Implications of the United States Medical Licensing Examination Step 1 Examination Transition to Pass/Fail on Medical Students Education and Future Career Opportunities

Abstract

Background United States Medical Licensing Examination (USMLE) Step 1 will transition to pass/fail score by 2022. We aim to investigate US medical students’ perspectives on the potential implications this transition would have on their education and career opportunities. Methods A cross-sectional study investigating US medical students’ perspectives on the implications of transition of the USMLE Step 1 exam to pass/fail. Students were asked their preferences regarding various aspects of the USMLE Step 1 examination, including activities, educational opportunities, expenses regarding preparation for the examination, and future career opportunities. Results 215 medical students responded to the survey, 59.1% were women, 80.9% were allopathic vs. 19.1% osteopathic students. 34.0% preferred the USMLE Step 1 to be graded on a pass/fail score, whereas 53.5% preferred a numeric scale. Osteopathic vs. allopathic students were more likely to report that the pass/fail transition will negatively impact their residency match (aOR = 1.454, 95% CI: 0.515, 4.106) and specialty of choice (aOR = 3.187, 95% CI: 0.980, 10.359). 57.7% of respondents reported that the transition to a pass/fail grading system will change their study habits. Conclusions The transition of the USMLE Step 1 to a pass/fail system has massive implications on medical students and residency programs alike. Though the majority of medical students did not prefer the USMLE Step 1 to have a pass/fail score, they must adapt their strategies to remain competitive for residency applications. Residency programs should create a composite score based off all aspects of medical students’ applications in order to create a holistic and fair evaluation and ranking system.

Comprehensive Reform and Greater Equity in Applying to Residency—Trainees' Mixed Responses to a Pass/Fail USMLE Step 1

“…Similarly, in a single institution cross-sectional survey of 215 medical students, osteopathic students were more likely to report that the pass/fail transition will negatively impact their residency match compared to allopathic students (adjust OR 1.454, 95% CI 0.515-4.106). 23 This sentiment is supported by our findings, as only a third of osteopathic trainees agreed with the change, and more osteopathic students felt they would be disadvantaged compared to their allopathic counterparts.…”

Transitioning of the United States Medical Licensing Examination Step 1 Examination to a Non-Numeric Pass/Fail Grading System: Toward Unbiased Residency Matching Process

“…Our anonymous analysis of 215 medical students nationwide aimed to evaluate their perspectives; this changeover may have on their medical education and career opportunities. 1 We found that 34.0% of students prefer a pass/fail grading system, with 57.7% reporting that the transition will change their study habits in preparing for the examination. 1 Compared to allopathic medical students, osteopathic medical students had 45% greater odds of reporting that the pass/fail transition will negatively impact their residency match and 3 times greater odds of reporting that the transition will negatively impact their specialty of choice.…”

“…1 We found that 34.0% of students prefer a pass/fail grading system, with 57.7% reporting that the transition will change their study habits in preparing for the examination. 1 Compared to allopathic medical students, osteopathic medical students had 45% greater odds of reporting that the pass/fail transition will negatively impact their residency match and 3 times greater odds of reporting that the transition will negatively impact their specialty of choice. 1 We concluded that this grading transition will likely have large ramifications in the matching process, and as such, students should optimize other areas of their application in order to increase the competitiveness of their applications.…”

“…We would like to thank the authors for their interest and thoughtful comments about our article titled “Implications of the United States Medical Licensing Examination Step 1 Examination Transition to Pass/Fail on Medical Students Education and Future Career Opportunities.” Our article analyzed possible implications of the USMLE Step 1 pass/fail transition. 1 With the recent transition of Step 1 to a non-numeric pass/fail grading system, there have been questions regarding the implications of this change.…”

US Medical Licensing Examination Step 1: To Grade or Not to Grade?

“…We read with great interest the article by Ehrlich et al, 1 in which the authors administered a cross-sectional survey to provide valuable insight into how US medical students perceived the transition of US Medical Licensing Examination (USMLE) Step 1 to pass/fail (P/F). While Ehrlich and colleagues provide a comprehensive assessment of the student's perspective following this drastic change in USMLE, we believe that there are some pertinent limitations worth consideration when interpreting the findings of this study.…”