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Diagnostic & interventional radiology residency program directors' perspectives on the USMLE step 1 exam shift to pass/fail scoring

  • Author Footnotes
    1 Denotes Co-First Authorship: LEM, CFB, and KJD contributed equally to this work.
    Laura E. Minton
    Footnotes
    1 Denotes Co-First Authorship: LEM, CFB, and KJD contributed equally to this work.
    Affiliations
    Marnix E. Heersink School of Medicine, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35233, USA
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  • Author Footnotes
    1 Denotes Co-First Authorship: LEM, CFB, and KJD contributed equally to this work.
    Channing F. Bruce
    Footnotes
    1 Denotes Co-First Authorship: LEM, CFB, and KJD contributed equally to this work.
    Affiliations
    Marnix E. Heersink School of Medicine, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35233, USA
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  • Author Footnotes
    1 Denotes Co-First Authorship: LEM, CFB, and KJD contributed equally to this work.
    Kory J. Dees
    Footnotes
    1 Denotes Co-First Authorship: LEM, CFB, and KJD contributed equally to this work.
    Affiliations
    Marnix E. Heersink School of Medicine, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35233, USA
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  • Will Haynes
    Affiliations
    Marnix E. Heersink School of Medicine, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35233, USA
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  • Om U. Patel
    Affiliations
    Marnix E. Heersink School of Medicine, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35233, USA
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  • Ishant Yadav
    Affiliations
    Marnix E. Heersink School of Medicine, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35233, USA
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  • Kaitlin Burge
    Affiliations
    Marnix E. Heersink School of Medicine, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35233, USA
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  • Nicholas Van Wagoner
    Affiliations
    Marnix E. Heersink School of Medicine, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35233, USA

    Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, AL, USA
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  • Kristin K. Porter
    Correspondence
    Corresponding author at: University of Alabama at Birmingham, Department of Radiology, 619 19th Street South, Birmingham, AL 35249, USA.
    Affiliations
    Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA
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  • Author Footnotes
    1 Denotes Co-First Authorship: LEM, CFB, and KJD contributed equally to this work.

      Highlights

      • USMLE Step 1 scores have been used to screen for Diagnostic Radiology and Interventional Radiology residency interviews and are now pass/fail.
      • There is question whether USMLE Step 1 or Step 2 CK scores accurately predict a resident’s ability to perform clinically in their specialty.
      • The added emphasis on other metrics may negate the positive impacts of changing Step 1 to pass/fail.

      Abstract

      Rationale and objectives

      As of January 2022, Step 1 of the United States Medical Licensing Examination (USMLE) has changed to pass/fail grading. The purpose of this study was to share survey results and communicate changes Diagnostic (DR) and integrated Interventional (IR) Radiology residency program directors (PDs) will make and aspire to make, given this change.

      Materials and methods

      An online survey was sent to DR and IR PDs. Data was collected over four months. Custom R programming and MATLAB language scripts were used to evaluate the survey responses. Chi squared tests were used to determine statistical significance for multiple choice questions regarding PD views of Step 1 transitioning to pass-fail. Paired t-tests were used to differentiate pre- and post-values for questions in which PDs ranked criteria for resident selection.

      Results

      After USMLE Step 1 becomes pass/fail, most respondents will use Step 2 CK scores as a more important factor than previously, believe medical schools should share National Board of Medical Examiners (NBME) shelf exam scores, do not believe students will be better prepared clinically, and believe a student's medical school rank will be considered more.

      Conclusion

      The added emphasis on Step 2 CK scores, NBME shelf exam scores, class rank, and a student's medical institution may negate the positive impacts of changing Step 1 to pass/fail. Alternatively, it may present an opportunity for programs to evaluate students more broadly.

      Abbreviations:

      AAPD (Assistant Program Director), APD (Associate Program Director), APDR (Association of Program Directors in Radiology), DR (Diagnostic Radiology), IR (Interventional Radiology), NBME (National Board of Medical Examiners), NRMP (National Residency Matching Program), PD (Program Director), USMLE (United States Medical Licensing Examination)

      Keywords

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