Ophthalmology Program Director Perspectives of Scoring Step 1 Pass/Fail

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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Ophthalmology Program Directors' Perspectives on the Impact of the United States Medical Licensing Examination Step 1 Change to Pass-Fail Scoring

Journal of Academic Ophthalmology ◽

10.1055/s-0040-1718569 ◽

2020 ◽

Vol 12 (02) ◽

pp. e277-e283

Author(s):

David Cui ◽

Ingrid U. Scott ◽

Heidi Luise Wingert

Keyword(s):

United States ◽

Medical Education ◽

Medical Students ◽

The United States ◽

Basic Science Knowledge ◽

Medical Licensing ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step ◽

The Impact

Abstract Purpose This article investigates the perspectives of ophthalmology residency program directors (PDs) regarding the impact of the United States Medical Licensing Examination (USMLE) Step 1 change from graded to pass-fail scoring on ophthalmology resident selection and medical education. Methods The PDs of all United States ophthalmology residency programs accredited by the Accreditation Council for Graduate Medical Education were identified using a public, online database. An anonymous web-based survey constructed using REDCap was emailed to each PD in February 2020. Results Surveys were completed by 64 (54.2%) PDs, with the majority (81.2%) disagreeing with the change to pass-fail scoring. The majority of PDs believe this change will negatively impact the ability to evaluate residency applicants (92.1%) and achieve a fair and meritocratic match process (76.6%), and will decrease medical students' basic science knowledge (75.0%). The factors identified most frequently by PDs as becoming more important in evaluating residency applicants as a result of the Step 1 scoring change include clerkship grades (90.6%), USMLE Step 2 Clinical Knowledge score (84.4%), and a rotation in the PD's department (79.7%). The majority of PDs believe the Step 1 grading change to pass-fail will benefit applicants from elite medical schools (60.9%), and disadvantage applicants from nonelite allopathic schools (82.8%), international medical graduate applicants (76.6%), and osteopathic applicants (54.7%). Conclusion The majority of ophthalmology PDs disagree with the change in USMLE Step 1 scoring from graded to pass-fail and believe this change will negatively impact the ability to evaluate residency applicants and achieve a fair and meritocratic match process, and will decrease medical students' basic science knowledge.

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The Use of COMLEX-USA and USMLE for Residency Applicant Selection

Journal of Graduate Medical Education ◽

10.4300/jgme-d-15-00246.1 ◽

2016 ◽

Vol 8 (3) ◽

pp. 358-363 ◽

Cited By ~ 3

Author(s):

Jeanne M. Sandella ◽

John R. Gimpel ◽

Larissa L. Smith ◽

John R. Boulet

Keyword(s):

United States ◽

Strong Association ◽

The United States ◽

Medical Licensing ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step ◽

Level 1 ◽

State Medical Boards ◽

Phi Coefficient

ABSTRACT The Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) and the United States Medical Licensing Examination (USMLE) are recognized by all state medical licensing boards in the United States, and the Federation of State Medical Boards has supported the validity of both examinations for medical licensure. Many osteopathic medical students take both examinations.Background The purpose of this study was to investigate performance on COMLEX-USA Level 1 and USMLE Step 1 of students from colleges of osteopathic medicine where the majority of students took both examinations.Objective Data were collected on the entering classes of 2010 and 2011. Relationships between the COMLEX-USA Level 1 and the USMLE Step 1 were quantified using Pearson correlations. The correlation between outcomes on the 2 examinations was evaluated using the phi coefficient. A contingency table was constructed to look at first-attempt outcomes (pass/fail).Methods Data for 2010 and 2011 were collected from 3 osteopathic medical schools, with 795 of 914 students (87%) taking both examinations. The correlation between first-attempt COMLEX-USA Level 1 and USMLE Step 1 scores was statistically significant across and within all 3 schools. The overall correlation was r(795) = 0.84 (P < .001). Pass/fail status on the 2 examinations was moderately correlated (ϕ = 0.39, P < .01).Results Our study found a strong association between COMLEX Level 1 and USMLE Step 1 performance. Additional studies to accurately compare scores on these examinations are warranted.Conclusions

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The United States Medical Licensing Examination Step 1 Is Changing—US Medical Curricula Should Too

JMIR Medical Education ◽

10.2196/20182 ◽

2020 ◽

Vol 6 (2) ◽

pp. e20182

Author(s):

Benjamin Liu

Keyword(s):

