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Lenze NR, Benjamin WJ, Kay HG, Watkins MO, Mihalic AP, Bohm LA, Thorne MC, Kupfer RA, Brenner MJ. Association of USMLE Step 1 Pass/Fail Reporting with Interview and Match Outcomes. JOURNAL OF SURGICAL EDUCATION 2024; 81:1428-1436. [PMID: 39043510 DOI: 10.1016/j.jsurg.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 05/13/2024] [Accepted: 06/17/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE To investigate interview and match outcomes of medical students who received pass/fail USMLE reporting vs medical students with numeric scoring during the same period. DESIGN Retrospective analysis of a cross-sectional survey-based study. SETTING United States 2023 residency match. PARTICIPANTS Medical student applicants in the 2023 residency match cycle who responded to the Texas Seeking Transparency in Application to Residency (STAR) survey. RESULTS Among 6756 applicants for the 2023 match, 496 (7.3%) took USMLE Step 1 with pass/fail reporting. Pass/fail reporting was associated with lower USMLE Step 2-CK scores (245.9 vs 250.7), fewer honored clerkships (2.4 vs 3.1), and lower Alpha Omega Alpha membership (12.5% vs 25.2%) (all p < 0.001). Applicants with numeric USMLE Step 1 scores received more interview offers after adjusting for academic performance (beta coefficient 1.04 (95% CI 0.28-1.79); p = 0.007). Numeric USMLE Step 1 scoring was associated with more interview offers in nonsurgical specialties (beta coefficient 1.64 [95% CI 0.74-2.53]; p < 0.001), but not in general surgery (beta coefficient 3.01 [95% CI -0.82 to 6.84]; p = 0.123) or surgical subspecialties (beta coefficient 1.92 [95% CI -0.78 to 4.62]; p = 0.163). Numeric USMLE Step 1 scoring was not associated with match outcome. CONCLUSIONS Applicants with numeric USMLE Step 1 scoring had stronger academic profiles than those with pass/fail scoring; however, adjusted analyses found only weak associations with interview or match outcomes. Further research is warranted to assess longitudinal outcomes.
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Affiliation(s)
- Nicholas R Lenze
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan.
| | - William J Benjamin
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Hannah G Kay
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Mariel O Watkins
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Angela P Mihalic
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Lauren A Bohm
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Marc C Thorne
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Robbi A Kupfer
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Michael J Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
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Khatri S, Samsonov AP. Flexible Scheduling for Shelf Exam Timing: A Paradigm Shift in Residency Selection and Beyond. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:474. [PMID: 38335133 DOI: 10.1097/acm.0000000000005659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
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Deleon MA, Lakhotia S, Gelfond J, Peebles C, Lathrop K, Botros-Brey S. Student Perspectives on the Undergraduate Medical Student Research Experience at a Single United States Allopathic Institution. Cureus 2024; 16:e60809. [PMID: 38910643 PMCID: PMC11191393 DOI: 10.7759/cureus.60809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction The purpose of this study was to identify student-reported institutional facilitators and barriers to successful research experiences at a single United States allopathic institution. Residency applications have increasingly become more competitive, and with the United States Medical Licensing Examination (USMLE) Step 1 exam's transition to pass/fail, factors such as research experience and outcomes may become more important to increase residency application competitiveness. This study sought to explore factors that impact successful research experiences leading to tangible outcomes for medical students at our medical school, the Joe R. & Teresa Lozano Long School of Medicine. Methods A cross-sectional survey was developed and administered via REDCap to 853 students in May 2022. Survey question domains included demographics, past and present research participation, perceived barriers/facilitators to research, tangible outcomes (e.g., publications and posters), and overall satisfaction with research comparing subjectively "best" and "worst" experiences. The Institutional Review Board (IRB) deemed this project as non-regulated research. Results We had a 24% (n = 204/853) response rate. The responses were distributed equally among the four classes. A big portion of the participants (71%, n = 59/83) identified a tangible outcome as the most important measure of success. Regarding facilitators, students identified having a mentor (89%, n = 165/184) and departmental connections (85%, n = 156/184) as the most important when looking for a project. Barriers included SMART goals (Specific, Measurable, Achievable, Relevant, and Time-Bound) lacking in 31% (n = 24/75) of worst projects, followed by a clear timeline in 29% (n = 22/76) and hours of commitment in 27% (n = 21/78). The best projects were more likely to have resulted in a publication (61% (27/44) vs. 32% (14/44)) or have a poster (64% (28/44) vs. 36% (16/44)). Conclusions Medical students are interested in participating in research, with important facilitators including mentorship and departmental connections. Modifiable variables include lack of clear timelines, well-defined roles and responsibilities, and time commitments. This information may be useful for faculty who mentor medical students or medical schools interested in designing medical student research programs.
