Relation Between Variables of Preadmission, Medical School Performance, and COMLEX–USA Levels 1 and 2 Performance

Donna Dixon

doi:10.7556/jaoa.2004.104.8.332

Abstract

The purpose of this study was to investigate the relation between preadmission academic variables, osteopathic medical school performance in the first 2 years, and performance on the Comprehensive Osteopathic Medical Licensing Examination (COMLEX–USA) Levels 1 and 2. The study group comprised 174 students in the class of 2001 of the New York College of Osteopathic Medicine of the New York Institute of Technology, Old Westbury. Preadmission academic variables were the Medical College Admission Test (MCAT) subscores and undergraduate grade point averages (UGPAs).

Physical sciences (physical MCAT) and biological sciences MCAT (biological MCAT) subscores were significantly correlated with COMLEX–USA Level 1 performance, and verbal reasoning, physical, and biological MCAT subscores were correlated with Level 2 performance. COMLEX–USA Level 1 performance was correlated with the year 1 grade point average (GPA) (0.78) and the year 2 GPA (0.83). COMLEX–USA Level 2 performance was correlated with the year 1 GPA (0.64) and the year 2 GPA (0.68). Strong correlations existed between all year 1 and most year 2 course grades and COMLEX–USA Level 1 scores. School-specific regression models that were highly predictive of school performance and COMLEX-USA Level 1 performance were developed. COMLEX–USA Level 1 predictive models used preadmission variables combined with the year 1 and year 2 course grades. The year 2 courses' model had a higher predictive value for COMLEX–USA Level 1 performance (R² = 0.81) than the year 1 courses' model (R² = 0.77). Significant predictors of COMLEX–USA Level 1 performance in the combined year 1 and 2 courses' model were the pharmacology II, neuropathology, and pulmonary pathology grades, and the verbal and physical MCAT subscores (R² = 0.820).

Medical schools have traditionally used Medical College Admission Test (MCAT) scores and undergraduate grade point averages (UGPAs) in the selection of candidates for admission. The validity of using preadmission academic variables to predict student performance has been studied. Most studies have focused on the relation of these variables to medical licensing examination scores as performance end-points. Only a few studies have examined the relationship between preadmission variables, osteopathic medical school performance, and Comprehensive Osteopathic Medical Licensing Examination–USA (COMLEX–USA) performance, and the results were not consistent. Medical College Admission Test scores were reported to be correlated with COMLEX–USA Level 1 and Level 2 scores,^1,2 whereas another study found no significant correlations between preadmission data and COMLEX–USA Level 1 scores.³ The relation of preadmission variables to osteopathic medical school performance and COMLEX–USA scores has not been sufficiently investigated at other schools. There has also been a lack of predictive validity studies of the relation of pre-medical and medical school performance to COMLEX–USA Levels 1 and 2.

Researchers in the current study previously reported significant correlations between MCAT subscores and year 1 and year 2 GPAs and COMLEX–USA Level 1 performance at the New York College of Osteopathic Medicine of the New York Institute of Technology (NYCOM), Old Westbury.⁴ The purpose of the present study was to further examine the relation between preadmission variables and student academic performance, including year 1 and 2 GPAs, individual course grades, and COMLEX–USA Level 1 performance at NYCOM.

Research Review

Allopathic Medical Education

Preadmission academic variables were correlated with performance on the United States Medical Licensing Examination (USMLE) Step 1.^5-7 Elam and Johnson⁵ found that the biological sciences MCAT (biological MCAT) subscore was the only significant preadmission predictor of USMLE Step 1 performance. A study using data from 14 allopathic medical schools reported that total MCAT scores and undergraduate GPAs were predictors of USMLE Step 1 performance.⁶ Silver and Hodgson⁷ found that total MCAT scores and science UGPAs were related to performance on the National Board of Medical Examiners Part I (NBME I), a forerunner of the present USMLE Step 1.

