Predictive Validity of Preclerkship Performance Metrics on USMLE Step 2 CK Outcomes in the Step 1 Pass/Fail Era

Preclinical NBME exam performance emerged as the strongest predictor of Step 2 CK success in our cohort, with MCAT and CBSE scores offering additional, though less robust, predictive value. These findings highlight the importance of early academic guidance to optimize residency preparedness and provide actionable insights for students assessing their readiness within the new Step 1 pass/fail framework. Further multi-institutional research is warranted to validate and generalize these results.