Perceptions of USMLE Step 1 Pass/Fail Score Reporting Among Orthopedic Surgery Residency Program Directors

Orthopedics ◽  
2021 ◽  
pp. 1-5
Author(s):  
Frederick Mun ◽  
Seongho Jeong ◽  
Paul J. Juliano ◽  
William L. Hennrikus
2019 ◽  
Vol 11 (3) ◽  
pp. 268-273 ◽  
Author(s):  
Nicholas D. Hartman ◽  
Cedric W. Lefebvre ◽  
David E. Manthey

ABSTRACT Background Residency applicants feel increasing pressure to maximize their chances of successfully matching into the program of their choice, and are applying to more programs than ever before. Objective In this narrative review, we examined the most common and highly rated factors used to select applicants for interviews. We also examined the literature surrounding those factors to illuminate the advantages and disadvantages of using them as differentiating elements in interviewee selection. Methods Using the 2018 NRMP Program Director Survey as a framework, we examined the last 10 years of literature to ascertain how residency directors are using these common factors to grant residency interviews, and whether these factors are predictive of success in residency. Results Residency program directors identified 12 factors that contribute substantially to the decision to invite applicants for interviews. Although United States Medical Licensing Examination (USMLE) Step 1 is often used as a comparative factor, most studies do not demonstrate its predictive value for resident performance, except in the case of test failure. We also found that structured letters of recommendation from within a specialty carry increased benefit when compared with generic letters. Failing USMLE Step 1 or 2 and unprofessional behavior predicted lower performance in residency. Conclusions We found that the evidence basis for the factors most commonly used by residency directors is decidedly mixed in terms of predicting success in residency and beyond. Given these limitations, program directors should be skeptical of making summative decisions based on any one factor.


Author(s):  
Wissam N. Raad ◽  
Adil Ayub ◽  
Chyun-Yin Huang ◽  
Landon Guntman ◽  
Sadiq S. Rehmani ◽  
...  

Objective Robotic-assisted surgery is increasingly being used in thoracic surgery. Currently, the Integrated Thoracic Surgery Residency Program lacks a standardized curriculum or requirement for training residents in robotic-assisted thoracic surgery. In most circumstances, because of the lack of formal residency training in robotic surgery, hospitals are requiring additional training, mentorship, and formal proctoring of cases before granting credentials to perform robotic-assisted surgery. Therefore, there is necessity for residents in Integrated Thoracic Surgery Residency Program to have early exposure and formal training on the robotic platform. We propose a curriculum that can be incorporated into such programs that would satisfy both training needs and hospital credential requirements. Methods We surveyed all 26 Integrated Thoracic Surgery Residency Program Directors in the United States. We also performed a PubMed literature search using the key word “robotic surgery training curriculum.” We reviewed various robotic surgery training curricula and evaluation tools used by urology, obstetrics gynecology, and general surgery training programs. We then designed a proposed curriculum geared toward thoracic Integrated Thoracic Surgery Residency Program adopted from our credentialing experience, literature review, and survey consensus. Results Of the 26 programs surveyed, we received 17 responses. Most Integrated Thoracic Surgery Residency Program directors believe that it is important to introduce robotic surgery training during residency. Our proposed curriculum is integrated during postgraduate years 2 to 6. In the preclinical stage postgraduate years 2 to 3, residents are required to complete introductory online modules, virtual reality simulator training, and in-house workshops. During clinical stage (postgraduate years 4–6), the resident will serve as a supervised bedside assistant and progress to a console surgeon. Each case will have defined steps that the resident must demonstrate competency. Evaluation will be based on standardized guidelines. Conclusions Expansion and utilization of robotic assistance in thoracic surgery have increased. Our proposed curriculum aims to enable Integrated Thoracic Surgery Residency Program residents to achieve competency in robotic-assisted thoracic surgery and to facilitate the acquirement of hospital privileges when they enter practice.


