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Thread: Elimination of 2 digit score for USMLE STEP 1

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    AUCMD2013 is offline Senior Member 527 points
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    Elimination of 2 digit score for USMLE STEP 1

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    I've been hearing rumors about the elimination of the 2 digit scores from the upcoming examinees score reports. Anyone else hear this? Since the value of a 99 fluctuates from exam to exam (sometimes it's a 230 and sometimes 235), I for one think this is a positive change. The 3 digit score is probably more consistent in what it represents.
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    hopefuldoc74's Avatar
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    I did read on the USMLE website that they are looking to change the structure of the exam, but not the scoring.

    Though it cost all you have, get understanding.

    SJSM - MD1 ( Hidden Content ) MD2 ( ) MD3 ( ) MD4 ( )

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    I got the ECFMG reporter today and that was reported in it.

    CHANGES TO USMLE PROCEDURES FOR REPORTING SCORES

    Starting July 1, 2011, USMLE transcripts reported through the ERAS reporting system will no longer include score results on the two-digit score scale. USMLE results will continue to be reported on the three-digit scale. This affects the Step 1, 2 CK, and 3 examinations only; Step 2 CS will continue to be reported as pass or fail. These changes do not alter the score required to pass or the difficulty of any of the USMLE Step examinations.

    Since its beginning in the 1990s, the USMLE program has reported two numeric scores for the Step 1, Step 2 CK, and Step 3 examinations, one on a three-digit scale and one on a two-digit scale. The three-digit score scale is considered the primary reporting scale; it is developed in a manner that allows reasonable comparisons across time. The two-digit scale is intended to meet statutory requirements of some state medical boards that rely on a score scale that has 75 as the minimum passing score. The process used to convert three-digit scores to two-digit scores is designed in such a way that the three-digit minimum passing score in effect when the examinee tests is associated with a two-digit score of 75.

    The USMLE program requires its governing committees to reevaluate the minimum passing score every three to four years. This process has, at times, resulted in changes in the minimum passing score, expressed on the three-digit scale, and an accompanying change in the score conversion process, to ensure that a two-digit score of 75 is associated with the new minimum passing requirement. A by-product of the adjustment of the score conversion system over time has been a shift in the relationship between the two score scales. This shift has no impact for USMLE score users who use the three-digit scoring scale or for those using the two-digit scale with a primary interest in whether the examinee has a passing two-digit score of at least 75. However, it may create challenges in interpretation for score users who are focusing on two-digit scores, other than 75, and are doing so for purposes of comparing USMLE scores that span several years.

    To simplify matters and make interpretation of USMLE information more convenient for score users, the USMLE Composite Committee has asked staff to report two-digit scores only to those score users for whom the scale is intended, i.e., the state medical boards. The Committee also asked that examinees continue to receive scores on both scales so that they are fully informed about the information that will be reported when they ask that results be sent to a state medical board. When examinees request that their results be sent to other score users, only the three-digit score will be reported. Current plans call for these changes to begin with the elimination of the two-digit score from USMLE transcripts reported through the ERAS reporting system starting July 1, 2011. Other systems and procedures for reporting results will be similarly modified as soon as possible after the July 1, 2011 date.
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    Thank God. If I hear one more person say they scored in the "99th" percentile I'm going to choke them.
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    axiomofchoice is offline Senior Member 6116 points
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    Quote Originally Posted by GQ_Doc View Post
    Thank God. If I hear one more person say they scored in the "99th" percentile I'm going to choke them.
    LOL. Agreed

    Maybe now people will realize that the 99th percentile is about 265+

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    Quote Originally Posted by axiomofchoice View Post
    LOL. Agreed

    Maybe now people will realize that the 99th percentile is about 265+
    I'm glad some people get it.

    I could be wrong, but I think for a Bell curve the 99th percentile is 2.756 standard deviations above the mean. The last published Step 1 average (January 2010) was 221 with a standard deviation of 23. Using those numbers, a 99th percentile score would calculate out to ~280

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    The two digit score is not a percentile score (in case you missed the sarcasm from the previous posts). When I took the exam, pretty much anyone who made in the 230's and up made a 99.

    While I appreciate the ECFMG attempting to standardize score reporting, I do find it interesting that the USMLE score report still says that the 3-digit score is only to be compared with other scores of that particular test administration - and yet, we are using it across the board for residency .
    Last edited by Slaol; 05-13-2011 at 02:03 AM.
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    dolphinsrcool is offline Newbie 46 points
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    Quote Originally Posted by Slaol_121 View Post
    The two digit score is not a percentile score (in case you missed the sarcasm from the previous posts). When I took the exam, pretty much anyone who made in the 230's and up made a 99.

    While I appreciate the ECFMG attempting to standardize score reporting, I do find it interesting that the USMLE score report still says that the 3-digit score is only to be compared with other scores of that particular test administration - and yet, we are using it across the board for residency .
    Step 1 is DESIGNED as a pass-fail test - like a driving test. It is meant to determine whether the student has sufficient scientific knowledge to move forward to giving supervised clinical care. PDs have used Step scores for their own purposes (cut down applicant pool to a manageable number) but that is not what it is designed for. The further away from pass/fail a score is, the less reliable it is. For example, if the same student takes the exam 3 times their scores should be very close (if they didn't do more studying between attempts!). That is exactly what you see around the 180-200 range but not in the 230-250 range. Since the test is designed as pass/fail, the further from the boundary a score is, the less reliable it is.
    USMLE regularly consider making the scores pass/fail, but PDs get very upset because they would have more work - reading ALL LORs, for example!
    Since PDs miss-use the scores it is obviously in every student's best interests to get as good a score as possible. Just remember that a 255 does not make you a lot smarter than a 235, on another day the scores could be reversed.
    Another point, many PDs expect the Step to be passed at the first attempt and will take a 1st attempt 205 over a 2nd attempt 235.

    Good luck to those visiting Prometric soon!
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    benevolo is offline Member 520 points
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    Quote Originally Posted by dolphinsrcool View Post
    Just remember that a 255 does not make you a lot smarter than a 235, on another day the scores could be reversed.
    While I agree a 255 doesn't necessarily mean you're smarter than someone who gets a 235, your second statement is incorrect. Your step score is an extremely reliable measure of how well you understand the content that is examined. I think the NBME gives a standard error of about 8 on the USMLE, and I'm not the best at statistics, but I think that means your actual score will fall within +/- 8 points of your true score 95% of the time.
    Last edited by benevolo; 05-14-2011 at 01:19 PM.

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    Tiger1 is offline Member 523 points
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    I won't comment on the statistics part of your comment, but as for the step being an extremely reliable of your understanding, that is simply incorrect as the above poster tried to explain. Step 1 was never designed to be an indicator of your understanding of the content once you reach the required amount of material needed to pass the exam. It was designed simply as a test to determine if you know enough material to pass the exam. This is one of the big issues that the people responsible for administering the step exams are looking at with possibly changing when step exams are given. The exams were never meant to separate 2 individuals at the highest levels of scoring. His statment is absolutely correct that on a given day the 2 scores could be reversed. When you get to numbers that high there are only a handful of questions that separate 2 scores. The person who scored higher may simply have guessed right on a few more questions or gotten a couple more questions on a topic they were more comfortable with whereas the person with the lower score may have guessed wrong on a couple more questions or gotten more questions on a subject they weren't as strong on. The people responsible for administering the exams are not particularly happy the exams are being used for a purpose they were never meant to be used for according to a person familiar with the reasoning behind the discussions on changing when the exams are given.
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