Examination of Medical College Admission Test Scores and US Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge Scores Among Students With Disabilities

Christina J Grabowski,Mark C Henderson,Melissa Plegue,Joel Purkiss,Sharad Jain,Lisa M Meeks,Michael H Kim

doi:10.1001/jamanetworkopen.2021.10914

Abstract

This cohort study examines the association between Medical College Admission Test (MCAT) scores, disability status and category, and performance on US Medical Licensing Examination (USMLE) Step 1 and Step 2 CK scores.

Highlights

An increasing number of medical students are disclosing disabilities,[1] yet little is known about the association between Medical College Admission Test (MCAT) and US Medical Licensing Examination (USMLE) performance in this population
Our models showed that MCAT scores were positively associated with USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores for all students (Table)
After adjusting for MCAT score, students with disabilities (SWD) status was associated with lower mean USMLE scores (B = −11.2; 95% CI, −14.0 to −8.4)

Summary

Introduction

An increasing number of medical students are disclosing disabilities,[1] yet little is known about the association between Medical College Admission Test (MCAT) and US Medical Licensing Examination (USMLE) performance in this population. Previous studies were focused on a single site[3] and were performed prior to changes in disability law and increases in disability disclosure.[2,3] Historical literature suggests that students with disabilities (SWD) have lower USMLE pass rates[2] and lower Step 1 and Step 2 Clinical Knowledge (CK) scores.[3] Despite recent attention to differential MCAT performance among students with lower socioeconomic status backgrounds and those identifying as races/ethnicities underrepresented in medicine,[4] disability has been conspicuously absent from these discussions. We examined the association of MCAT scores, disability status and category, and performance on Step 1 and Step 2 CK scores in a multisite, multiyear cohort of SWD who matriculated following amendments to the Americans with Disabilities Act.[6]

Methods

Results

Conclusion