Osteopathic Medical Education

Baker et al³ examined the relation between COMLEX–USA Level 1 scores, preadmission variables, and medical school performance in detail, and they found no correlations between preadmission variables and COMLEX–USA Level 1 performance. Cope et al⁸ used preadmission variables in predictive models and reported that the biological MCAT and cumulative UGPA were predictive of COMLEX–USA Level 1 scores. Moderate correlations were found between COMLEX–USA Levels 1 and 2 and total MCAT scores.^1,2

COMLEX–USA Level 1 performance was reported to be strongly correlated with the year 1 and year 2 GPAs, as was Level 2 performance.^1,3,8,9 A multisite study using data from 16 osteopathic medical schools found strong correlations between GPAs and COMLEX Level 1 scores within schools.¹⁰

Methods

The class of 2001 study group comprised 174 students (93 men and 81 women). These students completed the first 2 years of the standard NYCOM curriculum in 1999 and took the COMLEX–USA Level 1 examination in 1999 and the Level 2 examination in 2000. The database for analysis included preadmission academic variables, medical school course grades in years 1 and 2, and COMLEX–USA Level 1 and 2 scores. Individual course grades were obtained from institutional databases, and total COMLEX–USA scores were those reported by the National Board of Osteopathic Medical Examiners to the institution. Individual course grades used were those for written examinations. Grade point averages were calculated for the first year (year 1 GPA), the second year (year 2 GPA), and years 1 and 2 (2-year cumulative GPA).

Preadmission data were obtained from the American Association of Colleges of Osteopathic Medicine Application Service. The preadmission academic variables used in the analysis were MCAT subscores and UGPAs. Medical College Admission Test subscores used were verbal reasoning (verbal MCAT), physical sciences (physical MCAT), and biological MCAT. Pearson's correlation coefficients were calculated with Bonferroni adjustments. Researchers performed multiple linear regression analysis by entering all independent variables in a single step and constructed regression models to identify an optimal combination of predictors of COMLEX–USA Level 1 performance. All statistical analyses were calculated with Statistical Program for the Social Sciences (SPSS) statistical software for Windows, version 10.0.

Results

Descriptive Statistics for the Study Group

Preadmission data for the study group were mean MCAT subscores (verbal, 7.8; physical, 8.2; biological, 8.5) and mean UGPAs (science, 3.33; nonscience, 3.45; cumulative, 3.38). The study group had a mean COMLEX–USA Level 1 score of 514.87 (SD 73.90) and a mean COMLEX–USA Level 2 score of 525.87 (SD 74.12).

Relationship Between Preadmission Variables and Year GPAs

The correlations of preadmission academic variables with year 1 and 2 GPAs are shown in Table 1. The physical MCAT subscore, biological MCAT subscore, and the science and nonscience UGPA were significantly correlated with the year 1 GPA. The biological MCAT subscore, science UGPA, and nonscience UGPA were correlated with the year 2 GPA. The five preadmission variables were used in a regression model to predict the year GPAs. The physical MCAT subscore, biological MCAT subscore, and science UGPA were significant predictor variables for the year 1 GPA (R² = 0.284), and the biological MCAT subscore was a predictor for the year 2 GPA (R² = 0.157).

Table 1

Correlation of Preadmission Academic Variables With Undergraduate Grade Point Averages (UGPA) and COMLEX–USA* Scores

	MCAT
	Verbal Reasoning	Physical Sciences	Biological Sciences	Science	Non-Science
Grade point averages
Year 1	0.16	0.34†	0.40†	0.35†	0.24†
Year 2	0.17	0.18	0.26†	0.27†	0.28†
COMLEX-USA scores
Level 1	0.16	0.43†	0.44†	0.18	0.13
Level 2	0.31*	0.34†	0.34†	0.10	0.12

MCAT indicates Medical College Admission Test.

*COMLEX-USA, Comprehensive Osteopathic Medical Licensing Examination-USA.

†Correlations significant after Bonferroni adjustments, P < .05.

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Table 1

Correlation of Preadmission Academic Variables With Undergraduate Grade Point Averages (UGPA) and COMLEX–USA* Scores

	MCAT
	Verbal Reasoning	Physical Sciences	Biological Sciences	Science	Non-Science
Grade point averages
Year 1	0.16	0.34†	0.40†	0.35†	0.24†
Year 2	0.17	0.18	0.26†	0.27†	0.28†
COMLEX-USA scores
Level 1	0.16	0.43†	0.44†	0.18	0.13
Level 2	0.31*	0.34†	0.34†	0.10	0.12

MCAT indicates Medical College Admission Test.

*COMLEX-USA, Comprehensive Osteopathic Medical Licensing Examination-USA.

†Correlations significant after Bonferroni adjustments, P < .05.

