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

Frederick Mun, Seongho Jeong, Paul J Juliano

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    Orthopedic surgery residency programs will shift focus from USMLE Step 1 pass/fail scores to other factors like Step 2 scores and audition rotations for applicant selection.

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    Area of Science:

    • Medical Education
    • Orthopedic Surgery Training
    • Licensing Examinations

    Background:

    • The United States Medical Licensing Examination (USMLE) Step 1 is transitioning to a pass/fail scoring system.
    • This change significantly impacts orthopedic surgery residency program admissions criteria.
    • Program directors' perspectives on this transition are crucial for adapting selection processes.

    Purpose of the Study:

    • To investigate orthopedic surgery residency program directors' perceptions of the USMLE Step 1 scoring change.
    • To understand how this change will influence the evaluation of orthopedic surgery residency applicants.
    • To identify alternative factors that will gain importance in resident selection.

    Main Methods:

    • A survey was distributed to 161 allopathic orthopedic surgery program directors.
    • Data were collected from 75 program directors (46.6% response rate).
    • The survey assessed opinions on the Step 1 change and its impact on selection criteria.

    Main Results:

    • A significant majority (85.3%) of program directors opposed the Step 1 pass/fail change.
    • Increased importance is anticipated for USMLE Step 2 CK, audition electives, personal knowledge, grades, and letters of recommendation.
    • Concerns exist that the change may favor students from highly regarded medical schools.

    Conclusions:

    • Orthopedic surgery residency programs must adapt their applicant screening methods due to the USMLE Step 1 pass/fail transition.
    • Factors beyond Step 1 scores, including Step 2 CK, clinical performance, and personal attributes, will become more critical.
    • Program directors generally favor a graded preclinical curriculum and caps on application numbers.