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Affiliation(s)
- Michael A Deleon
- Office of Research, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Simren Lakhotia
- Office of Research, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Jonathan Gelfond
- Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Courtney Peebles
- School of Public Health, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Kate Lathrop
- Office of Research, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Sylvia Botros-Brey
- Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, USA
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Romeo DJ, Du S, Massenburg BB, Ng JJ, Wu M, Villavisanis DF, Fischer JP, Swanson JW, Bartlett SP, Taylor JA. Clinical Research Fellowship Fosters Mentorship, Teamwork, and Productivity: Our 11-Year Experience With a Craniofacial Research Fellowship. J Craniofac Surg 2024:00001665-990000000-01390. [PMID: 38421207 DOI: 10.1097/scs.0000000000009978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/03/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION This study describes the development and explores the academic impact of a cleft and craniofacial research fellowship. MATERIALS AND METHODS Research and career outcomes from 3 cleft and craniofacial surgeons, 14 clinical fellows, and 25 research fellows between 2010 and 2023 were examined. Academic productivity was measured by the number of peer-reviewed publications indexed in PubMed and podium presentations at national/international meetings. Residency match statistics were recorded for eligible research fellows. RESULTS Over this 14-year period (11 with research fellows), the team produced 500 publications in 96 peer-reviewed journals, with 153 (31%) in Plastic and Reconstructive Surgery, 117 (23%) in the Journal of Craniofacial Surgery, and 32 (6%) in The Cleft Palate-Craniofacial Journal. Yearly publications increased from 15.3±7.6 per year (before fellowship) to 23.0±5.3 (with 1 fellow) to 38.3±12.9 (2 fellows) to 81.0±5.7 (3 fellows; P<0.001). There was a strong annual linear growth in publications since the beginning the research fellowship position (r=0.88, P<0.001). All (100%) clinical research fellows developed strong relationships with senior surgeons, and all who applied to plastic surgery residency matched a significantly higher success rate than the national average (P<0.05). CONCLUSION Implementing a structured cleft and craniofacial clinical research fellowship was associated with a broad impact across all cleft and craniofacial team members, as reflected by increased academic output and high match rates among fellows. The fellowship also strengthens the talent pipeline into plastic surgery by fostering meaningful mentor/mentee relationships and provides a model that can be adopted in both surgical and nonsurgical fields.
