Presented By: Kaitlyn Novotny, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas
Co-Authors: Daniel Levine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas
Dale Netski, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas
Edward Simanton, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas

Purpose 
Shifting to pass/fail scoring for Step 1 prompts reevaluation of clerkships and Step 2 preparation as its significance has overtaken Step 1 for residency placement. Clerkships following the Traditional Block Rotation model are being replaced by Longitudinal Integrated Clerkships and Longitudinal Interleaved Clerkships (LInC) to enhance student's hands-on learning. The growth in longitudinal popularity sparks concern for the equity of success for various demographics as there is minimal research regarding LInC students' USMLE performance. Our study aims to uncover if LInCs provide equitable medical education for several demographic groups in medical school. 

Methods 
This study evaluated student's Step 1 and Step 2 scores as well as their self-identified demographic information prior to the change in Step 1 grading at Kirk Kerkorian School of Medicine. 145 students from 3 cohorts were categorized as Underrepresented in Medicine, Gender, Disadvantage, First Generation, Low SES, Low MCAT, and Low Step 1 Performance. Each group's mean Step 1 and mean Step 2 scores were calculated, and binary T-tests were performed using a p-value of 0.05. 

Results 
Analysis revealed significant score improvements between USMLE Step 1 and Step 2 for the following groups: Females, students with Low SES, and students who originally received lower Step 1 scores. 

Conclusion 
Upon completion of the LInC model, females, students with low SES, and students who initially scored low on Step 1 all experienced a significant improvement on Step 2. This study underscores the significance of considering demographics when designing clerkship models and has important implications for schools navigating the USMLE exam process. Further exploration should determine if these improvements stem from the experience of the LInC model or its associated testing schedule. Such insights, alongside our findings, could impact medical school's curriculum decisions to facilitate equitable student success.