These authors found that for each point increase in the MCAT science score, there was a 4.26-point increase in the Step 1 score. performed a retrospective study on 6,239 students entering medical school over 30 years and correlated MCAT scores, undergraduate GPA, age, and sex to performance on the Step 1 examination. He found that there was an overall pattern of better academic performance associated with higher MCAT scores, in all sections of the exam. He found that the contribution of undergraduate GPA to performance on Step 1 was overtaken by performance on the MCAT, and thus MCAT scores could be used as a surrogate measure of undergraduate performance. In fact, Julian performed a prospective study of two cohorts of medical school classes to examine the use of undergraduate grade point average (GPA) and MCAT to predict performance in medical school and beyond. A surrogate measurement for prior scientific knowledge may be performance on the Medical College Admission Test (MCAT), particularly on the biological and physical sciences sections. Whether or not the student had a science background before attending medical school may influence their understanding of certain concepts. Outside of study resources, other variables may also play significant roles in exam performance. These question banksĀ in combination with practice exam materials such as the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE), often give students an approximate idea of their level of knowledge and how much preparation is still required. Most students also utilize question banks such as UWorld Question Bank (UWorld) or Kaplan QBank to familiarize themselves with USMLE-style questions and content. In their preparation, many students use specific study aids such as First Aid for the USMLE Step 1 and Pathoma, which offer rapid review and exposure to relevant content that may appear on the exam. Naturally, study habits and ability are unique to each individual but one can attempt to observe overall patterns. In order to succeed on the USMLE Step 1 exam, students employ a wide variety of study habits and utilize an array of study resources. As such, the Step 1 exam is arguably the most pivotal assessment undertaken in medical school and thus medical students approach the exam very seriously. In fact, in the 2014 National Resident Matching Program Director Survey, 94% of the 1,793 residency programs directors spanning all medical specialties cited Step 1 scores as an important factor with a rating of 4.1 out of 5, and it was cited more than any other factor in the survey. Because studies have found that higher USMLE scores are associated with improved faculty evaluations and first-time board pass rates, it is held in extremely high regard by residency programs nationwide and can affect placement into competitive residencies. The United States Medical Licensing Examination (USMLE) Step 1 exam is the first of three required exams for the practice of medicine as a physician within the United States.