Implications of Pass/Fail Step 1 Scoring: Plastic Surgery Program Director and Applicant Perspective

Abstract

Background: As early as 2022, United States Medical Licensing Examination Step 1 results will be reported as pass or fail, rather than as 3-digit numeric scores. This survey examines the perspectives of plastic surgery applicants and program directors (PD) regarding this score reporting change. Methods: A 24-item survey was distributed to integrated applicants from the 2018–19 and 2019–20 application cycles. An analogous 28-item survey was sent to integrated and independent plastic surgery training program directors. Data were analyzed using summary tables and marginal homogeneity tests. Results: 164 applicants (33.2%) and 64 PDs (62.1%) completed the survey. Most applicants (60.3%) and PDs (81.0%) were not in favor of the score reporting change. As a result of binary scoring, a majority of respondents anticipate that residency programs will use Step 2 CK scores to screen applicants (applicants: 95.7%, PDs: 82.8%), prioritize students from more prestigious medical schools (applicants: 91.5%, PDs: 52.4%), and that dedicated research time will become more important (applicants: 87.9%, PDs: 45.3%). Most applicants (66.4%) and PDs (53.1%) believe that there will be an increase in plastic surgery applicants. Applicants and PDs anticipate that the top 3 metrics used by programs when deciding to offer an interview will change as a result of binary Step 1 scoring. Conclusions: Most plastic surgery applicants and PDs do not support the change in United States Medical Licensing Examination Step 1 scoring to pass or fail. The majority believe that other metrics (such as Step 2 CK scores, research experience, and medical school reputation) will become more important in the application process.

A comparison of orthopaedic surgery and internal medicine perceptions of USMLE Step 1 pass/fail scoring

“…The aim of this study was to compare the perceptions among program directors (PDs) in orthopaedics and IM on the change of Step 1 from a graded to a pass/fail exam, and its impact on the residency application process. Some groups have studied PD opinions of the Step 1 pass/fail change; however, to the best of our knowledge, the current study is the first comprehensive survey to directly compare the impact on medicine and a surgical subspecialty [4][5][6][7][8][9][10][11][12]. We chose to study IM PDs because IM has historically been a popular specialty that has had the most number of total applicants.…”

Matching into Plastic Surgery: Insights into the Data

“…Cutoff scores on USMLE Step 1 have been described in the literature, ranging from scores of 190–245+. 22 , 23 However, with the transition of W to a pass/fail system, Step 2 Clinical Knowledge (CK) may become a new metric for cutoff, 24 and applicant familiarity will likely become a more important factor. 25 Further, as mentioned previously, many have reported that membership in AOA is often considered in evaluation.…”

Integrated Plastic Surgery Programs Have Been Implemented at Top Grant-receiving Institutions

“…The new pass/fail method of step 1 yields room for school reputation, and thus prestige, to serve as a pertinent factor in applicant selection. 4 One may assume that if an institution has a substantial amount of grant money and has consequently established an IRP, as shown in our results, this combined sense of prestige may positively influence a student's outcome in matching to PS.…”