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In Reply We concur with Mr Barbieri regarding the importance of assessment being relevant to the profession for which the assessment is being used to judge competence. This is one principle of good test development. Initially one defines what is being measured; Step 1 assesses understanding and ability to apply important concepts of the sciences basic to the practice of medicine.1
Haist SA, Katsufrakis PJ, Dillon GF. Basic Science Content in the USMLE Step 1—Reply. JAMA. 2014;311(13):1359-1360. doi:10.1001/jama.2014.1186