Relationship Between Preadmission Variables and COMLEX–USA Performance

Physical and biological MCAT subscores were correlated with COMLEX Level 1 and the verbal, physical, and biological MCAT subscores were correlated with COMLEX Level 2 (Table 1). The science and nonscience UGPAs were not correlated. Scientists used the five preadmission variables in a regression model (Table 2) and found that the physical and biological MCAT subscores were modest predictors of COMLEX Level 1 performance (R² = 0.232). The verbal MCAT subscore was a weak predictor of COMLEX Level 2 performance (R² = 0.168).

Table 2

Prediction of COMLEX–USA* Level 1 Performance

Predictive Models	R ²	Predictor Variables	P
Preadmission variables	0.232	Physical MCAT†	.002
		Biological MCAT	.003
Year 1 and 2 GPAs and preadmission variables	0.774	Year 1 GPA‡	.000
		Year 2 GPA	.000
		Physical science MCAT	.000
Year 1 courses and preadmission variables	0.663	Physiology	.000
		Pharmacology I	.000
Year 2 courses and preadmission variables	0.807	Pharmacology II	.000
		Physical science MCAT	.000
		Neuropathology	.005
		Pulmonary pathology	.007
		Biological science MCAT	.010
Year 1 and 2 courses and preadmission variables	0.820	Physical science MCAT	.001
		Neuropathology	.002
		Verbal MCAT	.005
		Pharmacology II	.008
		Pulmonary pathology	.010

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†MCAT indicates Medical College Admission Test.

‡GPA indicates grade point average.

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Table 2

Prediction of COMLEX–USA* Level 1 Performance

Predictive Models	R ²	Predictor Variables	P
Preadmission variables	0.232	Physical MCAT†	.002
		Biological MCAT	.003
Year 1 and 2 GPAs and preadmission variables	0.774	Year 1 GPA‡	.000
		Year 2 GPA	.000
		Physical science MCAT	.000
Year 1 courses and preadmission variables	0.663	Physiology	.000
		Pharmacology I	.000
Year 2 courses and preadmission variables	0.807	Pharmacology II	.000
		Physical science MCAT	.000
		Neuropathology	.005
		Pulmonary pathology	.007
		Biological science MCAT	.010
Year 1 and 2 courses and preadmission variables	0.820	Physical science MCAT	.001
		Neuropathology	.002
		Verbal MCAT	.005
		Pharmacology II	.008
		Pulmonary pathology	.010

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†MCAT indicates Medical College Admission Test.

‡GPA indicates grade point average.

Correlation Between GPAs and COMLEX–USA Level 1 and Level 2 Performance

The correlations between medical school GPAs and COMLEX–USA scores are shown in Table 3. COMLEX–USA Level 1 scores were strongly correlated with both the year 1 and 2 GPAs. The correlations between year 1 and 2 GPAs and COMLEX–USA Level 2 scores were lower than for Level 1 scores. COMLEX–USA Level 1 performance and COMLEX–USA Level 2 performance were correlated (0.723). The year 1 and year 2 GPAs were predictors of COMLEX–USA Level 1 scores in a regression model (R² = 0.702). The addition of preadmission variables to the model with the year 1 and year 2 GPAs model (Table 2) resulted in a slightly higher R² value (0.774).

Table 3

Correlation of COMLEX–USA* Scores With Medical School Grade Point Averages for Years 1 and 2

	COMLEX-USA
Grade Point Average	Level 1	Level 2
Year 1	0.78†	0.64
Year 2	0.83	0.68
2-year cumulative	0.81	0.67

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†All correlations are significant at P < .000.

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Table 3

Correlation of COMLEX–USA* Scores With Medical School Grade Point Averages for Years 1 and 2

	COMLEX-USA
Grade Point Average	Level 1	Level 2
Year 1	0.78†	0.64
Year 2	0.83	0.68
2-year cumulative	0.81	0.67

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†All correlations are significant at P < .000.

Relationship Between Preadmission Variables, Year 1 Courses, and COMLEX–USA Level 1 Performance

First-year basic science courses included anatomy, biochemistry, general pathology, genetics, histology, microbiology, neuroscience, osteopathic principles I, pharmacology, and physiology. Most of the first-year courses were moderately correlated with only the physical and biological MCAT subscores (P<.05). Strong correlations existed between all year 1 course grades and COMLEX–USA Level 1 scores (Table 4).

