Two perspectives on the effects of a curriculum change: student experience and the United States medical licensing examination, step 1.

BACKGROUND Students' perceptions of curricular experience and study effort were compared for a traditional and a new integrative, interdisciplinary curriculum at a single institution. United States Medical Licensing Exam (USMLE) Step 1 scores were examined for subgroup interactions. METHOD Medical students from four cohorts completed an educational goals survey and USMLE Step 1. Analysis included subgroup performance based on admissions data. RESULTS Students rated the new curriculum as more helpful in achieving educational goals. USMLE Step 1 was significantly higher for students in the lowest quartile of MCAT scores in the new compared with the previous curriculum. CONCLUSIONS To understand the outcomes of a large-scale curricular intervention, interactions of curriculum and aptitude should be examined.