Evaluating the impact of pass/fail United States Medical Licensing Examination Step 1 scoring on pathology residency selection

Fujihashi, Ayaka; Yang, Lydia C; Haynes, W.B.; Patel, Om U; Burge, Kaitlin; Yadav, Ishant; Wagoner, Nicholas Van; McCleskey, Brandi

doi:10.1016/j.acpath.2023.100083

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…Future studies after the 2024 NRMP application cycle will be able to further elucidate what programs look for in ENT applicants. We also acknowledge that this study focuses on ENT programs specifically and that the transition to P/F impacts each specialty differently [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

A Survey of Otolaryngology Residency Programs on Adapting to the United States Medical Licensing Examination (USMLE) Step 1 Transitioning to Pass/Fail

Yang,

Bonner,

Patel

et al. 2023

Cureus

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In February 2020, the National Board of Medical Examiners (NBME) announced that the United States Medical Licensing Examination (USMLE) Step 1 licensing examination would change from a numerical score to Pass/Fail (P/F). After implementation, many believe that USMLE-Step 2-Clinical Knowledge (CK) will become an important metric for students applying to otolaryngology (ENT). The purpose of this study is to determine factors important to resident selection after these changes. MethodsA survey containing 15 questions related to resident selection practices and how changing USMLE Step 1 to P/F would impact future resident selection was designed. It was distributed to all ENT residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). ResultsForty percent of programs responded; 66% (95% confidence interval (CI): 51.1%-78.4%) felt that changing Step 1 scoring would not lead to students being more prepared for clinical rotations; 55% believe class rank will increase in significance (95% CI: 35.7%-64.3%). There was also an increase in the importance of Step 2 CK, which had a mean ranking of 10.67 prior to changes in Step 1 scoring and increased to 7.80 after P/F. ConclusionsThe changes in Step 1 scoring will likely lead to increasing importance of other objective measures like class rank or Step 2 CK. This may defeat the intended purpose put forth by the NBME. Therefore, further guidance on measures correlated with student performance as a resident will be integral to the selection process.

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Section: Discussionmentioning

confidence: 99%

A Survey of Otolaryngology Residency Programs on Adapting to the United States Medical Licensing Examination (USMLE) Step 1 Transitioning to Pass/Fail

Yang,

Bonner,

Patel

et al. 2023

Cureus

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“…After the initial search, 351 duplicates were removed and 44 were excluded after title and abstract review, 4,[7][8][9][10][11][12][13][14][15] based on inclusion and exclusion criteria. [16][17][18][19][20][21][22][23][24][25] Full-text review was performed on 98 articles, [26][27][28][29][30][31][32][33][34][35] of which 45 studies were included [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] (see Figure, Supplemental Digital Content 5, which illustrates a flow-chart of our literature search, as well as our full search strategies).…”

Section: Study Selectionmentioning

confidence: 99%

Perceptions and Expectations Regarding the Step 1 Score Change Among Surgical and Non-Surgical Program Directors: A Systematic Review and Meta-Analysis

Srinivasan,

Samaan,

Premkumar

et al. 2024

The American Surgeon™

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There are currently no studies examining differences in perceptions and expected impact of the Step 1 score change to pass/fail between surgical and non-surgical program directors (PDs). We conducted a systematic review in May 2023 of PubMed, Scopus, Web of Science, and PSYCInfo to evaluate studies examining PDs’ perspectives regarding the Step 1 score change. We performed random-effects meta-analyses to determine differences in perspectives among surgical and non-surgical PDs. Surgical PDs (76.8% [95% CI, 72.1%-82.0%], I2 = 52%) reported significantly greater rates of disagreement with the score change compared to non-surgical (65.1% [95% CI, 57.9%-73.1%], I2 = 69.7%) ( P = .01). Surgical PDs also reported significantly greater rates of agreement that the score change will increase the difficulty in objectively comparing applicants (88.1% [95% CI, 84.6%-91.7%], I2 = 16.4%), compared to non-surgical (81.0% [95% CI, 75.6%-86.8%], I2 = 72.6%) ( P = .04). There was less heterogeneity among non-surgical PDs (88.7% [95% CI, 86.2%-91.2%], I2 = 0%), compared to surgical (84.7% [95% CI, 79.0%-90.8%], I2 = 67.3%), regarding expected increases in emphasis on Step 2, although the difference in rates of agreement was not statistically significant. Overall, there is significant heterogeneity in the literature regarding expected changes in the residency application review process. Most PDs reported significant disagreement with the score change, greater expected difficulty in objectively evaluating applicants, and greater emphasis on Step 2, with surgical PDs reporting greater rates of disagreement, greater expected difficulty, and heterogeneity regarding expected increases in emphasis on Step 2, compared to non-surgical. Additionally, there is significant heterogeneity in the overall literature regarding expected changes in the residency application review process. Further research is needed to establish evidence-based guidelines that improve the overall residency application process for all stakeholders.

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“…However, this changed when Step 1 transitioned from a three-digit score to a pass/fail system in January 2022, aiming to alleviate the burden of exam preparation for medical students and foster a more holistic residency application process [ 5 ]. While some view this change positively, others question whether the pressure now shifts to achieving a competitive Step 2 CK score [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Correlation Between International Medical Graduates’ Self-Study Habits and Their United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) Scores

Garcia,

Navalgund

2024

Cureus

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Introduction: To secure a residency in the United States, medical students must pass the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 CK exams. This study examines the correlation between international medical graduates’ (IMGs) self-study habits and their USMLE scores. Materials and methods: A retrospective study was conducted with 51 anonymous third- and fourth-year IMGs from Saint James Medical School, IL, United States. Participants completed an online survey about their study habits and USMLE Step 1 and Step 2 CK scores. All participants were undergoing clinical clerkships at South Texas Health Hospitals in McAllen, TX. Results: The highest mean Step 1 scores were 211.3 for completing ≥7,000 questions, 222.2 for 91-120 days of study, 209.2 for 76-100% time on practice questions, 229.7 for 16-19 hours/day of study, and 228.0 for 51-75% group study. The highest mean Step 2 CK scores were 241.0 for completing ≥6,000 questions, 239.8 for <30 days of study, 238.8 for 76-100% time on practice questions, 239.0 for 16-19 hours/day of study, and 237.5 for 26-50% group study. No significant relationship was found between study habits and passing Step 1 scores (p>0.05), but moderate correlations were found for completing ≥4,000 questions and 61-90 days of study. No significant relationship was found between study habits and the national average Step 2 CK score, but a strong correlation was found for 25-50% time on practice questions. Conclusion: While some study habits correlate with higher scores, no significant relationship was found between specific study habits and passing Step 1 or achieving the national average Step 2 CK score.

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Evaluating the impact of pass/fail United States Medical Licensing Examination Step 1 scoring on pathology residency selection

Cited by 7 publications

References 9 publications

A Survey of Otolaryngology Residency Programs on Adapting to the United States Medical Licensing Examination (USMLE) Step 1 Transitioning to Pass/Fail

A Survey of Otolaryngology Residency Programs on Adapting to the United States Medical Licensing Examination (USMLE) Step 1 Transitioning to Pass/Fail

Perceptions and Expectations Regarding the Step 1 Score Change Among Surgical and Non-Surgical Program Directors: A Systematic Review and Meta-Analysis

The Correlation Between International Medical Graduates’ Self-Study Habits and Their United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) Scores

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