2015 ◽  
Vol 81 (8) ◽  
pp. 786-790 ◽  
Author(s):  
Mitesh Patel ◽  
Jasneet S. Bhullar ◽  
Gokulakkrishna Subhas ◽  
Vijay Mittal

As surgery residents graduate and begin their careers as junior attending surgeons, the question of whether a surgeon can complete a case alone still lingers. Allowing autonomy during residency answers this question. The purpose of this study was to gather input from general surgery residency program directors on how they achieve autonomy for residents in their programs. An online survey of 18 questions was sent to all general surgery residency program directors in the United States between April and June of 2013 via e-mail. Questions were asked regarding classification of autonomy, percentage of case completed by the resident independently, and in what area a resident worked with minimal supervision. Of the 202 delivered, 85 program directors were responded (42%). Seventy-eight per cent of programs classified a resident as surgeon junior whether the resident completed more than 50 per cent of the case. Most classified autonomy as either the resident completing >75 per cent of a case (41%) or completing the critical steps of a surgery (41%). Eighty-eight per cent stated that chief residents completed the majority of cases under supervision, whereas only 12 per cent stated the chief had autonomy in the operating room and also acted as teaching assistant. While, 60 per cent stated their chief residents did not work in any area of the hospital independently. Despite differences in how autonomy is defined among programs, most program directors feel that their chief residents do not achieve complete autonomy. Programs should allow their residents to work in a progressive responsibility as they progress into their fourth and fifth years of residency to achieve autonomy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Frederick Mun ◽  
Alyssa R. Scott ◽  
David Cui ◽  
Erik B. Lehman ◽  
Seong Ho Jeong ◽  
...  

Abstract Background United States Medical Licensing Examination Step 1 will transition from numeric grading to pass/fail, sometime after January 2022. The aim of this study was to compare how program directors in orthopaedics and internal medicine perceive a pass/fail Step 1 will impact the residency application process. Methods A 27-item survey was distributed through REDCap to 161 U.S. orthopaedic residency program directors and 548 U.S. internal medicine residency program directors. Program director emails were obtained from the American Medical Association’s Fellowship and Residency Electronic Interactive Database. Results We received 58 (36.0%) orthopaedic and 125 (22.8%) internal medicine program director responses. The majority of both groups disagree with the change to pass/fail, and felt that the decision was not transparent. Both groups believe that the Step 2 Clinical Knowledge exam and clerkship grades will take on more importance. Compared to internal medicine PDs, orthopaedic PDs were significantly more likely to emphasize research, letters of recommendation from known faculty, Alpha Omega Alpha membership, leadership/extracurricular activities, audition elective rotations, and personal knowledge of the applicant. Both groups believe that allopathic students from less prestigious medical schools, osteopathic students, and international medical graduates will be disadvantaged. Orthopaedic and internal medicine program directors agree that medical schools should adopt a graded pre-clinical curriculum, and that there should be a cap on the number of residency applications a student can submit. Conclusion Orthopaedic and internal medicine program directors disagree with the change of Step 1 to pass/fail. They also believe that this transition will make the match process more difficult, and disadvantage students from less highly-regarded medical schools. Both groups will rely more heavily on the Step 2 clinical knowledge exam score, but orthopaedics will place more importance on research, letters of recommendation, Alpha Omega Alpha membership, leadership/extracurricular activities, personal knowledge of the applicant, and audition electives.


2021 ◽  
Vol 13 (01) ◽  
pp. e88-e94
Author(s):  
Alyssa M. Kretz ◽  
Jennifer E. deSante-Bertkau ◽  
Michael V. Boland ◽  
Xinxing Guo ◽  
Megan E. Collins

Abstract Background While ethics and professionalism are important components of graduate medical education, there is limited data about how ethics and professionalism curricula are taught or assessed in ophthalmology residency programs. Objective This study aimed to determine how U.S. ophthalmology residency programs teach and assess ethics and professionalism and explore trainee preparedness in these areas. Methods Directors from accredited U.S. ophthalmology residency programs completed an online survey about components of programs' ethics and professionalism teaching curricula, strategies for assessing competence, and trainee preparedness in these areas. Results Directors from 55 of 116 programs (46%) responded. The most common ethics and professionalism topics taught were informed consent (38/49, 78%) and risk management and litigation (38/49, 78%), respectively; most programs assessed trainee competence via 360-degree global evaluation (36/48, 75%). While most (46/48, 95%) respondents reported that their trainees were well or very well prepared at the time of graduation, 15 of 48 (31%) had prohibited a trainee from graduating or required remediation prior to graduation due to unethical or unprofessional conduct. Nearly every program (37/48, 98%) thought that it was very important to dedicate curricular time to teaching ethics and professionalism. Overall, 16 of 48 respondents (33%) felt that the time spent teaching these topics was too little. Conclusion Ophthalmology residency program directors recognized the importance of an ethics and professionalism curriculum. However, there was marked variation in teaching and assessment methods. Additional work is necessary to identify optimal strategies for teaching and assessing competence in these areas. In addition, a substantial number of trainees were prohibited from graduating or required remediation due to ethics and professionalism issues, suggesting an impact of unethical and unprofessional behavior on resident attrition.


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