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Acad Med. 2003 Oct;78(10 Suppl):S10-2.

The impact of postgraduate training and timing on USMLE Step 3 performance.

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  • 1National Board of Medical Examiners, Philadelphia, PA 19104, USA.



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).


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 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.


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.

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