Impact of Pass/Fail USMLE Step 1 Scoring on the Internal Medicine Residency Application Process: a Program Director Survey

OBJECTIVEWith nearly half of graduating US medical students being female, it is imperative to understand why females typically make up less than 20% of the neurosurgery applicant pool, a number that has changed very slowly over the past several decades. Organized neurosurgery has strongly indicated the desire to overcome the underrepresentation of women, and it is critical to explore whether females are at a disadvantage during the residency application process, one of the first steps in a neurosurgical career. To date, there are no published studies on specific applicant characteristics, including gender, that are associated with match outcome among neurosurgery resident applicants. The purpose of this study is to determine which characteristics of neurosurgery residency applicants, including gender, are associated with a successful match outcome.METHODSDe-identified neurosurgical resident applicant data obtained from the San Francisco Fellowship and Residency Matching Service for the years 1990–2007 were analyzed. Applicant characteristics including gender, medical school attended, year of application, United States Medical Licensing Exam (USMLE) Step 1 score, Alpha Omega Alpha (AOA) status, and match outcome were available for study.RESULTSOf the total 3426 applicants studied, 473 (13.8%) applicants were female and 2953 (86.2%) were male. Two thousand four hundred forty-eight (71.5%) applicants successfully matched. USMLE Step 1 score was the strongest predictor of match outcome with scores > 245 having an OR of 20.84 (95% CI 10.31–42.12) compared with those scoring < 215. The mean USMLE Step 1 score for applicants who successfully matched was 233.2 and was 210.8 for those applicants who did not match (p < 0.001). Medical school rank was also associated with match outcome (p < 0.001). AOA status was not significantly associated with match outcome. Female gender was associated with significantly lower odds of matching in both simple (OR 0.59, 95% CI 0.48–0.72) and multivariate analyses (OR 0.57, 95% CI 0.34–0.94 CI). USMLE Step 1 scores were significantly lower for females compared to males with a mean score of 230.1 for males and 221.5 for females (p < 0.001). There was no significant difference in medical school ranking or AOA status when stratified by applicant gender.CONCLUSIONSThe limited historical applicant data from 1990–2007 suggests that USMLE Step 1 score is the best predictor of match outcome, although applicant gender may also play a role.

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The Effects of Pass/Fail USMLE Step 1 Scoring on the Otolaryngology Residency Application Process

The Laryngoscope ◽

10.1002/lary.29072 ◽

2020 ◽

Author(s):

Khodayar Goshtasbi ◽

Mehdi Abouzari ◽

Tjoson Tjoa ◽

Sonya Malekzadeh ◽

Naveen D. Bhandarkar

Keyword(s):

Application Process ◽

Usmle Step 1 ◽

Usmle Step ◽

Residency Application

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The Relationship Between Internal Medicine Residency Graduate Performance on the ABIM Certifying Examination, Yearly In-Service Training Examinations, and the USMLE Step 1 Examination

Academic Medicine ◽

10.1097/acm.0000000000000500 ◽

2015 ◽

Vol 90 (1) ◽

pp. 100-104 ◽

Cited By ~ 34

Author(s):

Cynthia Kay ◽

Jeffrey L. Jackson ◽

Michael Frank

Keyword(s):

Internal Medicine ◽

Internal Medicine Residency ◽

Service Training ◽

Usmle Step 1 ◽

Usmle Step ◽

Certifying Examination ◽

The Relationship

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Ophthalmology Program Director Perspectives of Scoring Step 1 Pass/Fail

Journal of Academic Ophthalmology ◽

10.1055/s-0040-1718568 ◽

2020 ◽

Vol 12 (02) ◽

pp. e251-e254

Author(s):

Saif A. Hamdan ◽

Alan T. Makhoul ◽

Brian C. Drolet ◽

Jennifer L. Lindsey ◽

Janice C. Law

Keyword(s):

Well Being ◽

The United States ◽

Application Process ◽

Medical Graduates ◽

Medical Licensing ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step ◽

Residency Application ◽

The Impact

Abstract Background Scoring for the United States Medical Licensing Examination (USMLE) Step 1 was recently announced to be reported as binary as early as 2022. The general perception among program directors (PDs) in all specialties has largely been negative, but the perspective within ophthalmology remains uncharacterized. Objective This article characterizes ophthalmology residency PDs' perspectives regarding the impact of pass/fail USMLE Step 1 scoring on the residency application process. Methods A validated 19-item anonymous survey was electronically distributed to 111 PDs of Accreditation Council for Graduate Medical Education-accredited ophthalmology training programs. Results Fifty-six PDs (50.5%) completed the survey. The median age of respondents was 48 years and the majority were male (71.4%); the average tenure as PD was 7.1 years. Only 6 (10.7%) PDs reported the change of the USMLE Step 1 to pass/fail was a good idea. Most PDs (92.9%) indicated that this will make it more difficult to objectively compare applicants, and many (69.6%) did not agree that the change would improve medical student well-being. The majority (82.1%) indicated that there will be an increased emphasis on Step 2 Clinical Knowledge (CK) scores, and many (70.4%) felt that medical school reputation will be more important in application decisions. Conclusion Most ophthalmology PDs who responded to the survey do not support binary Step 1 scoring. Many raised concerns regarding shifted overemphasis on Step 2 CK, uncertain impact on student well-being, and potential to disadvantage certain groups of medical students including international medical graduates. These concerns highlight the need for reform in the ophthalmology application process.

