Characteristics of the courses that best predict COMLEX-USA level 1 performance.

T he performance of medical students and other health professional students in their basic science coursework and on standardized tests has been shown to have a strong correlation to subsequent scores on national licensing examinations. 1-4 Osteopathic and allopathic medical students in the lowest quintile of grade point average (GPA) during the first 2 years of medical school have been identified as being at the greatest risk of failure on the Comprehensive Osteopathic Medical Licensing Examination–USA (COMLEX–USA) level 1 and the United States Medical Licensing Examination step 1, respectively. 4,5 In 1994, Swanson et al, 6 using the total basic science coursework GPA during the first 2 years for students at seven allopathic medical schools, demonstrated that there was a correlation of .72 to .83 to USMLE step 1 performance. In another study, Baker et al 5 demonstrated that the total GPA obtained during the first 2 years of training had a .70 correlation with performance on the COMLEX–USA level 1 (taken June 1998). While these studies clearly indicate that the GPA at the end of the second year correlates well with performance on licensing examinations, it is not an early enough screening measure to identify and intervene with students at risk of failing the COMLEX–USA level 1. National licensing examination scores have also been correlated to student performance in individual courses and subject areas. Holtman et al, 7 comparing student performance on individual basic science subject tests to scores obtained by first-time takers of the USMLE step 1 in 2000, demonstrated a correlation of .59 to .71 for the various subject areas; the two subjects with the strongest correlation were pathology (.71) and pharmacology (.70). Baker et al 6 demonstrated correlations for various courses, ranging from medical terminology (Ϫ.06) to pharmacology (.63). The National Board of Osteopathic Medical Examiners has developed and administers the COMLEX–USA, an examination series with three levels " designed to assess the osteo-pathic medical knowledge considered essential for osteo-pathic generalist physicians to practice medicine without supervision. " 8 Each level of the COMLEX–USA assesses knowledge that corresponds to the educational experiences of the test candidate. The COMLEX–USA level 1 emphasizes the scientific understanding of the mechanisms of medical problems and disease processes. The COMLEX–USA level 2 emphasizes medical diagnosis, focusing on the medical history and physical examination of patients. The COMLEX–USA level 3 emphasizes the management of patient problems. 8 The COMLEX–USA level 1, a …