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Affiliation(s)
- Dominic J Romeo
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Steven Du
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Benjamin B Massenburg
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Jinggang J Ng
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Meagan Wu
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Dillan F Villavisanis
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - John P Fischer
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Jordan W Swanson
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Scott P Bartlett
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
| | - Jesse A Taylor
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia
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Caretta-Weyer HA, Eva KW, Schumacher DJ, Yarris LM, Teunissen PW. Postgraduate Selection in Medical Education: A Scoping Review of Current Priorities and Values. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:S98-S107. [PMID: 37983402 DOI: 10.1097/acm.0000000000005365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE The process of screening and selecting trainees for postgraduate training has evolved significantly in recent years, yet remains a daunting task. Postgraduate training directors seek ways to feasibly and defensibly select candidates, which has resulted in an explosion of literature seeking to identify root causes for the problems observed in postgraduate selection and generate viable solutions. The authors therefore conducted a scoping review to analyze the problems and priorities presented within the postgraduate selection literature to explore practical implications and present a research agenda. METHOD Between May 2021 and February 2022, the authors searched PubMed, EMBASE, Web of Science, ERIC, and Google Scholar for English language literature published after 2000. Articles that described postgraduate selection were eligible for inclusion. 2,273 articles were ultimately eligible for inclusion. Thematic analysis was performed on a subset of 100 articles examining priorities and problems within postgraduate selection. Articles were sampled to ensure broad thematic and geographical variation across the breadth of articles that were eligible for inclusion. RESULTS Five distinct perspectives or value statements were identified in the thematic analysis: (1) Using available metrics to predict performance in postgraduate training; (2) identifying the best applicants via competitive comparison; (3) seeking alignment between applicant and program in the selection process; (4) ensuring diversity, mitigation of bias, and equity in the selection process; and (5) optimizing the logistics or mechanics of the selection process. CONCLUSIONS This review provides insight into the framing and value statements authors use to describe postgraduate selection within the literature. The identified value statements provide a window into the assumptions and subsequent implications of viewing postgraduate selection through each of these lenses. Future research must consider the outcomes and consequences of the value statement chosen and the impact on current and future approaches to postgraduate selection.
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Affiliation(s)
- Holly A Caretta-Weyer
- H.A. Caretta-Weyer is associate professor and associate residency director, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California; ORCID: https://orcid.org/0000-0002-9783-5797
| | - Kevin W Eva
- K.W. Eva is associate director and senior scientist, Centre for Health Education Scholarship, and professor and director, educational research and scholarship, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: http://orcid.org/0000-0002-8672-2500
| | - Daniel J Schumacher
- D.J. Schumacher is professor of pediatrics, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: http://orcid.org/0000-0001-5507-8452
| | - Lalena M Yarris
- L.M. Yarris is professor and vice chair of faculty development, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Pim W Teunissen
- P.W. Teunissen is professor of workplace learning in health care, School of Health Professions Education, and gynecologist, Department of Obstetrics & Gynecology, Maastricht University and Maastricht University Medical Center, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-0930-0048
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Love ER, Reminick JI, Dexter F, Goldstein R, Robbins B, Karan SB. Over-Application and Interviewing in the 2021 United States Primary Care Virtual Recruitment Season. Cureus 2023; 15:e39084. [PMID: 37332459 PMCID: PMC10269744 DOI: 10.7759/cureus.39084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/20/2023] Open
Abstract
Importance Over-application and interviewing are believed to be widespread in residency recruitment. These may have increased during the 2021 virtual recruitment season. The increase does not correspond to an increase in available residency positions and likely results in more interviews with low probabilities of yielding matches. Prior work demonstrates that such marginal interviews are identifiable ‑ from key explanatory factors like same-state for interviewee and program ‑ in sufficient volume to allow programs to substantially decrease interviews. Objective To evaluate the importance of same-state relationships in primary care and to determine the extent of over-interviewing in the 2021 virtual recruitment season. Design The National Resident Matching Program and Thalamus merged match (outcomes) and interview (explanatory variables) data from primary care specialties (family medicine, internal medicine, pediatrics). Data were analyzed by logistic regression, trained on the 2017-2020 seasons, and projected on the 2021 season for testing. Setting The setting was the 2017-2021 main residency matches. Participants This comprised 4,442 interviewees applying to 167 residency programs in primary care. Intervention This included the transition to virtual recruitment from in-person recruitment in the 2021 residency recruitment season. Measurements A total of 20,415 interviews and 20,791 preferred programs with program and interviewee characteristics and match outcomes were included. Results Same-state geographic relations predicted match probability in primary care residency interviews better than medical school/residency affiliation, with 86.0% of interviewees matching consistently with their preferences for the same state. Same-state was more effective than medical school affiliations with programs in predicting matching. Eliminating interviews with less than a 5% probability of matching (upper 95% prediction limit) removed 31.5% of interviews. Conclusions and relevance The large number of low-match probability interviews demonstrates over-interviewing in primary care. We suggest that programs eliminate interview offers to applications falling below their chosen match probability threshold.