Table 4

Correlations Between Year 1 Course Grades COMLEX–USA* Level 1 Scores

Year 1	Basic Science Courses
Physiology	0.750†
Pharmacology	0.685
Osteopathic principles I	0.541
Neuroscience	0.568
General pathology	0.686
Anatomy	0.646
Histology	0.505
Biochemistry	0.609
Genetics	0.460
Microbiology	0.543

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†All significant at P < .000.

View Large

Table 4

Correlations Between Year 1 Course Grades COMLEX–USA* Level 1 Scores

Year 1	Basic Science Courses
Physiology	0.750†
Pharmacology	0.685
Osteopathic principles I	0.541
Neuroscience	0.568
General pathology	0.686
Anatomy	0.646
Histology	0.505
Biochemistry	0.609
Genetics	0.460
Microbiology	0.543

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†All significant at P < .000.

Scientists used all year 1 course grades as variables in a regression analysis to predict COMLEX–USA Level 1 performance (Table 2; R² = 0.652). Physiology and pharmacology grades were predictors of COMLEX–USA Level 1 performance. The addition of preadmission variables to the year 1 courses' model resulted in a higher R² value (0.663).

Relationship Between Preadmission Variables, Year 2 Courses, and COMLEX–USA Level 1 Performance

Year 2 courses included the following pathology courses: cardiovascular, gastrointestinal, musculoskeletal, obstetric and gynecologic, pulmonary, renal, and neuropathology. The systems courses were cardiovascular, gastrointestinal, nervous, obstetrics-gynecology, renal, respiratory, and rheumatologic systems. Other specialty courses in year 2 included dermatology, endocrinology, family practice, hematology, immunology, pharmacology II, osteopathic principles II, pediatrics, psychiatry, surgery, and toxicology. When correlations between preadmission variables and individual year 2 grades were studied, the only significant correlations were between the biological MCAT subscore and cardiovascular pathology and between the verbal and physical MCAT subscores and pediatrics (P<.05).

Table 5 shows the correlations between individual year 2 course grades and COMLEX–USA Level 1 scores. All courses, except musculoskeletal pathology, family practice, and psychiatry, were significantly correlated with Level 1 (P<.05). All year 2 course grades were used in a regression model to predict COMLEX–USA Level 1 performance. Pharmacology II and pediatrics grades were found to be predictors of COMLEX–USA Level 1 performance (R² = 0.730). When preadmission variables were added to the model, the predictive variables were pharmacology II, neuropathology, pulmonary pathology, and the physical and biological MCAT subscores. The R² for this model was 0.807.

Table 5

Correlations Between Year 2 Course Grades and COMLEX–USA* Level 1 Scores

Year 2	Courses
Cardiovascular pathology	0.755†
Cardiovascular system	0.628
Gastrointestinal pathology	0.717
Gastrointestinal system	0.416
Pulmonary pathology	0.610
Respiratory system	0.381
Renal pathology	0.606
Renal system	0.415
Neurological pathology	0.630
Nervous system	0.524
Obstetric and gynecologic pathology	0.576
Obstetrics-gynecology system	0.514
Musculoskeletal pathology	0.170‡
Rheumatologic system	0.582
Pediatrics	0.618
PharmacologyII	0.744
Surgery	0.649
Osteopathic principlesII	0.500
Hematology	0.558
Immunology	0.445
Dermatology	0.493
Endocrinology	0.425
Psychiatry	0.267
Toxicology	0.340
Family practice	0.129†

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†Significant at P < .05, except as indicated.

‡Not significant.

View Large

Table 5

Correlations Between Year 2 Course Grades and COMLEX–USA* Level 1 Scores

Year 2	Courses
Cardiovascular pathology	0.755†
Cardiovascular system	0.628
Gastrointestinal pathology	0.717
Gastrointestinal system	0.416
Pulmonary pathology	0.610
Respiratory system	0.381
Renal pathology	0.606
Renal system	0.415
Neurological pathology	0.630
Nervous system	0.524
Obstetric and gynecologic pathology	0.576
Obstetrics-gynecology system	0.514
Musculoskeletal pathology	0.170‡
Rheumatologic system	0.582
Pediatrics	0.618
PharmacologyII	0.744
Surgery	0.649
Osteopathic principlesII	0.500
Hematology	0.558
Immunology	0.445
Dermatology	0.493
Endocrinology	0.425
Psychiatry	0.267
Toxicology	0.340
Family practice	0.129†

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†Significant at P < .05, except as indicated.

