Is Usmle Step 2 CK the New Usmle Step 1 for Ophthalmology Residency Applications? A San Francisco Match Analysis

To assess trends in Step 2 CK score by ophthalmology residency match status, and to compare Step 2 CK scores by applicant sex and race and ethnicity.

This is a retrospective cohort study from 2021 to 2023. Applicants were stratified by match status and mean Step 2 CK score was compared between matched and unmatched applicants. Step 2 CK scores were also compared by applicant sex, race/ethnicity, type of medical school, and Alpha Omega Alpha selection. Chi-Squared tests, Kruskal-Wallis tests, and multivariate logistic models were used to assess for association of (1) Step 2 CK score and matching into ophthalmology residency, and (2) applicant characteristics and achieving above the national cohort average (>250) Step 2 CK score.

The data is extracted from the San Francisco Match (SF Match).

Applicants who registered for the SF Match and submitted their application to at least 1 ophthalmology residency program from 2021 through 2023 were included.

Of 2367 total applicants in ophthalmology residency, 64.2% matched successfully. Overall mean Step 2 CK score was 255 for matched and 242 for unmatched applicants (p < 0.001). For each 10-point increase in Step 2 CK score, odds of matching in ophthalmology increased by approximately 63% (p < 0.001). White, Asian, and URiM applicants had mean scores of 252, 251, and 244, respectively (p < 0.001). Identifying as Asian, URiM, and female, and attending an osteopathic school were associated with lower odds of achieving a high Step 2 CK score (OR = 0.70, p = 0.011; OR = 0.32, p < 0.001; OR = 0.78, p = 0.042; OR = 0.31, p < 0.001; respectively).

Higher Step 2 CK score was associated with higher odds of matching in ophthalmology. Non-White and female students had lower odds of achieving an above average score. Future studies are necessary to determine the barriers that exist which put these applicants at a disadvantage with this standardized exam.