College Competitiveness and Medical School Exam Performance

Abstract Background: In medical school, students are tested through periodic USMLE Step 1 and 2 examinations before obtaining a medical license. Traditional predictors of medical school performance include MCAT scores, undergraduate grades, and undergraduate institutional selectivity. Prior studies indicate that admissions committees might unfairly discriminate against applicants who graduated from less competitive universities. However, there is limited literature to determine whether those who attended competitive colleges perform better on USMLE Step 1 and 2 examinations. Objective: The purpose of our study is to determine if students who attended competitive undergraduate colleges outperform those who did not on medical school benchmarks. Methods: We defined a Competitive College as having greater than 10% of its student body scoring 1400 or higher (on a 1600 scale) on the SAT. If this criterion was not met, colleges would be categorized as Non-Competitive. Descriptive statistics and unpaired t-tests were calculated to analyze average test scores on the MCAT, Phase 1 NBME, USMLE Step 1, Phase 2 NBME, and USMLE Step 2. Results: Our findings suggest there are no statistically significant differences between students who do or do not attend competitive undergraduate colleges on these medical school benchmark examinations following the MCAT. Additionally, students who do not attend competitive undergraduate colleges may outperform their counterparts on USMLE Step 2. Conclusions: Admissions committees should use this data to aid in their student selection as our research indicates that institutional selectivity accurately predicts MCAT scores, but not performance on standardized medical school examinations once admitted.