What predicts USMLE step 3 performance?

Background: Academic and other student-specific variables associated with United States Medical Licensing Examination (USMLE) Step 3 performance have not been fully defined. Method: We analyzed Step 3 scores in association with medical school academic-performance measures, gender, residency specialty, and first postgraduate year (PGY-I) of training program-director performance evaluations. Results: There were significant first-order associations between Step 3 scores and each of USMLE Step 1 and Step 2 scores, third-year clerkships' grade point average (GPA), Alpha Omega Alpha election, Medical Scientist Training Program graduation, broad-based specialty residency training, and PGY-I performance evaluation score. In a multiple linear regression model accounting for over 50% of the total variance in Step 3 scores, Step 2 scores, broad-based-specialty residency training, and GPA independently predicted Step 3 scores. Conclusions: Individualized Step 3 scores provide medical schools with additional means to externally validate their educational programs and to enhance the scope of outcomes assessments for their graduates.