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DOI: 10.1055/s-0040-1718569
Ophthalmology Program Directors' Perspectives on the Impact of the United States Medical Licensing Examination Step 1 Change to Pass-Fail Scoring
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Abstract
Purpose This article investigates the perspectives of ophthalmology residency program directors (PDs) regarding the impact of the United States Medical Licensing Examination (USMLE) Step 1 change from graded to pass-fail scoring on ophthalmology resident selection and medical education.
Methods The PDs of all United States ophthalmology residency programs accredited by the Accreditation Council for Graduate Medical Education were identified using a public, online database. An anonymous web-based survey constructed using REDCap was emailed to each PD in February 2020.
Results Surveys were completed by 64 (54.2%) PDs, with the majority (81.2%) disagreeing with the change to pass-fail scoring. The majority of PDs believe this change will negatively impact the ability to evaluate residency applicants (92.1%) and achieve a fair and meritocratic match process (76.6%), and will decrease medical students' basic science knowledge (75.0%). The factors identified most frequently by PDs as becoming more important in evaluating residency applicants as a result of the Step 1 scoring change include clerkship grades (90.6%), USMLE Step 2 Clinical Knowledge score (84.4%), and a rotation in the PD's department (79.7%). The majority of PDs believe the Step 1 grading change to pass-fail will benefit applicants from elite medical schools (60.9%), and disadvantage applicants from nonelite allopathic schools (82.8%), international medical graduate applicants (76.6%), and osteopathic applicants (54.7%).
Conclusion The majority of ophthalmology PDs disagree with the change in USMLE Step 1 scoring from graded to pass-fail and believe this change will negatively impact the ability to evaluate residency applicants and achieve a fair and meritocratic match process, and will decrease medical students' basic science knowledge.
Keywords
ophthalmology match - Step 1 - United States Medical Licensing Examination - USMLE - pass-fail - Step 2 - Step 2 Clinical Knowledge - residency match - ophthalmology resident - medical student - residency program director - medical educationPublication History
Received: 30 May 2020
Accepted: 03 September 2020
Article published online:
26 November 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 San Francisco Match, Overview: Ophthalmology residency match. Available at: https://sfmatch.org/SpecialtyInsideAll.aspx?id=6&typ=2&name=Ophthalmology. Accessed April 15, 2020
- 2 The National Residency Matching Program, 2–2- Main residency match calendar. Available at: https://nrmp.org/match-calendars/. Accessed April 15, 2020
- 3 The National Resident and Matching Program, Results of the 2018 NRMP program director survey. Available at: https://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf. Accessed April 15, 2020
- 4 Loh AR, Joseph D, Keenan JD, Lietman TM, Naseri A. Predictors of matching in an ophthalmology residency program. Ophthalmology 2013; 120 (04) 865-870
- 5 Siatkowski RM, Mian SI, Culican SM. Association of University Professors of Ophthalmology. et al. Probability of success in the ophthalmology residency match: three-year outcome analysis of San Francisco matching program data. J Acad Ophthalmol 2018; 10 (01) e150-e157
- 6 Nallasamy S, Uhler T, Nallasamy N, Tapino PJ, Volpe NJ. Ophthalmology resident selection: current trends in selection criteria and improving the process. Ophthalmology 2010; 117 (05) 1041-1047
- 7 Driver TH, Loh AR, Joseph D, Keenan JD, Naseri A. Predictors of matching in ophthalmology residency for international medical graduates. Ophthalmology 2014; 121 (04) 974-975
- 8 Yousuf SJ, Jones LS. Ophthalmology residency match outcomes for 2011. Ophthalmology 2012; 119 (03) 642-646
- 9 Grubbs Jr JR, Mian SI. Advising students interested in ophthalmology: a summary of the evidence. Ophthalmology 2016; 123 (07) 1406-1410
- 10 The National Resident Matching Program, Charting outcomes in the match: U.S. allopathic seniors, Characteristics of U.S. allopathic seniors who matched to their preferred specialty in the 2018 main residency match. Available at: nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-In-The-Match-2018-Seniors.pdf. Accessed April 15, 2020
- 11 The National Resident Matching Program, Charting outcomes in the 2011 match: U.S. allopathic seniors, Characteristics of U.S. allopathic seniors who matched to their preferred specialty in the 2011 main residency match. Available at: nrmp.org/report-archives/. Accessed April 15, 2020
- 12 The San Francisco Match and the Association of University Professors of Ophthalmology, Ophthalmology Residency Match Report. Available at: sfmatch.org/SpecialtyINsideAll.aspx?id=6&typ=2&name=Ophthalmology#. Accessed April 15, 2020
- 13 Prober CG, Kolars JC, First LR, Melnick DE. A plea to reassess the role of United States Medical Licensing Examination Step 1 scores in residency selection. Acad Med 2016; 91 (01) 12-15
- 14 Invitation Conference on USMLE Scoring (InCUS). Summary report and preliminary recommendation from the invitation conference on USMLE scoring, March 11–12. 2019 . Available at: https://usmle.org/pdfs/incbus/incus_summary_report.pdf. Accessed April 15, 2020
- 15 Black KP, Abzug JM, Chinchilli VM. Orthopaedic in-training examination scores: a correlation with USMLE results. J Bone Joint Surg Am 2006; 88 (03) 671-676
- 16 Gunderman RB, Jackson VP. Are NBME examination scores useful in selecting radiology residency candidates?. Acad Radiol 2000; 7 (08) 603-606
- 17 United States Medical Licensing Examination, Change to pass/fail score reporting for Step 1. Available at: https://www.usmle.org/incus/. Accessed April 15, 2020
- 18 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
- 19 The American Medical Association, FREIDA the AMA residency & fellowship database. Available at: https://freida.ama-assn.org/Freida. Accessed April 15, 2020
- 20 Davis D, Dorsey JK, Franks RD, Sackett PR, Searcy CA, Zhao X. Do racial and ethnic group differences in performance on the MCAT exam reflect test bias?. Acad Med 2013; 88 (05) 593-602
- 21 United States Medical Licensing Examination, Three decision to result in future changes to USMLE. Available at: https://www.usmle.org/pdfs/viewer/viewer.html?file=/pdfs/podcast/Three-decision-to-result-in-future-changes-toUSMLE.pdf?123. Accessed April 15, 2020
- 22 Venincasa MJ, Cai LZ, Gedde SJ, Uhler T, Sridhar J. Current applicant perceptions of the ophthalmology residency match. JAMA Ophthalmol 2020; DOI: 10.1001/jamaophthalmol.2020.0252.
- 23 Greenberg PB, Scott IU. et al. Video conference interviewing for the ophthalmology residency match. JAMA Ophthalmol (in press)
- 24 Kloosterboer A, Yannuzzi NA, Gedde SJ, Sridhar J. Residency program directors of United States ophthalmology programs: a descriptive analysis. Am J Ophthalmol 2020; 209: 71-76