Association of USMLE Step 1 Pass/Fail Reporting with Interview and Match Outcomes.

Area of Science:

• Medical Education
• Residency Admissions
• Standardized Testing

Background:

• The transition of the United States Medical Licensing Examination (USMLE) Step 1 to pass/fail reporting impacts residency applications.
• Understanding the effects of this change on interview and match outcomes is crucial for medical students and programs.

Purpose of the Study:

• To compare the interview and residency match outcomes of medical students who took the USMLE Step 1 with pass/fail reporting versus those with numeric scoring.

Main Methods:

• Retrospective analysis of a cross-sectional survey.
• Data collected from the Texas Seeking Transparency in Application to Residency (STAR) survey.
• Analysis of 6756 medical student applicants in the 2023 US residency match cycle.

Main Results:

• Applicants with pass/fail USMLE Step 1 had lower USMLE Step 2-CK scores, fewer honored clerkships, and less Alpha Omega Alpha membership.
• Numeric USMLE Step 1 scores were associated with more interview offers, particularly in nonsurgical specialties, after adjusting for academic performance.
• Numeric USMLE Step 1 scoring was not significantly associated with the final residency match outcome.

Conclusions:

• Medical students with numeric USMLE Step 1 scores demonstrated stronger academic profiles.
• Adjusted analyses revealed only weak associations between numeric scoring and interview or match outcomes.
• Longitudinal studies are necessary to fully evaluate the impact of USMLE Step 1 pass/fail reporting.