Stepping Up: How U.S. Neurosurgery Training Programs Can Innovatively Assess Resident Applicants in a Post-Step 1 World

Abstract

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change: Overview for Applicants and Educators

“…The reliance on USMLE Step 1 scores for residency application considerations was particularly notable in competitive specialties. A case in point is a survey of over half of all neurosurgical residency program directors that found that 77% of them had always screened candidates using Step 1 scores [10], and a score of >245 was the most significant predictor of success in the neurosurgery match (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) [11]. Thus, aspirants for these specialties would find their specialty of choice out of reach if they had a low Step 1 score.…”

“…In the otorhinolaryngology board exam [ 30 ], underperforming (score<210) was linked to a higher chance of not passing board exams. Regardless of the debate surrounding their predictive utility [ 11 ], underperforming in specialty boards incurs fines on programs; therefore, these potential correlations were valuable for program directors.…”

Letter: Neurological Surgery Residency Programs in the United States: A National Cross-Sectional Survey

“…Evaluating publications as a numbers game, particularly in lieu of standardized test scores, has led to an explosion of resume padding, forcing students to focus on volume over quality, but is not necessarily a good predictor of resident success. [2][3][4][5][6] This can encourage applicants to seek out "paper mills" which turn out high quantities of papers with a many names which does not correlate to authors' involvement, and the trend is then carried forward through residency. This method is flawed as a measure of interest in and dedication to the field: These high-output groups may not be publishing topics of interest for learners, but simply act as another checkbox for resumes.…”