• Amy J Sawhill, Gerard F Dillon, Douglas R Ripkey, Richard E Hawkins, and David B Swanson.
• National Board of Medical Examiners, Philadelphia, PA 19104, USA. asawhill@nbme.org
• Acad Med. 2003 Oct 1;78(10 Suppl):S10-2.

PurposeThis 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).MethodSubjects 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.ResultsResults 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.ConclusionsStudy 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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