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The USMLE Step 1 Pass/Fail Reporting Proposal: Another View.

J Bryan Carmody1, David Sarkany2, Darel E Heitkamp3

  • 1Eastern Virginia Medical School, Department of Pediatrics, Division of Nephrology, Norfolk, Virginia.

Academic Radiology
|July 13, 2019
PubMed
Summary
This summary is machine-generated.

The United States Medical Licensing Examination (USMLE) Step 1 should be pass/fail, not a three-digit score. This change would reduce application screening burdens and improve trainee well-being.

Keywords:
DiversityMedical Student EducationNBMENational Board of Medical ExaminersPass/FailScoreStep 1USMLEUnited States Medical Licensing ExaminationWellness

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Area of Science:

  • Medical Education
  • Psychometrics
  • Radiology Residency Admissions

Background:

  • The Association of Program Directors in Radiology (APDR) supports reporting USMLE Step 1 as a three-digit score.
  • This stance may not represent all radiology program directors' opinions.
  • Increasing application numbers lead program directors to rely heavily on scores for screening.

Purpose of the Study:

  • To advocate for reporting USMLE Step 1 results as pass/fail.
  • To address the negative consequences of using three-digit scores in residency admissions.

Main Methods:

  • This is an argument-based paper, not an empirical study.
  • It analyzes the psychometric design of the USMLE Step 1.
  • It discusses the impact of score-based screening on medical education and diversity.

Main Results:

  • USMLE Step 1 is designed for licensure decisions, not comparative ranking.
  • Score-based screening negatively impacts educational focus and workforce diversity.
  • "Step 1 Mania" adversely affects trainee mental health.
  • Limited data correlate USMLE Step 1 scores with patient care outcomes.

Conclusions:

  • The current reliance on USMLE Step 1 scores for screening is problematic.
  • Transitioning to a pass/fail system is a necessary step for reform.
  • This change could alleviate pressure and promote a more equitable admissions process.