United States ◽

Clinical Decision Making ◽

Clinical Decision ◽

The United States ◽

Medical Decision ◽

Medical Licensing ◽

Traditional Lectures ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step

In recent years, US medical students have been increasingly absent from medical school classrooms. They do so to maximize their competitiveness for a good residency program, by achieving high scores on the United States Medical Licensing Examination (USMLE) Step 1. As a US medical student, I know that most of these class-skipping students are utilizing external learning resources, which are perceived to be more efficient than traditional lectures. Now that the USMLE Step 1 is adopting a pass/fail grading system, it may be tempting to expect students to return to traditional basic science lectures. Unfortunately, my experiences tell me this will not happen. Instead, US medical schools must adapt their curricula. These new curricula should focus on clinical decision making, team-based learning, and new medical decision technologies, while leveraging the validated ability of these external resources to teach the basic sciences. In doing so, faculty will not only increase student engagement but also modernize the curricula to meet new standards on effective medical learning.

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Relationship between pathology curricular approaches and performance in the United States medical licensing examination (USMLE), step 1: a national cross-sectional study

Human Pathology ◽

10.1016/s0046-8177(03)00082-0 ◽

2003 ◽

Vol 34 (5) ◽

pp. 417-422 ◽

Cited By ~ 4

Author(s):

K Kumar

Keyword(s):

United States ◽

The United States ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Medical Licensing ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step ◽

And Performance

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The United States Medical Licensing Examination Step 1 Is Changing—US Medical Curricula Should Too (Preprint)

10.2196/preprints.20182 ◽

2020 ◽

Author(s):

Benjamin Liu

Keyword(s):

United States ◽

Clinical Decision Making ◽

Clinical Decision ◽

The United States ◽

Medical Decision ◽

Medical Licensing ◽

Traditional Lectures ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step

UNSTRUCTURED In recent years, US medical students have been increasingly absent from medical school classrooms. They do so to maximize their competitiveness for a good residency program, by achieving high scores on the United States Medical Licensing Examination (USMLE) Step 1. As a US medical student, I know that most of these class-skipping students are utilizing external learning resources, which are perceived to be more efficient than traditional lectures. Now that the USMLE Step 1 is adopting a pass/fail grading system, it may be tempting to expect students to return to traditional basic science lectures. Unfortunately, my experiences tell me this will not happen. Instead, US medical schools must adapt their curricula. These new curricula should focus on clinical decision making, team-based learning, and new medical decision technologies, while leveraging the validated ability of these external resources to teach the basic sciences. In doing so, faculty will not only increase student engagement but also modernize the curricula to meet new standards on effective medical learning.

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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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Reliability and Validity of Conversion Formulas Between Comprehensive Osteopathic Medical Licensing Examination of the United States Level 1 and United States Medical Licensing Examination Step 1

Journal of Graduate Medical Education ◽

10.4300/jgme-d-13-00302.1 ◽

2014 ◽

Vol 6 (2) ◽

pp. 280-283 ◽

Cited By ~ 5

Author(s):

Albert S. Lee ◽

Lynn Chang ◽

Eric Feng ◽

Scott Helf

Keyword(s):

United States ◽

Selection Process ◽

Reliability And Validity ◽

The United States ◽

Medical Licensing ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step ◽

Level 1 ◽

College Of Osteopathic Medicine

Abstract Background The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 1 and United States Medical Licensing Examination (USMLE) Step 1 scores are important factors in the selection process of medical students into US residency programs. Objectives The goals of this study were to investigate the correlation between the COMLEX-USA Level 1 and the USMLE Step 1 and to assess the accuracy of the existing formulas in predicting USMLE scores from COMLEX-USA scores. Methods A retrospective study of 1016 paired COMLEX-USA Level 1 and USMLE Step 1 scores was conducted. Formulas by Sarko et al and by Slocum and Louder were used to estimate USMLE Step 1 scores from COMLEX-USA Level 1 scores, and a paired t test between calculated USMLE Step 1 scores and actual USMLE Step 1 scores was performed. Results During 2006–2012, 1016 of 1440 students (71%) took both the USMLE Step 1 and the COMLEX-USA Level 1 tests in the College of Osteopathic Medicine of the Pacific. The USMLE Step 1 scores were higher than those predicted by Slocum and Louder and by Sarko et al by an average of 14.16 ± 11.69 (P < .001) and 7.80 ± 12.48 (P < .001), respectively. A Pearson coefficient of 0.83 was observed. Regression analysis yielded the following formula: USMLE Step 1 = 0.2392 × COMLEX-USA Level 1 + 82.563 (R2 = 0.69577). Conclusions The USMLE Step 1 scores, on average, were higher than those predicted by the formulas derived by Slocum and Louder and by Sarko et al. Residency program directors should use caution when using formulas to derive USMLE Step 1 scores from COMLEX-USA Level 1 scores.

