The Rising Importance of Research Output in ENT Residency Applications Without Numeric Step 1 Scores

To evaluate trends in research output (RO) among otolaryngology residency applicants following the transition of the United States Medical Licensing Examination (USMLE) Step 1 to pass/fail scoring, and to explore implications for equity and applicant experience.

This commentary analyzes publicly available data from the National Resident Matching Program (NRMP) Charting Outcomes in the Match reports from 2016 to 2022. The focus is on the average number of abstracts, presentations, and publications reported by matched and unmatched otolaryngology applicants.

Between 2016 and 2022, the average number of research items reported by matched applicants increased from 8.4 to 17.2. In 2022, unmatched applicants reported an average of 11.0 items-similar to what matched applicants reported in 2020. This upward trend appears to align with the announcement and implementation of Step 1 pass/fail scoring.

The increase in RO suggests that both programs and applicants are adapting to Step 1's scoring change by placing greater emphasis on scholarly productivity. However, this shift raises concerns about equity. Applicants without access to a home otolaryngology department or robust research infrastructure may face barriers to mentorship and publication opportunities. Financial costs associated with research presentation and the pressure to start research early in medical school further compound these disparities. The otolaryngology community must critically assess how RO is valued in the application process and develop strategies to ensure fair, meaningful engagement across diverse educational settings.