Correlation of NBME Pharmacology Subject Exam Performance with Medical School Internal Pharmacology Scores and Academic Metrics

Background This study evaluates the extent to which the National Board of Medical Examiners (NBME) Pharmacology Subject Examination scores correlate with medical school pharmacology internal exam scores and other academic metrics such as undergraduate grade point average (GPA), and Biology, Chemistry, Physics, and Mathematics GPA (BCPM), and Medical College Admission Test (MCAT) scores. This study also aimed at curricular assessment of pharmacology in relation to pharmacology internal exam score with NBME Pharmacology subject exam performance. Methods Data from 290 medical students graduating between 2019 and 2023 were analyzed using R (version 4.3.1). Pearson correlation coefficients were calculated to examine the strength of associations between NBME scores and internal exam scores, GPA, BCPM, and MCAT. A stepwise multiple linear regression model was developed to determine which predictors best explained NBME score variance. Multicollinearity was evaluated using variance inflation factor (VIF) analysis. Results A strong positive correlation was found between NBME Pharmacology scores and internal pharmacology exam scores (r = 0.69, p < 0.001). MCAT scores showed a moderate correlation (r = 0.45, p < 0.001), while GPA and BCPM were weak but statistically significant predictors (r = 0.18 each, p < 0.01). Multiple regression analysis identified internal pharmacology exam score (β = 0.6, p < 0.001) and MCAT (β = 0.3, p < 0.001) as significant predictors, with an adjusted R² of 0.54. VIF scores were ≤ 2.1. Conclusions Performance on the NBME Pharmacology Subject Exam showed a strong correlation with internal pharmacology exam scores and a moderate correlation with MCAT scores. These findings underscore the value of aligning the pharmacology curriculum with the NBME content framework to ensure that internal assessments more accurately reflect and predict students’ pharmacological knowledge and, to some extent, their overall academic performance. Moreover, the observed relationship between MCAT scores and medical school performance indicates that MCAT results may remain a meaningful predictor of future academic success and could help guide admissions decisions and recruitment strategies. In contrast, pre-admission metrics such as GPA and BCPM appear to offer limited predictive value for subsequent success in medical school.