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The State of the Otolaryngology Match: A Review of Applicant Trends, “Impossible” Qualifications, and Implications

Otolaryngology ◽

10.1177/0194599817695804 ◽

2017 ◽

Vol 156 (6) ◽

pp. 985-990 ◽

Cited By ~ 36

Author(s):

Sarah N. Bowe ◽

Cecelia E. Schmalbach ◽

Adrienne M. Laury

Keyword(s):

The Past ◽

Application Service ◽

Research Publications ◽

Medical Licensing ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step ◽

And Performance ◽

Residency Application ◽

The Relationship

Objective This State of the Art Review aims (1) to define recent qualifications of otolaryngology resident applicants by focusing on United States Medical Licensing Examination (USMLE) scores, Alpha Omega Alpha (AOA) status, and research/publications and (2) to summarize the current literature regarding the relationship between these measures and performance in residency. Data Sources Electronic Residency Application Service, National Residency Matching Program, PubMed, Ovid, and GoogleScholar. Review Methods Electronic Residency Application Service and National Residency Matching Program data were analyzed to evaluate trends in applicant numbers and qualifications. Additionally, a literature search was performed with the aforementioned databases to identify relevant articles published in the past 5 years that examined USMLE Step 1 scores, AOA status, and research/publications. Conclusions Compared with other highly competitive fields over the past 3 years, the only specialty with decreasing applicant numbers is otolaryngology, with the rest remaining relatively stable or slightly increased. Additionally, USMLE Step 1 scores, AOA status, and research/publications do not reliably correlate with performance in residency. Implications for Practice The consistent decline in applications for otolaryngology residency is concerning and reflects a need for change in the current stereotype of the “ideal” otolaryngology applicant. This includes consideration of additional selection measures focusing on noncognitive and holistic qualities. Furthermore, otolaryngology faculty should counsel medical students that applying in otolaryngology is not “impossible” but rather a feasible and worthwhile endeavor.

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Implications of the United States Medical Licensing Examination Step 1 Examination Transition to Pass/Fail on Medical Students Education and Future Career Opportunities

The American Surgeon ◽

10.1177/0003134820973382 ◽

2020 ◽

pp. 000313482097338

Author(s):

Haley Ehrlich ◽

Mason Sutherland ◽

Mark McKenney ◽

Adel Elkbuli

Keyword(s):

United States ◽

Medical Students ◽

The United States ◽

Residency Programs ◽

Future Career ◽

Career Opportunities ◽

Medical Licensing ◽

Usmle Step 1 ◽

Licensing Examination ◽

Usmle Step

Background United States Medical Licensing Examination (USMLE) Step 1 will transition to pass/fail score by 2022. We aim to investigate US medical students’ perspectives on the potential implications this transition would have on their education and career opportunities. Methods A cross-sectional study investigating US medical students’ perspectives on the implications of transition of the USMLE Step 1 exam to pass/fail. Students were asked their preferences regarding various aspects of the USMLE Step 1 examination, including activities, educational opportunities, expenses regarding preparation for the examination, and future career opportunities. Results 215 medical students responded to the survey, 59.1% were women, 80.9% were allopathic vs. 19.1% osteopathic students. 34.0% preferred the USMLE Step 1 to be graded on a pass/fail score, whereas 53.5% preferred a numeric scale. Osteopathic vs. allopathic students were more likely to report that the pass/fail transition will negatively impact their residency match (aOR = 1.454, 95% CI: 0.515, 4.106) and specialty of choice (aOR = 3.187, 95% CI: 0.980, 10.359). 57.7% of respondents reported that the transition to a pass/fail grading system will change their study habits. Conclusions The transition of the USMLE Step 1 to a pass/fail system has massive implications on medical students and residency programs alike. Though the majority of medical students did not prefer the USMLE Step 1 to have a pass/fail score, they must adapt their strategies to remain competitive for residency applications. Residency programs should create a composite score based off all aspects of medical students’ applications in order to create a holistic and fair evaluation and ranking system.

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