Trends in Medical Student Publications in the Pass/Fail Licensing Examination Era

The transition of the US Medical Licensing Examination Step 1 to pass/fail scoring has intensified concerns about a research "arms race" among medical students seeking advantage in the residency application process. Over three graduating cohorts of medical students (classes of 2022-2024), the study aimed to determine whether medical students have increased participation in published scholarship and whether medical student publications exhibited diminishing quality, as measured by citations, authorship position, and publication type.

Data from a registry of recently enumerated medical providers (to identify newly matched US residents) were linked to publication data from the PubMed and Scopus databases.

Based on a sample of 28,926 Doctor of Medicine (MD) graduates and 7983 Doctor of Osteopathic Medicine (DO) graduates, there was a slight increase in publication (from 43% to 48% of MD graduates and from 24% to 31% of DO graduates, comparing the classes of 2022 and 2024). Analysis of 44,055 unique publications attributed to MD and DO graduates in all three cohorts revealed no meaningful changes in publication type, author position, or citations per year.

Medical student publications have grown at a slow rate and with minimal changes in quality metrics. These results suggest that prioritizing quality over quantity of research activities during medical school remains a sound strategy for the research component of residency applications.