had this on my mind from the other day. I would be interested in hearing what other people who have taken Step 1 already think.
 
Pubmed search:

MCAT and USMLE

example:

1: Acad Med. 2007 Jan;82(1):100-6.

The predictive validity of the MCAT for medical school performance and medical
board licensing examinations: a meta-analysis of the published research.

Donnon T, Paolucci EO, Violato C.

Medical Education and Research Unit, Department of Community Health Sciences,
Faculty of Medicine, University of Calgary, Calgary, Canada. [email protected]

PURPOSE: To conduct a meta-analysis of published studies to determine the
predictive validity of the MCAT on medical school performance and medical board
licensing examinations. METHOD: The authors included all peer-reviewed published
studies reporting empirical data on the relationship between MCAT scores and
medical school performance or medical board licensing exam measures. Moderator
variables, participant characteristics, and medical school performance/medical
board licensing exam measures were extracted and reviewed separately by three
reviewers using a standardized protocol. RESULTS: Medical school performance
measures from 11 studies and medical board licensing examinations from 18
studies, for a total of 23 studies, were selected. A random-effects model
meta-analysis of weighted effects sizes (r) resulted in (1) a predictive validity
coefficient for the MCAT in the preclinical years of r = 0.39 (95% confidence
interval [CI], 0.21-0.54) and on the USMLE Step 1 of r = 0.60 (95% CI,
0.50-0.67); and (2) the biological sciences subtest as the best predictor of
medical school performance in the preclinical years (r = 0.32 95% CI, 0.21-0.42)
and on the USMLE Step 1 (r = 0.48 95% CI, 0.41-0.54). CONCLUSIONS: The predictive
validity of the MCAT ranges from small to medium for both medical school
performance and medical board licensing exam measures. The medical profession is
challenged to develop screening and selection criteria with improved validity
that can supplement the MCAT as an important criterion for admission to medical
schools.
 

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bd4727 said:
Just fyi since I had this on my mind from the other day. I would be interested in hearing what other people who have taken Step 1 already think.
Click to expand...


I think there is a good correlation. If you really want a high score, pay your dues and put in 9 weeks of 10 hour days.
 
Ugh. My program only allowed me 4 weeks to study! That used to be normal. Now everytime I talk to someone it's 8+ weeks for Step I! No wonder the average scores are creeping up!

Ah well, let's just knock out 6 months of first year and replace it with 6 months of Step I study time. Then Neuronix's medical school will have the highest Step I scores evar!!!
 
Neuronix said:
No wonder the average scores are creeping up!
Click to expand...

Sorry to put you on the spot Neuronix, but do you think it's possible that average step I scores can increase if the standard deviation and mean are scaled each year? I'm not an expert in stats.
 
echod said:
Sorry to put you on the spot Neuronix, but do you think it's possible that average step I scores can increase if the standard deviation and mean are scaled each year? I'm not an expert in stats.
Click to expand...

Of course not. But everyone talks about the average Step I scores in competitive specialties creeping up. I have no data offhand to support this though, so maybe I shouldn't have said anything. It still stands that the amount of time to prepare for Step I keeps increasing, along with Step II now becoming more important.
 
Neuronix said:
Of course not. But everyone talks about the average Step I scores in competitive specialties creeping up. I have no data offhand to support this though, so maybe I shouldn't have said anything. It still stands that the amount of time to prepare for Step I keeps increasing, along with Step II now becoming more important.
Click to expand...
I would expect that as the number of med school spots increases, the absolute number of high-scorers could increase while the relative percentage would remain constant. As residency slots are not increasing enough relative to number of spots, high-end residencies (ROAD, whatever) would have more high-scoring applicants to choose from, without the mean or std dev changing.
 
ParabolaMDPHd said:
Ive heard about this correlation many times and always wondered about its validity, anyone care to comment?
Click to expand...
Like D&G pointed out, it does correlate somewhat, but it doesn't correlate "well." If you coast through your preclinical years because your MCAT was sky-high, that stellar MCAT score isn't going to grant you a free pass to a top score on Step 1. The tests aren't really that similar. The people who do very well on Step 1 IMO are the ones who work hard first and second years and who also do a ton of practice questions. You need a lot more background knowledge for Step 1 than you do for the MCAT, and you also need to practice sifting through long paragraphs of info (some of it extraneous) to get out the pertinent things that will allow you to answer the questions. Multiply that process x 48 questions per section x 7 straight hours. Step 1 is probably going to be a lot harder than you expect it to be, even if you aced the MCAT.
 
I blew off my pre-clinical time in med school more or less. I barely passed most of my exams, taking a lot of grad school work and having a good time on the side (skiing, girlfriend, etc...). When Step I prep time came I studied hard for that month and pulled 1 SD over the national mean. I think how much of your pre-clinical stuff will actually end up on the Step I depends on your school. You should focus on that, but I found that there was all this extraneous junk that profs like to test on that is so random and superfluous it does nothing except to separate you and your classmates into test score brackets. I blew that junk off, instead studying for Step I core material every block. That made my test grades kind of lousy, but expanded my core, important knowledge base. Also, keep in mind the actual exam is mostly Pharm, Path, and Physio, with minimal first year topics. On my step ! I had 2 easy anatomy questions and 1 easy embryo question. 😴

Use my plan at your own risk, but you can see why I don't think your pre-clinical studies matter much for Step I score.
 
