Implications of United States Medical Licensing Examination Step 1 Becoming Pass/Fail on the Integrated Plastic Surgery Match

Boyd, Carter J.; Inglesby, Dani C.

doi:10.1097/prs.0000000000007309

Cited by 16 publications

(19 citation statements)

References 6 publications

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“…However, while matched applicants had significantly higher Step 1 scores than unmatched applicants, when accounting for other variables, Step 1 did not predict the odds of matching into a PRS program, a first-ranked program, or a program where a subinternship was completed. These same trends were found for Step 2 CK, which is anticipated to take the functional role of Step 1 as a standardized stratification tool 23–25 . This highlights a critical point: while USMLE scores are a highly valued part of the residency application, other factors such as mentorship are far more important for matching.…”

Section: Discussionsupporting

confidence: 59%

“…The PRS has historically maintained one of the highest score means among matched applicants, with competitive benchmarks set to select candidates for residency interviews 2,21,22 . Elimination of the numerical score has raised concerns about future methods to fairly compare applicants 23–25 . However, while matched applicants had significantly higher Step 1 scores than unmatched applicants, when accounting for other variables, Step 1 did not predict the odds of matching into a PRS program, a first-ranked program, or a program where a subinternship was completed.…”

Section: Discussionmentioning

confidence: 99%

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Mentorship is Critical

et al. 2023

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Background As the second cycle impacted by COVID-19, the 2022 Plastic and Reconstructive Surgery (PRS) Match maintained virtual interviews while offering a modest lift of subinternship restrictions. The residency application process continues to evolve, with changes such as pass/fail United States Medical Licensing Examination Step 1 reporting prompting programs to reconsider metrics of applicant success. It is critical to address the impact of board scores, mentorship, and resource availability on a diverse applicant population in the PRS Match. Methods A survey was electronically administered to students applying to a single institutional PRS residency program. The survey inquired about demographics, application statistics, mentorship experience, and match outcomes. Logistic regressions were modeled to assess for odds of matching into plastic surgery. Results In total, 151 responses were analyzed, a 49.7% response rate. Most participants were female (52.3%), White (68.9%), and not Hispanic/Latino (84.8%). The largest percentage of respondents had a faculty mentor only from their home institution (55.0%) and a resident mentor from only their home institution (32.3%). Participants with a faculty mentor from both a home and outside institution had 7.4 times the odds of matching into PRS (P = 0.02) than students with no faculty mentorship. Students with dual-institution resident mentorship had 18.5 times higher the odds of matching compared with students with no resident mentorship (P < 0.001). Conclusions Subjective metrics, rather than objective scores, had the most influence on successfully matching into plastic surgery. As the PRS Match continues to become increasingly competitive, it behooves programs to provide equitable access to resources such as mentorship.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Mentorship is Critical

et al. 2023

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“…It is unclear what factors will become more important in terms of resident selection following this change as this examination is one of the few standardized objective measures across all medical schools. Previously, Boyd et al theorized that research productivity may become increasingly important for applicant success, similar to what occurred in Canada after implementing a pass/fail system for their national board examination [14,15]. It will be interesting to see how residency program directors will respond to these changes across all fields of medicine, especially in competitive specialties such as integrated plastic surgery.…”

Section: Discussionmentioning

confidence: 91%

Evaluating the Integrated Plastic Surgery Residency Match During the Novel Coronavirus Pandemic

Whisonant¹,

Shahriari²,

Harrison³

et al. 2021

Cureus

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The COVID-19 pandemic had significant impacts on medical education and on the 2021 Match. Visiting student rotations at locations other than students' home institutions were cancelled and residency interviews were hosted virtually. This study evaluated the impact that COVID-19 had on the 2021 Match including residency programs matching applicants from within their own institution as well as from within the same region. The sex of matched applicants in the Match cycles was analyzed as well. Data were collected from residency program websites, social media accounts, and communication with current residents. Data were tabulated and chi-square analysis was performed. The overall difference in matched internal candidates pre-/post-pandemic was determined to be statistically significant (8.3% increase; p = 0.004). The Midwest was determined to exhibit a significant increase for matching residents from medical schools in the same region (15.6% increase; p = 0.04). Female applicants were also determined to be significantly more likely to match into integrated plastic surgery programs in 2021. COVID-19 significantly impacted the 2021 Match with an increased number of programs selecting internal candidates, matched female applicants, and regional selectivity, especially in the Midwest. It is our hope that applicants, programs, and the plastic surgery community will use this information to continue to improve the residency selection process in the future.

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“…The 2022 PRS residency application cycle was subject to unique circumstances that may offer lessons to better inform our selection process of future applicants. As residency programs adapt to new challenges from COVID-19, including subinternship restrictions and virtual interviews, it is critical to monitor the impacts of applicant assessment on populations that are persistently underrepresented in PRS amid a backdrop of advocacy for increased equity and diversity in the medical profession 28–30 . Our study found that inequitable access to other implicit components of the residency application such as mentorship, academic resources, and application/interview quantity disproportionately disadvantaged Black and low-income students, resulting in significantly fewer matches for these applicants.…”

Section: Discussionmentioning

confidence: 83%

The Impact of Socioeconomic Factors on the 2022 Plastic Surgery Match

et al. 2023

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BackgroundIn 2022, the plastic and reconstructive surgery (PRS) match faced unprecedented system-wide transitions that have redefined conventional measures of applicant success. This challenges the equitable assessment of student competitiveness and diversity in the field.MethodsA survey of demography, application content, and 2022 match outcomes was distributed to applicants to a single PRS residency program. Comparative statistics and regression models were performed to assess the predictive value of factors in match success and quality.ResultsA total of 151 respondents (response rate 49.7%) were analyzed. Although step 1 and step 2 CK scores were significantly higher among matched applicants, neither examination predicted match success. Most respondents (52.3%) were women, although gender was also not significantly associated with match success. Underrepresented in medicine applicants made up 19.2% of responses and 16.7% of matches, and the plurality of respondents (22.5%) were raised with a household income ≥$300,000. Both Black race and household income ≤$100,000 were associated with lower odds of scoring above a 240 on either step 1 or step 2 CK (Black: OR, 0.03 and 0.06; P < 0.05 and P < 0.001; income: OR, 0.07–0.47 and 0.1 to 0.8, among income subgroups), receiving interview offers (OR, −9.4; P < 0.05; OR, −11.0 to −5.4), and matching into PRS (OR, 0.2; P < 0.05; OR, 0.2 to 0.5), compared with White and high-income applicants, respectively.ConclusionsSystemic inequities in the match process disadvantage underrepresented in medicine candidates and those from lower household incomes. As the residency match continues to evolve, programs must understand and mitigate the impacts of bias in various application components.

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Implications of United States Medical Licensing Examination Step 1 Becoming Pass/Fail on the Integrated Plastic Surgery Match

Cited by 16 publications

References 6 publications

Mentorship is Critical

Mentorship is Critical

Evaluating the Integrated Plastic Surgery Residency Match During the Novel Coronavirus Pandemic

The Impact of Socioeconomic Factors on the 2022 Plastic Surgery Match

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