The Impact of Postgraduate Training and Timing on USMLE Step 3 Performance

PURPOSE: This study examined the extent to which differences in clinical experience, gained in postgraduate training programs, affect performance on Step 3 of the United States Medical Licensing Examination (USMLE). METHOD: Subjects in the study were 36,805 U.S. and Canadian medical school graduates who took USMLE Step 3 for the first time between November 1999 and December 2002. Regression analyses examined the relation between length and type of postgraduate training and Step 3 score after controlling for prior performance on previous USMLE examinations. RESULTS: Results indicate that postgraduate training in programs that provide exposure to a broad range of patient problems, and continued training in such areas, improves performance on Step 3. CONCLUSIONS: Study data reaffirm the validity of the USMLE Step 3 examination, and the information found in the pattern of results across specialties may be useful to residents and program directors.