Objective Measures Needed: Dermatology Program Directors' Perspectives on the USMLE Step 1 Pass/Fail Transition
Background:
Since January 2022, the United States Medical Licensing Examination (USMLE) Step 1 discontinued reporting a 3-digit score. The objective of this study is to share survey results and to communicate the changes Dermatology residency program directors (PDs) will make to evaluate candidates.
Methods:
The research team conducted an online survey of PDs and analyzed the responses using R programming and MATLAB scripts. Chi-squared tests were used to identify significant differences in responses to multiple-choice questions, while paired t tests were utilized to compare pre- and post-values for criteria ranking questions.
Results:
Following the implementation of a pass/fail grading system for Step 1, many PDs will place greater emphasis on Step 2 CK (Clinical Knowledge) scores to differentiate among candidates. Some believe that medical schools should also disclose National Board of Medical Examiners (NBME) shelf exam scores and factor in a student's medical school ranking.
Conclusion:
The added emphasis on Step 2 CK scores, NBME shelf exam scores, a student's medical institution, and class rank may cloud the positive impacts of this change, providing an opportunity for programs to evaluate students more holistically.  .
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