LAUSR

From Patients to Test Questions: Do Clinical Clerkships Really Improve Student Performance on USMLE Step 1? To the Editor: Dr. Jurich and colleagues concluded that taking the United States Medical Licensing Examination (USMLE) Step 1 after clerkships increases scores. While they adjusted for Medical College Admission Test scores and national Step 1 averages in their multiyear analysis, their findings may be confounded by changes to preclinical classes, addition of basic science to clerkships, and increased emphasis on Step 1 after the curricular change. We had hoped to address these limitations in a quasi-experimental study of Step 1 performance in a single class year.