Examining the Relationship between Performance on Pre-Clerkship Exam Metrics and Interrupted Academic Progress

Abstract This retrospective study examines the relationship between performance on pre-clerkship exam metrics and interrupted academic progress (IAP) within the context of a pass/fail grading system and pass/fail Step 1 scoring. For this study, IAP refers to a disruption in the expected transition from the pre-clerkship phase to clinical clerkships, characterized by failure to meet Comprehensive Basic Science Exam (CBSE) and/or Step 1 milestones on schedule or a delay in starting clinical clerkships. Data from cohorts matriculating between 2019 and 2021 were analyzed using exam z-scores, quartile rankings, cumulative averages, cumulative deviation scores, and exam failure counts. Results indicated that students experiencing IAP had lower cumulative z-scores (≤ -1.00), more frequent bottom quartile placements, cumulative exam averages below 81%, three or more exam failures, and/or cumulative deviation scores two standard deviations below cohort means. Logistic regression confirmed these metrics as significant predictors of IAP. These findings suggest that in a pass/fail context, exam metrics remain valuable in identifying students at-risk for IAP.