Selecting the Next Generation of Surgeons: General Surgery Program Directors and Coordinators Perspective on USMLE Changes and Holistic Approach

Abstract

Introduction The United States Medical Licensing Examination (USMLE) was designed as a universal assessment tool for states to determine physician’s medical licensure's candidacy. Recent changes in the USMLE exam have changed the way future surgical residency candidate applications will be reviewed. The survey aimed to assess the effect of changes in USMLE exams—USMLE Step 1 pass/fail, complete dissolution of USMLE clinical skills exam, and the role of holistic review in future surgical residency candidacy selection. Methods An anonymous online survey was created and distributed to general surgery program directors and coordinators across the USA. The survey aimed to assess attitudes toward changes to USMLE exams and the potential changes with a holistic review of candidate applications. Results The response rate was 63.7%. Most program directors and coordinators disagree with changing USMLE Step 1 to a pass/fail scoring system. The majority felt that contacts, the medical school's name, and performance in clinical electives and sub-internships would hold more significance. They also believe that a holistic review of application will decrease socioeconomic discrepancies and promote a more diverse and inclusive resident cohort. Conclusion Step 2 clinical knowledge (CK) will gain more importance in future residency matches because of the change in the scoring system of Step 1. The medical school's name, personal contacts, and clinical performance in rotations will hold more significance.

Interview Invitations for Otolaryngology Residency Positions Across Demographic Groups Following Implementation of Preference Signaling

“…Preference signaling was implemented in OHNS 5 with the goals of mitigating a surge in applications, 1 aligning program and applicant interests during the interview selection phase, and enhancing the capacity for holistic review, the preferred method for candidate assessment. 6,7 While preference signaling has not previously been used in the residency application process, this system was developed and implemented in the economics PhD marketplace 8 and several authors [9][10][11][12] have advocated for this approach during the residency selection process.…”

Residency Program Directors’ Views on Research Conducted During Medical School: A National Survey

“…The observation that some PDs will consider research of equal or greater importance than the Step 2 score is provocative. The changing significance of Step 2 is a topic that has been hotly debated of late, with multiple survey studies reporting and blog posts opining that PDs will consider Step 2 “the new Step 1.” 46–57 The sentiment that Step 2 will be relied on more heavily, at least compared with student research activity, was not expressed by respondents in this study. Most likely, the process of selecting applicants for interviews and ranking without a numeric Step 1 score will take several years to refine, and the question of whether research continues to be of equal or greater importance to the Step 2 score will merit revisiting at a future date.…”

Identifying Attitudes Toward and Acceptance of Osteopathic Graduates in Surgical Residency Programs in the Era of Single Accreditation: Results of the American College of Osteopathic Surgeons Medical Student Section Questionnaire of Program Directors

“…A study performed by Aziz et al in 2021 determined the attitudes of general surgery program directors in regards to USMLE step 1 changing to pass/fail scoring. They concluded that not only will step 2CK scores become more emphasized, but that the medical school name, personal contacts, and clinical performance will hold more significance as well [ 25 ]. Program directors in the fields of otolaryngology, neurological surgery, plastic surgery, and orthopedic surgery also disagreed with the policy change based on studies from their respective specialty groups.…”