Rate of USMLE Step 2 CK Scores Included on Orthopedic Surgery Applications and Associations With Step 1 Score

Area of Science:

• Medical Education
• Orthopedic Surgery Training
• USMLE Performance Analysis

Background:

• Orthopedic surgery applicants' inclusion of Step 2 Clinical Knowledge (CK) scores is not standardized.
• The transition of Step 1 to pass/fail scoring may increase Step 2 CK score reporting.
• Current rates and implications of Step 2 CK inclusion remain underreported.

Purpose of the Study:

• Determine the percentage of orthopedic surgery applications including Step 2 CK scores.
• Compare Step 1 scores between applicants who included and did not include Step 2 CK.
• Analyze the correlation between Step 1 and Step 2 CK scores and score improvement.

Main Methods:

• Analysis of orthopedic surgery residency applicants over two cycles (2019-2020).
• Recorded the inclusion rates of Step 1 and Step 2 CK scores.
• Compared Step 1 scores and analyzed score differences stratified by Step 1 performance.

Main Results:

• 79% of applicants reported Step 2 CK scores (1,316/1,660).
• Applicants including Step 2 CK had lower average Step 1 scores (244.3 ± 13.1) than those who did not (250.7 ± 10.9) (p < 0.0001).
• Applicants with lower Step 1 scores showed greater percentile improvement between Step 1 and Step 2 CK.

Conclusions:

• A significant majority (79%) of orthopedic surgery applicants reported Step 2 CK scores between 2019-2020.
• Lower Step 1 performance correlated with a higher likelihood of including Step 2 CK and demonstrating score improvement.
• The impact of the Step 1 scoring change on these trends requires further investigation.