‡Not significant.

When all year 1 and 2 course grades were used in a predictive model for COMLEX–USA Level 1, physiology, pharmacology II, and neuropathology were significant variables (R² = 0.771). When preadmission variables were added to the model, the significant predictors were pharmacology II, neuropathology, pulmonary pathology, and the verbal and physical MCAT subscores (R² = 0.820) (Table 2).

Comment

This study has demonstrated significant correlations between academic preadmission variables, osteopathic medical school performance in the first 2 years, and COMLEX–USA Level 1 and 2 scores. The physical and biological MCAT subscores were correlated with both year 1 and 2 osteopathic medical school GPAs. Regression models identified the physical and biological MCAT subscores as predictor variables for COMLEX–USA Level 1 and the verbal MCAT subscore as a predictor for COMLEX–USA Level 2. Most previous studies have used composite MCAT scores (sum of the individual subscores) as a variable. Researchers reporting on the predictive validity of MCAT scores noted that the use of MCAT composite scores limits its use as a predictor and recommended that future studies investigate the differential validities of subscores.¹¹ The use of MCAT subscores in the present study was more informative. While the preadmission variables alone were not highly predictive of either COMLEX–USA Level 1 or 2 performance, together with other performance measures preadmission variables improved the total predictive validity.

Only the physical and biological MCAT subscores were moderately correlated with first-year grades. Individual course grades in the first 2 years were strongly correlated to COMLEX–USA Level 1 scores with the exception of a few year 2 courses. Although many of the correlations between course grades and COMLEX–USA Level 1 are similar to some previously reported,³ differences among school courses make data comparisons between individual schools difficult to interpret.

Individual year 1 and 2 course grades with preadmission variables were used in predictive models of COMLEX–USA Level 1 scores. In all the models tested, the addition of preadmission variables raised the predictive value. The year 2 courses' model had a higher predictive validity than the year 1 model. The combined model, using all year 1 and 2 course grades and preadmission variables, had a higher predictive validity than the cumulative year 1 and 2 GPAs model. The predictive value of these models is higher than previously reported Level 1 models.⁸ The higher values found for COMLEX–USA Level 1 predictive models at NYCOM may be due to greater class heterogeneity and larger class size. More detailed studies of data from other NYCOM classes are needed to further confirm the predictive value of the COMLEX–USA Level 1 predictive models. A factor that might improve the predictive value of the preadmission variables would be the use of an undergraduate school selectivity index.

This study has identified many academic performance variables that predict both year 1 and 2 GPAs and COMLEX–USA Level 1 performance. These findings may be useful in predicting future performance of NYCOM students on Level 1 examinations. Further research is needed to determine the relationships between these variables, performance in the third and fourth years, and performance on COMLEX–USA Levels 2 and 3.

The author thanks Arnold L. Nagler, PhD, (NYCOM) for his support and Larry R. Stepp, PhD (also of NYCOM), for his helpful comments on this manuscript.

1

Meoli FG, Wallace WS, Kaiser-Smith J, Shen L. Relationship of osteopathic medical licensure examinations with undergraduate admission measures and predictive value of identifying future performance in osteopathic principles and practice/osteopathic manipulative medicine courses and rotations. J Am Osteopath Assoc. 2002;102:615-620.

2

Evans P, Goodson LB, Schoffman SI. Relationship between academic achievement and student performance on the Comprehensive Osteopathic Medical Licensing Examination–USA Level 2. J Am Osteopath Assoc. 2003;103:331-336.

3

Baker HH, Cope MK, Fisk R, Gorby JN, Foster RW. Relationship of preadmission variables and first- and second-year course performance to performance on the National Board of Osteopathic Medical Examiners' COMLEX–USA Level 1 Examination. J Am Osteopath Assoc. 2000;100:153-161.

4

Dixon D. Correlation of preadmission variables with medical school performance and level 1 COMLEX–USA scores [abstract]. J Am Osteopath Assoc. 2002;102:510 .

