USMLE-Rx Predicts USMLE Step 1 Performance

Rationale: Medical students have few validated predictors of USMLE performance. We hypothesized that USMLE-Rx Step 1 Qmax could predict USMLE Step 1 performance.

Methods: In this prospective cohort study, 26 U.S. medical students who used USMLE-Rx for USMLE preparation completed baseline questionnaires regarding their performance on USMLE-Rx, Kaplan Qbank, and the Medical College Admissions Test (MCAT). All questionnaires were completed within one week of participants taking their USMLE examination. Participants subsequently reported their 3-digit USMLE Step 1 scores when they became available. Spearman’s rho and single linear regression modeling were used to assess associations between variables.

Results: See table below. Participants had higher than average scores for the USMLE Step 1, MCAT, and USMLE-Rx. USMLE-Rx scores strongly correlated with USMLE scores. Kaplan and MCAT scores had moderate correlation. In single linear regression modeling, USMLE-Rx, Kaplan Qbank, and MCAT scores were highly significant predictors of USMLE performance with high T-scores. USMLE-Rx scores were able to account almost 80% of the variance in USMLE scores.


Mean score (SD)

Correlation (Rho)



Variance (R2)


68.9 ±7.7












31.7 ±0.5





USMLE (3-digit)

234.7 ±19.8


Conclusions: USMLE-Rx, Kaplan, and MCAT scores appear to be significant predictors of USMLE performance. In this sample, USMLE-Rx was highly correlated with the USMLE Step 1 performance and was able to predict approximately 80% of the variation in USMLE scores.

You can also use the following formula:
USMLE-Rx(%)*2.64 + 47 = USMLE 3-digit score (+/- 20 for the 95% CI)


9 thoughts on “USMLE-Rx Predicts USMLE Step 1 Performance”

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