What do Program Directors Think of USMLE P/F? (RECENT DATA RELEASE!)

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The USMLE (United States Medical Licensing Examination) Step 1 is a necessary hurdle that medical students must surpass, typically during their second year of medical school. The one-day exam tests students on basic science principles, specifically behavioral science, microbiology, physiology, and anatomy.

Here is an insight into how the residency process is going to change as the USMLE Step 1 goes pass fail. Throughout this entire video, I make a reference to a specific paper, and that is published here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785015. Here is an introduction from that paper: In recent landmark decisions on February 12, 2020, and January 26, 2021, the United States Medical Licensing Examination (USMLE) cosponsors announced the adoption of reporting Step 1 pass/fail and the discontinuation of Step 2 Clinical Skills (CS), respectively. These changes were met with mixed reviews from program directors and medical students applying to residency. The authors (A.W., J.D.S., K.L.K.) manually queried a subset (1600 of more than 5000, outreach 50% for every medical specialty except internal medicine and family medicine) of valid PD emails through the Accreditation Council for Graduate Medical Education’s public 2019 to 2020 List of Specialty Programs (n = 31) across all medical specialties.

Conclusions (Again directly from the paper): With the quantitative changes to USMLE, PDs may be encouraged to consider other application components. Although only PDs from nonprimary care specialties reported that the personal statement will become more important, PDs across specialties will consider leadership experience and academic awards or honor society membership as more important. The latter finding is particularly important as rising concern regarding racial disparities in the Alpha Omega Alpha (AΩA) Honor Medical Society membership has led medical schools to reevaluate their AΩA affiliations. Reduced competition and improved student wellness are commonly cited benefits of pass/fail scoring.4 However, the vast majority of PDs responded that they would increase emphasis on Step 2 CK and NBME subject examinations, suggesting that PDs remain resolute in using standardized scores when reviewing applications. Without Step 2 CS and numerical scores for Step 1, heightened academic pressure may be placed on students to perform well on Step 2 CK as the only standardized metric.

AMA's FAQ (https://www.ama-assn.org/residents-students/usmle/usmle-step-1-moves-pass-fail-answers-7-key-questions): What will replace Step 1 as a differentiator? (reinforced by this video!)

Without the USMLE score as a metric, trusted quantitative and qualitative assessments of a candidate’s competencies and unique characteristics will be tracked in other ways. Other elements of a prospective resident’s application, such as the medical student performance evaluation (MSPE, aka “dean’s letter”), may take on a new importance.

Will scores be released more quickly?
Step 1 scores are typically released within three to four weeks of a test date. The sponsoring organizations expect that to remain the case going forward.

00:00-02:30 - Background for USMLE

02:30-03:53 - Overview of the Study

03:53-08:54 - Results of Studies

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