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Surveying Obstetrics and Gynecology Residents About Their Residency Applications, Interviews, and Ranking

Journal of Graduate Medical Education ◽

10.4300/jgme-d-20-00939.1 ◽

2021 ◽

Vol 13 (2) ◽

pp. 257-265

Author(s):

Karen E. George ◽

Gregory M. Gressel ◽

Tony Ogburn ◽

Mark B. Woodland ◽

Erika Banks

Keyword(s):

United States ◽

The United States ◽

Obstetrics And Gynecology ◽

Application Process ◽

Factors Associated ◽

Usmle Step 1 ◽

Usmle Step ◽

Residency Application

ABSTRACT Background Residency applications have increased in the last decade, creating growing challenges for applicants and programs. Objective We evaluated factors associated with application and match into obstetrics and gynecology residency. Methods During the annual in-training examination administered to all obstetrics and gynecology residents in the United States, residents were surveyed on the residency application process. Results Ninety-five percent (5094 of 5347) residents responded to the survey. Thirty-six percent reported applying to 30 or fewer programs, 26.7% applied to more than 31 programs, and 37.1% opted not to answer this question. Forty-nine percent of residents received honors in their obstetrics and gynecology clerkship and 37.1% did not. The majority of residents (88.6%) reported scoring between 200 and 250 on USMLE Step 1. Eighty-six percent matched into one of their top 5 programs. The only factor associated with matching in residents' top 5 programs was receiving honors in their clerkship (OR 1.29; 95% CI 1.08–1.54; P < .005). The only factor associated with matching below the top 5 programs was a couples match (OR 0.56; 95% CI 0.43–0.72; P < .001). In choosing where to apply, residents identified program location and reputation as the most important factors, while for ranking, location and residency culture were the most important. Conclusions Most obstetrics and gynecology residents reported matching into their top 5 choices. Receiving an honors grade in the clerkship was the only factor associated with matching in applicants' top 5 programs. Location was the most important factor for applying to and ranking of programs.

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USMLE Step 1 Scoring Changes and the Urology Residency Application Process: Program Directors’ Perspectives

Urology ◽

10.1016/j.urology.2020.08.033 ◽

2020 ◽

Vol 145 ◽

pp. 79-82

Author(s):

Leah P. Chisholm ◽

Brian C. Drolet

Keyword(s):

Program Directors ◽

Application Process ◽

Usmle Step 1 ◽

Usmle Step ◽

Residency Application ◽

Urology Residency

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Use of Filters for Residency Application Review: Results From the Internal Medicine In-Training Examination Program Director Survey

Journal of Graduate Medical Education ◽

10.4300/jgme-d-19-00345.1 ◽

2019 ◽

Vol 11 (6) ◽

pp. 704-707 ◽

Cited By ~ 2

Author(s):

Adam M. Garber ◽

Brian Kwan ◽

Christopher M. Williams ◽

Steven V. Angus ◽

T. Robert Vu ◽

...

Keyword(s):

Internal Medicine ◽

Knowledge Score ◽

Web Based ◽

Residency Programs ◽

Initial Application ◽

Data Points ◽

Usmle Step 1 ◽

Usmle Step ◽

Review Cycle ◽

Residency Application

ABSTRACT Background The increase in applications to residency programs, known as “application inflation,” creates challenges for program directors (PDs). Prior studies have shown that internal medicine (IM) PDs utilize criteria, such as United States Medical Licensing Examination (USMLE) Step examination performance, when reviewing applications. However, little is known about how early these filters are utilized in the application review cycle. Objective This study sought to assess the frequency and types of filters utilized by IM PDs during initial residency application screening and prior to more in-depth application review. Methods A web-based request for the 2016 Internal Medicine In-Training Examination (IM-ITE) PD Survey was sent to IM PDs. Responses from this survey were analyzed, excluding non-US programs. Results With a 50% response rate (214 of 424), IM PDs responded that the most commonly used data points to filter applicants prior to in-depth application review were the USMLE Step 2 Clinical Knowledge score (32%, 67 of 208), USMLE Step 1 score (24%, 50 of 208), and medical school attended (12%, 25 of 208). Over half of US IM PD respondents (55%, 114 of 208) indicated that they list qualifying interview criteria on their program website, and 31% of respondents (50 of 160) indicated that more than half of their applicant pool does not meet the program's specified interview criteria. Conclusions Results from the 2016 IM-ITE PD Survey indicate many IM PDs use filters for initial application screening, and that these filters, when available to applicants, do not affect many applicants' decisions to apply.

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