Overemphasis of Step 1 Scores May Affect Application Pool Diversity in Radiation Oncology

Fernandez, Christian; Lopez, Bernard L.; Kushner, Marlene; Leiby, Benjamin E.; Den, Robert B.

doi:10.1016/j.prro.2019.07.009

Cited by 19 publications

(19 citation statements)

References 16 publications

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“…Age was categorized as <30 versus ≥30 years; gender as man versus woman; applicant type as US allopathic, US osteopathic, or international medical graduate (IMG); and race/ethnicity as URM versus non-URM. URM was defined as African American/Black, Hawaiian/Pacific Islander, Hispanic/Latino, or Alaskan Native/Native American, 6 and non-URM was defined as any race/ethnicity not in the URM definition, including Caucasian, Asian, and prefer not to state . The Step 1 cutoff score was set at ≥240 for in-depth Step 2 univariate and multivariable regression analyses and labeled Step 1 ≥240 .…”

Section: Methodsmentioning

confidence: 99%

“… 4 , 5 This overemphasis on Step 1 scores for resident selection may have unintended consequences of reducing diversity in competitive specialties based on gender, age, and distribution of underrepresented minorities (URMs). 6 Various studies have reported the positive effect on patients and communities as a whole when a diverse physician workforce is in place. 7 - 9 Otolaryngology lags behind other medical specialties in the representation of URMs and women.…”

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confidence: 99%

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Overemphasis of USMLE and Its Potential Impact on Diversity in Otolaryngology

Quesada¹,

Solis

Ojeaga

et al. 2021

OTO Open

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Objective Applicant demographics during the 2019-2020 residency cycle were evaluated to determine if strict utilization of United States Medical Licensing Examination (USMLE) scores in applicant selection could lead to a restriction in diversity. Study Design Cross-sectional study. Setting Otolaryngology residency applicants to a single institution. Methods A total of 381 applicants were analyzed by age, gender, applicant type, race/ethnicity, USMLE scores, permanent zip code, and graduating medical school. Results Among applicants, 37% were women; 9% were ≥30 years of age; 12% were underrepresented minorities (URMs); 71% to 81% had above-average socioeconomic surrogate markers; 22% were from a top 25 US News & World Report–ranked institution; and 81% were from an institution with an otolaryngology residency program. There was no increase in applicants who identified as URM from the 2015-2020 cycles. Multivariable regression analysis showed that applicants who were international medical graduates, URMs, and ≥30 years of age had lower Step 1 and Step 2 scores ( P < .05). Applicants who identified as women had a lower Step 1 score, and those from top 25 National Institutes of Health–funded institutions had a higher Step 1 score; however, there was no difference when Step 2 scores were compared ( P > .05). Conclusion Our data suggest that in the pre–USMLE Step 1 pass/fail setting, strict adherence to USMLE scores may lead to disproportionally low recruitment of applicants who are women, ≥30 years of age, URMs, and from institutions without an otolaryngology residency program. We must implement measures against overemphasizing the absolute values of USMLE scores for a true holistic review of applicants, specifically to prevent an overemphasis on the USMLE Step 2 score.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Overemphasis of USMLE and Its Potential Impact on Diversity in Otolaryngology

Quesada¹,

Solis

Ojeaga

et al. 2021

OTO Open

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“…In addition, related studies from the radiation oncology literature identified Step 1 screening cutoffs as associated with a disproportionately negative impact on female and under-represented minority applicants-groups that are critical to improving diversity in the neurosurgery workforce. 5…”

Section: Strengths and Weakness Of The Step 1 Scorementioning

confidence: 99%

Stepping Up: How U.S. Neurosurgery Training Programs Can Innovatively Assess Resident Applicants in a Post-Step 1 World

2020

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“…Currently used differentiators are limited: clerkship grading is inconsistent across institutions and Step 1 licensing examination scores will soon be retired (with good reason). 9 Even personal statements and letters of recommendation can be fraught with bias, leaving unreliable narrators to advise the PDs on applicant potential. 10,11 Furthermore, COVID19-related disruptions to clinical rotations and away electives will result in less clinical exposure of faculty to candidates and may affect the strength and scope of their subsequent letters of recommendation.…”

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confidence: 99%