Dermatology - A complete Review for your Final Exam and for your USMLE / COMLEX (1)
One of the goals of the current study was to use statistical analysis to explore this association in a large sample of students, from one institution, across several years. Furthermore, when the NRMP reports match statistics, they report on the specialty students match into for their first year of residency. For many students, the first year is a preliminary residency, and they then continue on into an advanced residency in a different specialty.
This advanced residency is the specialty that those students actually intend to practice in. Therefore, the NRMP data may not reflect the actual final career paths of all students. By choosing to use the advanced residency data for our students with multiple residencies, we can more accurately reflect the relationships between exam scores and final specialty career choices. At a public state institution, such as the institution involved in the current study, medical school leaders may notice a particular physician workforce need in their state, and wonder how to direct students to the needed specialty.
In a situation like this, it is also helpful for medical school leaders to understand what might predict the geographic locations where their students go for residency. For example, if a public state university is located in a state that has a deficit of family medicine practitioners, it is incumbent on the leaders of that medical school to select and train future physicians who will both be interested in family medicine and elect to remain in that state.
Although a survey found that geographic region was regarded as the most important factor in choice of specific residency program for seniors from 37 American medical schools [ 21 ], the literature on the role of location in specialty program choice is relatively lacking. For this study, we analyzed USMLE scores and residency placement data for students from five graduating classes at the University of Minnesota Medical School in order to answer the following research questions: Ethical approval for this research was granted by the Institutional Review Board at the University of Minnesota on 19 March Of the included students, At the University of Minnesota, medical students matriculate at either the Twin Cities campus or the Duluth campus.
They complete the first two years of the degree foundational science courses at their campus of matriculation, and then all students complete the second two years of the degree clinical clerkships through the Twin Cities campus. Of the students in this study, Academic and demographic data, including date of matriculation, date of graduation, and residency match information, were collected from student records held by the Office of Medical Education in the Academic Health Center at the University of Minnesota.
The two dependent variables were Step 1 scores and Step 2 CK scores, and the independent variable was residency specialty. We conducted preliminary assumption testing to check for multivariate normality, homogeneity of variance-covariance matrices, and multicollinearity, with no serious violations noted. We also conducted independent-samples t-tests for students who stayed in-state vs. Finally, we conducted a chi-square test of association to determine whether there was a significant association between whether a student was a legal resident of Minnesota at the time of application to medical school and whether they stayed in-state for residency.
We coded the specialties matched into by our students, following the specialty categories used by the National Resident Matching Program [ 2 ]. However, since some specialties were not well-represented in our sample, we combined certain small specialties with related larger specialties. Ultimately, we were left with the following 20 specialties: When the results for the dependent variables were considered separately, both reached statistical significance using a Bonferroni adjusted alpha level of 0.
Charts showing the mean Step 1 and Step 2 CK scores by specialty can be found in Figures 1 and 2 , respectively. In this dataset, students matching into Dermatology had the highest mean scores, and students matching into Family Medicine had the lowest mean scores, for both Step 1 and Step 2 CK. Overall Step 1 mean score: Overall Step 2 CK mean score: These results suggest that, although both Step 1 and Step 2 CK scores were higher on average for students going out-of-state for residency, only Step 1 scores were significantly different.
We also explored whether students who were legal residents of Minnesota were more likely to stay in-state for residency than students who were not legal residents of Minnesota, regardless of USMLE score.
The association of USMLE Step 1 and Step 2 CK scores with residency match specialty and location
Numbers and percentages of residents and non-residents staying or leaving the state for residency can be found in Table 1. Students who were not legal residents of Minnesota at the time of application to the medical school were less likely than those who were legal residents to stay in Minnesota for residency. Numbers and percentages of Minnesota MN residents and non-residents staying in-state or leaving the state for residency. While this is the first study we are aware of that explores these differences statistically, this finding is consistent with previous literature that shows differences in mean exam scores across specialties on the national level.
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Furthermore, the specialties with the highest Dermatology and lowest Family Medicine mean USMLE scores in our dataset are consistent with the specialties showing the highest and lowest median scores in the national Match data from the NRMP [ 2 ]. It is reasonable to believe that this pattern is maintained at least in part by students with lower scores either not achieving admission to the most competitive programs or self-selecting into specialties with USMLE scores more similar to their own.
Our results also provide evidence that a relationship exists between USMLE Step 1 scores and students leaving the state for residency. This relationship may be caused by students with higher scores applying to and being accepted by the most prestigious programs, which are not necessarily in-state.
The association of USMLE Step 1 and Step 2 CK scores with residency match specialty and location
Also, the most competitive specialties tend to be smaller, so students may have fewer local choices, and may need to seek programs out-of-state both to find a program they like and to improve their chances of matching. It is important to note that even though this difference was significant, the mean difference was only 2. Students and institutions may find that difference meaningful or not depending on their context. Interestingly, our findings did not indicate a relationship between Step 2 CK scores and location of residency.
This may be due in part to the timing of when students take Step 2. I have used these videos for every single clerkship so far and they not only help me study in an organized way, but they also make me look good on the wards! Thank you so much for helping me crush 3rd year. I saved a lot of money, learned so much and preformed over points higher.
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Largely attribute this to OME. I've used OME primarily for shelf prep. OME has made preparation SO easy. Great product and value - thanks guys! Joshua, Harvard Medical School, Class of It's pretty much the Uworld of clinical rotations. The paid content where you can download the audio and pdfs was essential to my success on multiple rotations and on step II. I am so thankful for everything you folks do. I will definitely be revisiting the site in residency. The new gold standard for third year rotations.
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Learn everything you need and nothing you don't. And make it stick. The book includes multiple images for every topic you read, almost like an atlas. I highly recommend this book, a "must read" before Step 2 CK!!! One person found this helpful. It is an excellent book. I would strongly recommend this book. Wish I would have had this book years ago!!! Great book for all essential derm info! Used it during my derm rotation and i loved it! Pictures are great quality, includes most clinically relevant disorders and pathologies.
Definitely recommend for anyone interested in dermatology. Am a second-year med student and recently bought this book and has proven to be a great untapped resource for my pathology and microbiology classes especially micro. Thanks to the accurate information and excellent images, it has helped me visualize and better understand many diseases. Many times, you lose time looking for a lot of these images and to have them accessible in a single resource is very helpful. Also, this book has USMLE pearls that are useful when distinguishing between differential diagnostics.
This book is an easy read and contains the complete information general information, clinical, diagnosis, treatment and USMLE pearls and well summarized for each dermatological disease. It covers all the information necessary for you to do great on your exams and it will give you that extra knowledge that will make you look really smart and stand out on your clerkships. If you are really serious about getting those extra points on your board exams, this is the way to go. See all 47 reviews. Amazon Giveaway allows you to run promotional giveaways in order to create buzz, reward your audience, and attract new followers and customers.
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