Internal medicine resident perspectives on scoring USMLE as pass/fail.

Area of Science:

• Medical Education
• Physician Training
• Licensure Examinations

Background:

• The United States Medical Licensing Examination (USMLE) Step 1 is transitioning to a pass/fail scoring system in January 2022.
• This change impacts the evaluation and training of future physicians.
• Understanding resident perspectives is crucial for assessing the implications of this policy shift.

Purpose of the Study:

• To gauge national-level opinions of internal medicine residents concerning the USMLE Step 1 pass/fail scoring change.
• To analyze how demographic and academic factors (gender, USMLE scores, postgraduate year (PGY) status, medical school type) correlate with resident views.

Main Methods:

• An online survey was distributed to internal medicine residents across the USA in Fall 2019.
• Data collected included resident demographics, PGY level, medical school type, and self-reported USMLE Step 1 and Step 2 Clinical Knowledge score ranges.
• Statistical analysis employed Pearson Chi-square testing and multivariable logistic regression.

Main Results:

• A total of 4012 residents responded, representing 13% of US internal medicine residents.
• 55% of respondents disagreed with the move to pass/fail scoring, while 34% agreed.
• Significant differences in opinion were observed based on gender, PGY level, USMLE Step 1 scores, and medical school type, with males, PGY1 residents, and international medical school graduates more likely to oppose the change.

Conclusions:

• A majority of current internal medicine residents favor retaining numerical scoring for the USMLE Step 1.
• The transition to pass/fail scoring is met with significant resident opposition.
• Resident opinions on the USMLE scoring change are influenced by various demographic and academic factors.