Doctor&Geek said:
You know, some of us want to be AOA.
Click to expand...

At my school AOA is determined almost entirely from clinical grades... A lot of schools have gone to P/F in the preclinical years because the clinical grades are the ones that everyone knows matter.
 
One could make the following arguement:

1) Medical schools are and have been good at picking the best applicants.
2) Opening additional seats at medicals schools therefore allows applicants who in previous years would not have gained admission to gain admission.
3) These applicants then will mostly end up in the bottom half of their class and have below average boards.
4) Because you are adding to the bottom, there also become more students with higher scores; however, you still need to be in the top x students (based on all factors, boards, grades, school, interviews, etc) in order to match to _____.
5) Competition doesn't really increase for those specialities because the realitity is that the new seats are being occupied by people who are not top applicants anyways.

This, of course, is a hypothetical based on PURELY on the assumption (that is not nesecerily my belief nor is it testable) that medical schools typically select the applicants that will be most successful all around and make the top candidates.
 
My impression is that the two are not very well correlated. Of course, a great Step 1 score requires some of the skills that allow for a great MCAT score - i.e. fast reading, screening out extraneous information while not neglecting crucial details, multiple choice elimination/narrowing down techniques, etc.

However, the MCAT does not require all that much knowledge. The Step 1 requires a huge knowledge base, and some questions require very little processing of information - just spit the answer out.

I think anyone who rocked the MCAT can also rock the Step 1, provided they have a good memory. Unfortunately, I think a lot of people who rock the MCAT are often not the most studious type in the first 2 years of medical school (and in general), so that hurts them in the end.
 
Personally I think your performance on Step 1 correlates with how much time (blood, sweat, and tears) you are willing to put into it. Sure some people are smarter than others, but we're all smart enough after getting into medical school to do well on the test. The ability to deal with stress and not freak out helps as well. My $0.02.
 
So Step 1 is harder than the MCAT, even just based on content right?

Which puts more pressure on the student to do well? I heard it was the MCAT, since it's needed to get INTO med school, but this is just annecdotal.
 
Shawnpremed said:
So Step 1 is harder than the MCAT, even just based on content right?

Which puts more pressure on the student to do well? I heard it was the MCAT, since it's needed to get INTO med school, but this is just annecdotal.
Click to expand...
They're hard in different ways. It's like saying, which is harder, doing a handstand or doing a split? Both will require practice and skill, and neither is something that can easily be done by most people who haven't specifically prepared for them. Some people are naturally more flexible and will tell you that a split is easier. Others are naturally stronger and will tell you that the handstand is easier. I'm in the latter camp; all those years of running have not done wonders for my hamstring flexibility. :d
 
Shawnpremed said:
Which puts more pressure on the student to do well? I heard it was the MCAT, since it's needed to get INTO med school, but this is just annecdotal.
Click to expand...

MCAT you take again if you have to. Step I you only get one chance unless you fail and if you fail you're pretty screwed unless you like PM&R or FP. If you're interested in competitive specialties or even competitive programs (i.e. research ones) within non-competitive specialties, you'll want at least above the national average on Step I. For me going into a competitive specialty, I'm told frequently I needed a score at least in the 85th percentile on Step I. Except now you're competing with a lot of other med students who feel these same pressures, and not a lot of random people taking the MCAT, some of whom really have no chance.
 
Shawnpremed said:
So Step 1 is harder than the MCAT, even just based on content right?...
Click to expand...
Eh. I've taken harder exams than either the MCAT or the USMLE. Don't stress about it. If you make it into med school, you should be prepared to take Step I once you get there. If you don't make it into med school, then you don't need to worry about the USMLEs.

Shawnpremed said:
...Which puts more pressure on the student to do well? I heard it was the MCAT, since it's needed to get INTO med school, but this is just annecdotal.
Click to expand...
Both have their 'fear inducing factor' because many feel that your Step I score will determine what specialty you go into for the rest of your life. Don't get me wrong, Step I scores play a big part in getting into residency, but it's not everything and you can't let an exam freak you out. It doesn't determine your life. Too many of my classmates got freaked out during studying and that just kills your productivity.
 
Neuronix said:
...For me going into a competitive specialty, I'm told frequently I needed a score at least in the 85th percentile on Step I...
Click to expand...
When you say "percentile," are you referring to the two-digit score, or the actual percentile? I think 235+ gets you a two-digit of 99, but 235 isn't the 99th percentile. Something more like 245 or 250 would be the 99th.
 
RxnMan said:
When you say "percentile," are you referring to the two-digit score, or the actual percentile? I think 235+ gets you a two-digit of 99, but 235 isn't the 99th percentile. Something more like 245 or 250 would be the 99th.
Click to expand...

The two digit score is largely ignored and is not a percentile. My three digit was higher than 235 and was not a two digit 99.

