JAMA, June 28, 2022. doi:10.1001/jamanetworkopen.2022.19212
Results of a National Survey of Program Directors’ Perspectives on a Pass/Fail US Medical Licensing Examination Step 1
In January 2022, Step 1 of the US Medical Licensing Examination (USMLE) began reporting as pass/fail.1,2 How this change might affect resident selection and medical student advising remains unclear. This survey study assesses opinions of allopathic residency program directors (PDs) representing 25 specialties regarding USMLE examinations’ current ability to project clinical and specialty board examination performance, the relative importance of USMLE Step 1 in the current selection process for residents, and how the change to pass/fail will affect the relative importance of other factors in residency selection. While understanding program directors’ perceptions in aggregate has value, we hypothesized that differences exist by type of specialty. Analysis was performed comparing perceptions of procedural with nonprocedural specialty PDs.
Studies show that Program Directors (PD) in aggregate want more objective measures of applicant performance to guide the resident selection process. While our study confirms this, our results also demonstrate differences between PDs in procedural and nonprocedural specialties regarding the value they place on objective measures before and after the transition of Step 1 to pass/fail, with procedural specialties prioritizing USMLE examinations. The relative importance of academic performance characteristics, personal characteristics, and knowledge of applicant in resident selection was projected to remain similar following the transition of Step 1 to pass/fail.
Published: June 28, 2022. doi:10.1001/jamanetworkopen.2022.19212