The Impact of Step 1 Scores on Medical Students’ Residency Specialty Choice

Khan, Masrur; Gil, Nelson; Lin, Wilson; Fiter, Ryan; Kenawy, Dahlia M.; Downs, Ian; Burton, William B.; Raff, Amanda

doi:10.1007/s40670-018-0615-5

Cited by 4 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Students felt achieving a particular score would influence specialty choice, a well-documented phenomenon [38,39]. One student commented on their Step 1 performance, saying "It was fine for OB [obstetrics/gynecology], but had I wanted to go into derm [dermatology] or ophtho [ophthalmology], it was automatic.…”

Section: One Test To Rule Them All? Consequences Of "Exam Mania"mentioning

confidence: 99%

“…Further, exams such as Step 2 CK are taken at a challenging time, when they are balancing numerous high-stakes experiences including away rotations, sub-internships, securing letters of recommendation, and preparing their residency applications [42]. Students experience burnout and loss of idealism which could have consequences for subsequent exam performance and specialty choice [38,39,43]. This sense of burnout also has social consequences: "You need to eat, you need to grocery shop, and you need to clean your apartment, and spend time with your partner if you have one, you know?…”

Section: One Test To Rule Them All? Consequences Of "Exam Mania"mentioning

confidence: 99%

See 1 more Smart Citation

One test to rule them all: A qualitative study of formal, informal, and hidden curricula as drivers of USMLE “exam mania”

et al. 2023

View full text Add to dashboard Cite

High-stakes examinations are an integral part of medical education. To practice in the United States (U.S.), students must pass the U.S. Medical Licensing Examinations (USMLE). With the transition of USMLE Step 1 to pass/fail scoring on January 26, 2022, a worldwide debate regarding how residency program directors will view the Step 2 Clinical Knowledge (CK) exam emerged. Here, the authors explore the role of formal, informal, and hidden curricula related to USMLE, with broader implications for high-stakes examinations. Six focus groups of fourth-year students who recently took Step 2 CK and a supplemental curricular content analysis were conducted to explore students’ decision-making and emotions regarding the exam, including how the formal, informal, and hidden curricula influence their perspectives. Participants highlighted how informal and hidden curricula drive the belief that high-stakes examinations are the single most important factor in medical school. Prior experience with Step 1 drives behaviors and attitudes when preparing for Step 2 CK. Pressures from these examinations have unintended consequences on burnout, professional identity, specialty choice, and interpersonal interactions. Both interpersonal interactions within medical education as well as subconscious, unintended messaging can influence medical student approaches to and perspectives about high-stakes examinations. Within the context of U.S. medical training, with the transition to a new era of a pass/fail Step 1 examination, careful consideration to prevent shifting the current “Step 1 mania” to a “Step 2 CK mania” is warranted. More broadly, medical educators must examine the unintended yet potentially damaging pressures institutions generate in their medical trainees in relation to high-stakes examinations.

show abstract

Section: One Test To Rule Them All? Consequences Of "Exam Mania"mentioning

confidence: 99%

Section: One Test To Rule Them All? Consequences Of "Exam Mania"mentioning

confidence: 99%

One test to rule them all: A qualitative study of formal, informal, and hidden curricula as drivers of USMLE “exam mania”

et al. 2023

View full text Add to dashboard Cite

show abstract

“…To demonstrate the overall expertise and experience in otorhinolaryngology, various questions were asked and evaluated and were put along to enhance the preferences of individuals regarding the otorhinolaryngology as the field of specialty. A Likert scale was selected having numbering from 1-5 in which, strongly agree [1], agree [2], not sure [3], disagree [4], strongly disagree [5]. The document was prepared in accordance with the "uniform requirements submitted to biomedical journals" 15 .…”

Section: Methodsmentioning

confidence: 99%

“…The specialty of otorhinolaryngology is equipped with a modest level of field across the globe. The tendencies of graduates choosing a specialty are varying across the world 1 . Perceived that the newer generation being more attentive on family and friends; are opting for professions where they can spend quality time with family.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Otolaryngology specialty choice among the 4th year MBBS students

Umar¹,

Mushwani²,

Arshad³

2022

PJMHS

View full text Add to dashboard Cite

Background: The discipline of otorhinolaryngology specialty is a very promising field all over the globe. This field is equipped with modified lifestyle as compared to general surgery field. However, otolaryngology is a flexible, promising and important field but still its trend is decreasing all over the world across the undergraduate’s professionals. Aim: To determine the frequency of otolaryngology specialty choice being taken by 4th year MBBS students. Methods: A descriptive cross-sectional study was conducted in otorhinolaryngology department of Islamabad Medical and Dental College, Islamabad from January to December 2020. The answers were obtained through the Likert scale-5 having the following components, as strongly agree, agree, not sure, disagree, strongly disagree. Results: A 100 undergraduate students participated in this survey. All students were of 4th year MBBS. 20% students were agreed and 40% not sure about the question regarding taking up otorhinolaryngology as a career choice and 15% strongly agreed for this. Conclusion: The study concluded that the graduates are not sure whether they want to choose otorhinolaryngology as their final career choice. We suggest that it should be one of the compulsory rotations during the internship. Keywords: Otorhinolaryngology; Specialty; Undergraduate medical education; Postgraduate; Career choice.

show abstract

Pass/Fail Score Reporting for USMLE Step 1: An Opportunity to Redefine the Transition to Residency Together

2020

View full text Add to dashboard Cite

The upcoming transition of the United States Medical Licensing Examination Step 1 to pass/fail score reporting has wide-ranging implications for the medical education community. The decision to discontinue 3-digit numeric score reporting comes following advocacy to change the exam because of its disproportionate importance in the residency match process, the negative impact the exam has on student well-being, and the prominent influence the exam has on medical school curricula. Shifting to pass/fail score reporting for Step 1 creates significant uncertainties to be addressed by the stakeholders in the transition from undergraduate medical education to graduate medical education. In this Invited Commentary, the authors reflect on the positive implications of this scoring change, potential negative ramifications that need to be proactively addressed, and future ways that the transition to residency can be optimized. The transition to pass/fail score reporting for Step 1 creates an opportunity to redefine the residency match process, to support applicant decision making, and to encourage a holistic review of applicants. These changes to the review process will require grace and trust among stakeholders, including students, as well as active support for students who might be negatively impacted during a complex implementation phase. By removing the dominance of Step 1 numeric scores from the residency selection process, the change to pass/fail scoring provides a unique opportunity for all stakeholders to work together and redefine the transition to residency while protecting students from unintended negative consequences.

show abstract

The Impact of Step 1 Scores on Medical Students’ Residency Specialty Choice

Cited by 4 publications

References 15 publications

One test to rule them all: A qualitative study of formal, informal, and hidden curricula as drivers of USMLE “exam mania”

One test to rule them all: A qualitative study of formal, informal, and hidden curricula as drivers of USMLE “exam mania”

Otolaryngology specialty choice among the 4th year MBBS students

Pass/Fail Score Reporting for USMLE Step 1: An Opportunity to Redefine the Transition to Residency Together

Contact Info

Product

Resources

About