5

Elam CL, Johnson MM. NBME Part 1 versus USMLE Step1: predicting scores based on preadmission and medical school performances. Acad Med. 1994;69:155 .

6

Wiley A, Koenig JA. The validity of the Medical College Admission Test for predicting performance in the first two years of medical school. Acad Med. 1996;71(10 Suppl):S83-S85.

7

Silver B, Hodgson CS. Evaluating GPAs and MCAT scores as predictors of NBME I and clerkship performances based on students' data from one undergraduate institution. Acad Med. 1997;72:394-396.

8

Cope MK, Baker HH, Fisk R, Gorby JN, Foster RW. Prediction of student performance on the Comprehensive Osteopathic Medical Licensing Examination Level 1 based on admission data and course performance. J Am Osteopath Assoc. 2001;101:84-90.

9

Hartman SE, Bates BP, Sprafka SA. Correlation of scores for the Comprehensive Osteopathic Medical Licensing Examination with osteopathic medical school grades. J Am Osteopath Assoc. 2001;101:347-349.

10

Baker HH, Foster RW, Bates BP, Cope MK, McWilliams TE, Musser A, et al. Relationship between academic achievement and COMLEX–USA Level 1 performance: a multisite study. J Am Osteopath Assoc. 2000;100:238-242.

11

Koenig JA, Sireci SG, Wiley A. Evaluating the predictive validity of MCAT scores across diverse applicant groups. Acad Med. 1998;73:1095-1106.

Table 1

Correlation of Preadmission Academic Variables With Undergraduate Grade Point Averages (UGPA) and COMLEX–USA* Scores

	MCAT
	Verbal Reasoning	Physical Sciences	Biological Sciences	Science	Non-Science
Grade point averages
Year 1	0.16	0.34†	0.40†	0.35†	0.24†
Year 2	0.17	0.18	0.26†	0.27†	0.28†
COMLEX-USA scores
Level 1	0.16	0.43†	0.44†	0.18	0.13
Level 2	0.31*	0.34†	0.34†	0.10	0.12

MCAT indicates Medical College Admission Test.

*COMLEX-USA, Comprehensive Osteopathic Medical Licensing Examination-USA.

†Correlations significant after Bonferroni adjustments, P < .05.

View Large

Table 1

Correlation of Preadmission Academic Variables With Undergraduate Grade Point Averages (UGPA) and COMLEX–USA* Scores

	MCAT
	Verbal Reasoning	Physical Sciences	Biological Sciences	Science	Non-Science
Grade point averages
Year 1	0.16	0.34†	0.40†	0.35†	0.24†
Year 2	0.17	0.18	0.26†	0.27†	0.28†
COMLEX-USA scores
Level 1	0.16	0.43†	0.44†	0.18	0.13
Level 2	0.31*	0.34†	0.34†	0.10	0.12

MCAT indicates Medical College Admission Test.

*COMLEX-USA, Comprehensive Osteopathic Medical Licensing Examination-USA.

†Correlations significant after Bonferroni adjustments, P < .05.

Table 2

Prediction of COMLEX–USA* Level 1 Performance

Predictive Models	R ²	Predictor Variables	P
Preadmission variables	0.232	Physical MCAT†	.002
		Biological MCAT	.003
Year 1 and 2 GPAs and preadmission variables	0.774	Year 1 GPA‡	.000
		Year 2 GPA	.000
		Physical science MCAT	.000
Year 1 courses and preadmission variables	0.663	Physiology	.000
		Pharmacology I	.000
Year 2 courses and preadmission variables	0.807	Pharmacology II	.000
		Physical science MCAT	.000
		Neuropathology	.005
		Pulmonary pathology	.007
		Biological science MCAT	.010
Year 1 and 2 courses and preadmission variables	0.820	Physical science MCAT	.001
		Neuropathology	.002
		Verbal MCAT	.005
		Pharmacology II	.008
		Pulmonary pathology	.010

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†MCAT indicates Medical College Admission Test.

‡GPA indicates grade point average.

