The MD program at SUNY Upstate Medical University’s Norton College of Medicine begins with a Foundations course focusing on medical applications of undergraduate-level biochemistry, cell biology, genetics, molecular biology, bacteriology, virology, and immunology. Students with less or less-recent academic preparation often find it difficult to keep pace with their peers.

Seeking to help these students, we created the MedReady Checkup — a pre-matriculation self-assessment with 35 multiple-choice questions, covering each of the seven content areas above with five questions per area. Students who answer fewer than four questions correctly in a section are prompted to review faculty-curated resources before the course begins. They also receive contact information for our primary instructor in each content area.

For the 2023–2024 academic year, completing the MedReady Checkup was a required Orientation activity. Data showed that performance on the immunology section was significantly correlated with overall student performance not only in the Foundations course but throughout the pre-clerkship curriculum. Furthermore, immunology scores were significantly associated with Step 1 outcomes. Students who needed Step 1 delays had lower Checkup immunology scores than students who passed Step 1 on time.

We administered the MedReady Checkup again in 2024-2025. Subsequent student performance demonstrated a strong, statistically significant correlation between MedReady scores and performance in the Foundations course and later organ system courses. A linear regression analysis identified microbiology and molecular biology as the most predictive domains for future performance.

Prompt and successful completion of the Phase 1 curriculum and Step 1 exam are critical developmental milestones for medical students. As such, it is in our and every medical school’s best interest to identify at-risk students early in their career. The MedReady assessment is capable of doing just that.