The USMLE® STEP 1 Pass or Fail Era of the Vascular Surgery Residency Application Process: Implications for Structural Bias and Recommendations

Alnahhal, Khaled I.; Lyden, Sean P.; Caputo, Francis J.; Sorour, Ahmed A.; Rowe, Vincent L.; Colglazier, Jill J.; Smith, Brigitte K.; Shames, Murray L.; Kirksey, Lee

doi:10.1016/j.avsg.2023.04.018

Cited by 4 publications

(1 citation statement)

References 62 publications

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“…Many stakeholders have expressed concerns about removing the standardized Step-1 score and posit additional issues that may arise from this scoring change 2,27,28,29 . Some have highlighted the potential impact of structural biases on URM applicants, given the existing socioeconomic inequities that lead to reduced nancial and community resources among the URM population 30 .…”

Section: Introductionmentioning

confidence: 99%

Securing Interviews as an Underrepresented Applicant Post-USMLE Pass/Fail: A National Survey of Competitive Residency Directors

Kindler,

Kahn,

Uddin

et al. 2023

Preprint

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Background In January 2022, the United States Medical Licensing Examination (USMLE) changed Step-1 score reporting to pass/fail.Objective To report selection criteria important to residency program directors (PDs) and whether they believe pass/fail scoring will impact underrepresented in medicine (URM), international (IMG), or osteopathic (OG) residency applicants.Methods A Qualtrics survey was sent between August, 2022 – January, 2023 to 1,141 US PDs from specialties with traditionally low match rates: dermatology, ophthalmology, otolaryngology, orthopedic surgery, neurosurgery, interventional radiology, diagnostic radiology, radiation oncology, thoracic surgery, vascular surgery, plastic surgery, and urology. Contact information was obtained from AMA, FRIEDA, or program websites.Results We received 433 responses (38%). When asked to anticipate the difficulty student groups will face matching into their specialty, PDs reported: for URM, 24.0% increased, 46.0% unchanged, and 30.0% decreased, OG, 49.19% increased, 44.58% unchanged, and 6.23% decreased; for IMG, 56.35% increased, 39.72% unchanged, and 3.93% decreased. When asked to rank the most important selection factors, the top two responses were Step-2 CK score and away rotation participation at their site.Conclusion PDs overwhelmingly believed match difficulty would either increase or remain unchanged for OG (93.77%) and IMG (96.07%). In contrast, 76.0% reported difficulty for URM students would either decrease or remain unchanged. Paradoxically, PDs ranked Step-2 CK score and away rotation participation as the most important selection factors. Although the intention may be to dismantle barriers for URM applicants, enhanced emphasis on Step 2CK and away rotations place additional socioeconomic and standardized exam barriers.

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Section: Introductionmentioning

confidence: 99%

Securing Interviews as an Underrepresented Applicant Post-USMLE Pass/Fail: A National Survey of Competitive Residency Directors

Kindler,

Kahn,

Uddin

et al. 2023

Preprint

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Examining the Aftermath of Virtual Interviewing on Surgical Residency Matches

Becker,

Xu,

Pratt

et al. 2024

Journal of Surgical Research

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Underrepresented Applicants Post-USMLE Pass/Fail: A National Survey of Competitive Residency Directors

Kindler,

Kahn,

Uddin

et al. 2024

Journal of Medical Education and Curricular Development

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Objective To report the selection criteria important to residency program directors (PDs) and whether they believe pass/fail scoring will impact underrepresented in medicine (URM), International Medical Graduate (IMG), or osteopathic (DO) residency applicants after the United States Medical Licensing Examination (USMLE) changed Step 1 score reporting to pass/fail in January 2022. Methods A Qualtrics survey was sent between August 2022 and January 2023 to 1141 US PDs from specialties with traditionally low residency selection rates: dermatology, ophthalmology, otolaryngology, orthopedic surgery, neurosurgery, interventional radiology, diagnostic radiology, radiation oncology, thoracic surgery, vascular surgery, plastic surgery, and urology. Contact information was obtained from AMA, FRIEDA, or program websites. Results We received 433 responses (38%). When asked to anticipate the difficulty student groups will face matching into their specialty, PDs reported: for URM, 24.0% increased, 46.0% unchanged, and 30.0% decreased; for DO, 49.19% increased, 44.58% unchanged, and 6.23% decreased and for IMG, 56.35% increased, 39.72% unchanged, and 3.93% decreased. When asked to rank the most important selection factors, the top two responses were Step 2 CK score and away rotation participation at their site. Conclusion PDs overwhelmingly believed residency selection difficulty would either increase or remain unchanged for DO (93.77%) and IMG (96.07%). In contrast, 76.0% reported difficulty for URM students would either decrease or remain unchanged. PDs ranked Step 2 CK score and away rotation participation as the most important selection factors. Despite PDs’ belief that the Step 1 pass/fail scoring system may mitigate one barrier for URM students, emphasis on Step 2 CK and away rotations place additional barriers.

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The USMLE® STEP 1 Pass or Fail Era of the Vascular Surgery Residency Application Process: Implications for Structural Bias and Recommendations

Cited by 4 publications

References 62 publications

Securing Interviews as an Underrepresented Applicant Post-USMLE Pass/Fail: A National Survey of Competitive Residency Directors

Securing Interviews as an Underrepresented Applicant Post-USMLE Pass/Fail: A National Survey of Competitive Residency Directors

Examining the Aftermath of Virtual Interviewing on Surgical Residency Matches

Underrepresented Applicants Post-USMLE Pass/Fail: A National Survey of Competitive Residency Directors

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