The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change:...

Area of Science:

• Medical Education
• Residency Selection Process
• Licensing Examinations

Background:

• The United States Medical Licensing Examination (USMLE) Step 1 transitioned from a numerical score to a pass/fail system in January 2022.
• Historically, USMLE Step 1 scores correlated with future performance in specialty board examinations.

Purpose of the Study:

• To provide a comprehensive review of the historical context and impact of the USMLE Step 1 scoring change.
• To analyze the implications of this transition for various stakeholders in residency selection.

Main Methods:

• Conducted keyword-based literature searches in PubMed, Google Scholar, and Scopus.
• Synthesized findings to review the historical significance and effects of the scoring change.

Main Results:

• The pass/fail change significantly impacts US and international medical graduates, and residency program directors.
• Residency applicants face considerable uncertainty during this transition.
• Educators anticipate increased reliance on objective measures, with USMLE Step 2 Clinical Knowledge likely becoming a primary screening tool.

Conclusions:

• The shift to pass/fail USMLE Step 1 introduces significant implications for medical education and residency admissions.
• While efforts are underway to ensure a smooth transition, challenges remain for applicants and educators.
• USMLE Step 2 Clinical Knowledge is expected to gain prominence in residency application screening.