View Large

Table 2

Prediction of COMLEX–USA* Level 1 Performance

Predictive Models	R ²	Predictor Variables	P
Preadmission variables	0.232	Physical MCAT†	.002
		Biological MCAT	.003
Year 1 and 2 GPAs and preadmission variables	0.774	Year 1 GPA‡	.000
		Year 2 GPA	.000
		Physical science MCAT	.000
Year 1 courses and preadmission variables	0.663	Physiology	.000
		Pharmacology I	.000
Year 2 courses and preadmission variables	0.807	Pharmacology II	.000
		Physical science MCAT	.000
		Neuropathology	.005
		Pulmonary pathology	.007
		Biological science MCAT	.010
Year 1 and 2 courses and preadmission variables	0.820	Physical science MCAT	.001
		Neuropathology	.002
		Verbal MCAT	.005
		Pharmacology II	.008
		Pulmonary pathology	.010

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†MCAT indicates Medical College Admission Test.

‡GPA indicates grade point average.

Table 3

Correlation of COMLEX–USA* Scores With Medical School Grade Point Averages for Years 1 and 2

	COMLEX-USA
Grade Point Average	Level 1	Level 2
Year 1	0.78†	0.64
Year 2	0.83	0.68
2-year cumulative	0.81	0.67

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†All correlations are significant at P < .000.

View Large

Table 3

Correlation of COMLEX–USA* Scores With Medical School Grade Point Averages for Years 1 and 2

	COMLEX-USA
Grade Point Average	Level 1	Level 2
Year 1	0.78†	0.64
Year 2	0.83	0.68
2-year cumulative	0.81	0.67

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†All correlations are significant at P < .000.

Table 4

Correlations Between Year 1 Course Grades COMLEX–USA* Level 1 Scores

Year 1	Basic Science Courses
Physiology	0.750†
Pharmacology	0.685
Osteopathic principles I	0.541
Neuroscience	0.568
General pathology	0.686
Anatomy	0.646
Histology	0.505
Biochemistry	0.609
Genetics	0.460
Microbiology	0.543

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†All significant at P < .000.

View Large

Table 4

Correlations Between Year 1 Course Grades COMLEX–USA* Level 1 Scores

Year 1	Basic Science Courses
Physiology	0.750†
Pharmacology	0.685
Osteopathic principles I	0.541
Neuroscience	0.568
General pathology	0.686
Anatomy	0.646
Histology	0.505
Biochemistry	0.609
Genetics	0.460
Microbiology	0.543

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†All significant at P < .000.

Table 5

Correlations Between Year 2 Course Grades and COMLEX–USA* Level 1 Scores

Year 2	Courses
Cardiovascular pathology	0.755†
Cardiovascular system	0.628
Gastrointestinal pathology	0.717
Gastrointestinal system	0.416
Pulmonary pathology	0.610
Respiratory system	0.381
Renal pathology	0.606
Renal system	0.415
Neurological pathology	0.630
Nervous system	0.524
Obstetric and gynecologic pathology	0.576
Obstetrics-gynecology system	0.514
Musculoskeletal pathology	0.170‡
Rheumatologic system	0.582
Pediatrics	0.618
PharmacologyII	0.744
Surgery	0.649
Osteopathic principlesII	0.500
Hematology	0.558
Immunology	0.445
Dermatology	0.493
Endocrinology	0.425
Psychiatry	0.267
Toxicology	0.340
Family practice	0.129†

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†Significant at P < .05, except as indicated.

‡Not significant.

View Large

Table 5

Correlations Between Year 2 Course Grades and COMLEX–USA* Level 1 Scores

Year 2	Courses
Cardiovascular pathology	0.755†
Cardiovascular system	0.628
Gastrointestinal pathology	0.717
Gastrointestinal system	0.416
Pulmonary pathology	0.610
Respiratory system	0.381
Renal pathology	0.606
Renal system	0.415
Neurological pathology	0.630
Nervous system	0.524
Obstetric and gynecologic pathology	0.576
Obstetrics-gynecology system	0.514
Musculoskeletal pathology	0.170‡
Rheumatologic system	0.582
Pediatrics	0.618
PharmacologyII	0.744
Surgery	0.649
Osteopathic principlesII	0.500
Hematology	0.558
Immunology	0.445
Dermatology	0.493
Endocrinology	0.425
Psychiatry	0.267
Toxicology	0.340
Family practice	0.129†

*COMLEX-USA indicates Comprehensive Osteopathic Medical Licensing Examination-USA.

†Significant at P < .05, except as indicated.

‡Not significant.

Relation Between Variables of Preadmission, Medical School Performance, and COMLEX–USA Levels 1 and 2 Performance

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