IIRC, In my administration the average was a 216 and standard deviation was 24. The Step I cutoff for interview at research-oriented programs in Radiology is 240 (source: UCSF Rads website, conversations with other PDs). One standard deviation above the mean corresponds to 85th percentile. This score is higher than the average at any medical school and the average scores for competitive specialties continue to increase as more medical schools open.
 
Neuronix said:
The two digit score is largely ignored and is not a percentile. My three digit was higher than 235 and was not a two digit 99...
Click to expand...
I hear it being described (esp on SDN) as a percentile, which is why I asked. My math comes to the same estimates. I wonder, though, because when you're in the Match, if PDs care about when a test was administered. I doubt they have all of that data on-hand, or are willing to apply it to the thousand applications they get. I also bet the average drops due to re-apps. I bet they just use some gestalt like 215, 220, and go from there.

FWIW, I hear the two digit is used by PDs.
 
RxnMan said:
I hear it being described (esp on SDN) as a percentile, which is why I asked.
Click to expand...

That is incorrect. Some PDs also think it's a percentile, but it is not true. You can check the Step I NBME site FAQs for confirmation on this if you'd like.

I bet they just use some gestalt like 215, 220, and go from there.
Click to expand...

Sounds right to me. The only thing that seems to vary is if Step I score is used at all (less competitive specialties), whether it's just a cutoff or determining factor for interview, or if it also goes into the formula for selecting residents. It depends on the specialty and program it seems to me. Interview cutoffs in Radiology at competitive programs are typically 230, 235, or 240 (based on location and prestige).

FWIW, I hear the two digit is used by PDs.
Click to expand...

Well the two digit and the three digit are perfectly linearly correlated (though the range on the two-digit is smaller so two-digit looks like a step-wise function against three-digit scores). So it doesn't really matter which number you talk about. Most AMGs talk about the three digit and most residency adcoms I talk to are more interested in three digit scores. Do some go by two digit? Sure. Six eggs, half dozen eggs, same diff.
 
Neuronix said:
Ugh. My program only allowed me 4 weeks to study! That used to be normal. Now everytime I talk to someone it's 8+ weeks for Step I! No wonder the average scores are creeping up!

Ah well, let's just knock out 6 months of first year and replace it with 6 months of Step I study time. Then Neuronix's medical school will have the highest Step I scores evar!!!
Click to expand...

I think people who say yea go study 8 or 10 weeks are exaggerating. Most people I know studied 6-7 weeks. very few people i know studied 8+. IMO there's no point in studying so long. sure, you can study forever for step 1... you'll never get a 300, so what's the point? i hit the books hard for 5 weeks and enjoyed 2.5 weeks of summer before ms3 started.


ParabolaMDPHd said:
Ive heard about this correlation many times and always wondered about its validity, anyone care to comment?
Click to expand...

Correlation between MCAT and Step 1 is total bs in my book. my mcat score was 11bs/7v/11ps... i was told my verbal would kill me not just cuz it's low and bad but because it's the best predictor of performance in med school and on step 1. what a lie that was. yea, it hurt me getting interviews but here i am in ms3 with a really solid step 1 score, significantly higher than average.

Doctor&Geek said:
Pubmed search:

MCAT and USMLE

example:

1: Acad Med. 2007 Jan;82(1):100-6.

The predictive validity of the MCAT for medical school performance and medical
board licensing examinations: a meta-analysis of the published research.

Donnon T, Paolucci EO, Violato C.

Medical Education and Research Unit, Department of Community Health Sciences,
Faculty of Medicine, University of Calgary, Calgary, Canada. [email protected]

PURPOSE: To conduct a meta-analysis of published studies to determine the
predictive validity of the MCAT on medical school performance and medical board
licensing examinations. METHOD: The authors included all peer-reviewed published
studies reporting empirical data on the relationship between MCAT scores and
medical school performance or medical board licensing exam measures. Moderator
variables, participant characteristics, and medical school performance/medical
board licensing exam measures were extracted and reviewed separately by three
reviewers using a standardized protocol. RESULTS: Medical school performance
measures from 11 studies and medical board licensing examinations from 18
studies, for a total of 23 studies, were selected. A random-effects model
meta-analysis of weighted effects sizes (r) resulted in (1) a predictive validity
coefficient for the MCAT in the preclinical years of r = 0.39 (95% confidence
interval [CI], 0.21-0.54) and on the USMLE Step 1 of r = 0.60 (95% CI,
0.50-0.67); and (2) the biological sciences subtest as the best predictor of
medical school performance in the preclinical years (r = 0.32 95% CI, 0.21-0.42)
and on the USMLE Step 1 (r = 0.48 95% CI, 0.41-0.54). CONCLUSIONS: The predictive
validity of the MCAT ranges from small to medium for both medical school
performance and medical board licensing exam measures. The medical profession is
challenged to develop screening and selection criteria with improved validity
that can supplement the MCAT as an important criterion for admission to medical
schools.
Click to expand...

i guess if anything bio sciences section makes more sense, but i still don't buy it.

---
Bottom line: study hard and do well in ms1 and ms2, then you'll know what you're doing when step 1 rolls around.
 
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