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Extra time on MCATs linked to lower odds of passing USMLE Step Exam

Students who were given extra test administration time on their MCATs were less likely to pass the USMLE Step exam on the first attempt and less likely to graduate from medical school within 4 to 8 years after matriculation compared with students who took MCATs within the standard test time.

“Mean MCAT scores and rates of acceptance to medical school were not significantly different for applicants who had MCAT scores obtained with standard vs. extra time, yet students who tested with extra time performed less well on the USMLE Step examinations and graduated at significantly lower rates at various times,” the researchers wrote.

Extra test administration time is an accommodation often provided to individuals with documented mental or physical disabilities, according to the study.

To assess the correlation between length of time for MCAT exams and medical school acceptance and performance, researchers conducted a retrospective cohort study of applicants to U.S. medical schools between 2011 and 2013, and of students who matriculated in U.S. medical schools between 2000 and 2004.

Among students who took the MCAT with additional time, 29.9% tested with 25% extra time, 54.3% tested with 50% more time and 8.7% tested with 100% more time. Most students (77.5%), had mental impairments, 14% had physical impairments and 6.2% had both.

No significant association was found between acceptance to medical school and length of time on the MCAT exam.

Students who were allotted extra time for the MCAT were less likely to pass the USMLE Step exams on the first attempt compared with students who took the MCAT in the standard time length (Step 1, 82.1% vs 94%; Step 2 CK, 85.5% vs 95.4%; Step 2 CS, 92% vs 97%).

Additionally, medical school graduation rates and length of time to complete schooling varied significantly between standard-time and extra-time students, with the extra-time students graduating at much lower rates. Four years after matriculation, 86.1% of standard-time students graduated compared with 67.2% of extra-time students (P < .001). After 8 years, 96.5% of standard-time students graduated compared with only 88.4% of extra-time students. 

“The poorer performance on the USMLE Step examinations, and the longer time needed to graduate from medical school for individuals who have received extra testing time on the MCAT, also suggest that medical schools should examine their learning environments and support systems for individuals with disabilities. Medical school educators and administrators need a better understanding of potential barriers to medical education for students with disabilities in order to develop evidence-based policies, procedures and resources,” the researchers wrote. – by Casey Hower

Disclosure: Searcy reported no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.