Pass/Fail Scoring of USMLE Step 1 and the Need for Residency Selection Reform

Heiser

Ann Otol Rhinol Laryngol

et al. 2021

Self Cite

Purpose: To evaluate the recent Otolaryngology-Head and Neck Surgery (OTO-HNS) applicant characteristics, to identify which applicant characteristics are associated with successful match into OTO-HNS, and to compare OTO-HNS applicant trends and characteristics to that of peer surgical specialties (PS). Materials and Methods: Data were obtained from official reports by the National Residency Matching Program (NRMP) for OTO-HNS, plastic and reconstructive surgery, orthopedic surgery, neurosurgery, and dermatology from 2006 to 2019. Alpha Omega Alpha (AOA) membership, United States Medical Licensing Examination (USMLE) scores, research productivity, graduation from a top-40 NIH-funded U.S. medical school, and additional graduate degree were recorded. Odds ratios (OR) were calculated to evaluate the relationship between applicant qualifications and match success. Results: From 2014 to 2018, the OTO-HNS applicant pool shrunk from 443 to 333, representing the largest drop of all PS. Furthermore, OTO-HNS reported the most unfilled positions and highest match rates in 2017 (n = 14; 92.1%) and 2018 (n = 12; 94.6%) among any PS. Despite recent trends, 2019 NRMP data revealed a 38.74% increase in OTO-HNS applicant numbers compared to 2018. AOA membership (OR, 7.3; P = .030), USMLE Step 2 scores between 241 and 260 (OR, 6.5; P = .009), and research productivity (OR, 5.6; P = .005) significantly increased the odds of matching into OTO-HNS. Conclusions: Despite recent fluctuations in application trends, OTO-HNS continues to successfully match highly qualified applicants, including applicants with AOA membership, high Step 2 scores, and high research productivity. An understanding of the qualifications used to evaluate residency applicants may be helpful to both applicants and residency programs of OTO-HNS.

Section: Discussionmentioning

confidence: 94%

“…With the upcoming change in step 1 scoring (described below), step 2 may carry even greater importance moving forward. 8…”

Section: Discussionmentioning

confidence: 99%

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Otolaryngology Applicant Characteristics and Trends: Comparing OTO-HNS with Peer Specialties

Heiser

Ann Otol Rhinol Laryngol

et al. 2021

Self Cite

Laryngoscope Investig Oto

“…Future research is warranted to better understand the influence of clerkship grading scheme on match outcomes. Finally, it is unknown how the findings from this study will be influenced by new changes to the residency selection process such as the transition of USMLE Step 1 to Pass/Fail 17 and the implementation of preference signaling in otolaryngology 18 …”

Section: Discussionmentioning

confidence: 99%

Predictors of otolaryngology applicant success using the Texas STAR database

Lenze

Mihalic

DeMason

et al. 2021

Objectives To examine applicant characteristics and behaviors associated with a successful match into otolaryngology residency. Methods Self‐reported survey data from applicants to otolaryngology residency between 2018 and 2020 were obtained from the Texas STAR database. Characteristics and predictors associated with a successful match were examined using Chi‐square tests, two‐sided t‐tests, and logistic regression models. Results A total of 315 otolaryngology residency applicants responded to the survey of whom 274 matched (87%) and 41 did not match (13%). Matched applicants had a significantly higher mean USMLE Step 1 score (P = .016) and Step 2 CK score (P = .007). There were no significant differences in AOA status (45% vs 36%; P = .207), mean number of applications submitted (70 vs 69; P = .544), and mean number of away rotations (2.1 vs 2.0; P = .687) between matched and unmatched applicants. Significant predictors of a successful match included receiving honors in 5 or more clerkships (OR 2.0, 95% CI 1.0‐4.0; P = .040), receiving honors in an ENT clerkship (OR 3.7, 95% CI 1.0‐12.9; P = .044), and having 3 or more peer‐reviewed publications (OR 2.3, 95% CI 1.1‐4.5; P = .020). The majority of applicants (79.9%) matched at a program where they either did an away rotation, had a personal geographic connection, or attended medical school in the same geographic region. Conclusions Board scores, excelling on clinical rotations, and having productive research experience appear to be strong predictors of a successful match in otolaryngology. The majority of applicants report a personal or geographic connection to the program at which they match. Level of evidence 4.

“…1,6 Moreover, as more than half of OTO-HNS programs use USMLE scores as a screening tool, 41 the recently announced change of the USMLE Step 1 examination to pass/fail scoring furthers the need for residency selection reform. 69,70 Additional reasons supporting the need for process reform include curtailing the massive application cycle costs incurred by applicants, 3,37 increasing the understanding of which applicant characteristics are best correlated with an ideal resident, 8 and ultimately ensuring the highest quality of future otolaryngologists to lead the specialty.…”

Section: The Need For Residency Selection Reformmentioning

confidence: 99%

Ideas and Innovations to Improve the Otolaryngology–Head and Neck Surgery Residency Application and Selection Process

Heiser

Otolaryngol.--head neck surg.

et al. 2020

Self Cite

Objective To (1) summarize strategies proposed in the recent otolaryngology–head and neck surgery (OTO-HNS) literature for improving the residency application and selection process, (2) evaluate the effects of recently implemented changes to the OTO-HNS match, and (3) discuss recommendations for future changes to the OTO-HNS residency application and selection process. Data Sources PubMed, Medline Ovid database, and article reference lists. Review Methods A structured literature search was performed to identify current English language articles relating to the objectives of this study using the aforementioned data sources, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The search was limited to submissions published between January 1, 2015, and January 1, 2020. Conclusions Numerous proposals have been made for improving the otolaryngology residency application and selection process and addressing the competitive nature of the Match. These proposals include but are not limited to mandating a secondary essay, implementing consortia and early match processes, using a signaling system, conducting regional and web-based interviews, offering early engagement with interest groups, instituting a hard cap on applications, increasing costs of applying, counseling self-restraint to prospective applicants, and creating application filters. Implications for Practice As the volume of literature surrounding the OTO-HNS Match continues to increase, this review aims to provide a summary of past proposals and serve as a guide for possible future innovations. We propose 3 initiatives that may improve the residency application and selection process for both program and resident, with minimal impact to the current National Resident Matching Program (NRMP) Match structure.