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Affiliation(s)
- Ephy R Love
- Thalamus, SJ Medconnect, Inc., Santa Clara, USA
| | | | | | - Risë Goldstein
- Research, National Resident Matching Program, Washington DC, USA
| | - Brett Robbins
- Internal Medicine - Pediatrics, University of Rochester, Rochester, USA
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Baniadam K, Elkadi S, Towfighi P, Aminpour N, Sutariya R, Chen HC. The Impact on Medical Student Stress in Relation to a Change in USMLE Step 1 Examination Score Reporting to Pass/Fail. MEDICAL SCIENCE EDUCATOR 2023; 33:401-407. [PMID: 37251203 PMCID: PMC9969017 DOI: 10.1007/s40670-023-01749-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 05/31/2023]
Abstract
The United States Medical Licensing Examination (USMLE) Step 1 was designed to be a benchmark measure of knowledge and has been used heavily in the residency application process. Step 1 has moved from 3-digit scoring to a pass/fail scoring system, in part to decrease the stress associated with the exam. Emerging literature suggests that this transition has led to other stresses for students. Our study compared student stress levels, both overall and in relation to Step 1, leading up to the exam between a scored cohort and pass/fail cohort. We administered to each cohort a 14-item survey that included demographics, the PSS-4 stress scale, and 6 other potential stressors. Data was analyzed using two-tailed t test for independent means and analysis of variance. We found that while there was no difference in general overall stress between the students who took Step 1 for a score and students who took Step 1 pass/fail, we did see differences in stress related to the Step 1 exam. Step 1 stress was significantly lower for the pass/fail cohort than the score cohort during the second year of medical education leading up to the exam. However, this difference in Step 1 stress between the cohorts disappeared by the dedicated study period immediately before the exam. The change in scoring appears to have decreased stress specifically related to Step 1, but this reduction was not sustained as students entered their study period to prepare for Step 1.
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Affiliation(s)
- Kahlo Baniadam
- Georgetown University School of Medicine, Washington, DC USA
| | - Seleem Elkadi
- Georgetown University School of Medicine, Washington, DC USA
| | - Parhom Towfighi
- Georgetown University School of Medicine, Washington, DC USA
| | - Nathan Aminpour
- Georgetown University School of Medicine, Washington, DC USA
| | - Ronak Sutariya
- Georgetown University School of Medicine, Washington, DC USA
| | - H. Carrie Chen
- Georgetown University School of Medicine, Washington, DC USA
- Department of Pediatrics, Georgetown University School of Medicine, Washington, DC USA
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Mabeza RM, Christophers B, Ederaine SA, Glenn EJ, Benton-Slocum ZP, Marcelin JR. Interventions Associated With Racial and Ethnic Diversity in US Graduate Medical Education: A Scoping Review. JAMA Netw Open 2023; 6:e2249335. [PMID: 36595293 PMCID: PMC9856938 DOI: 10.1001/jamanetworkopen.2022.49335] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE Racially and ethnically minoritized individuals remain underrepresented in graduate medical education relative to their proportion in the population. While many programs and initiatives have been developed to address this problem, there is little consensus regarding strategies that work to improve representation across specialties. OBJECTIVE To examine and synthesize evidence-based practices that have been used to increase the proportions of underrepresented in medicine (URiM) trainees at US residency and fellowship programs. EVIDENCE REVIEW The authors searched PubMed, Google Scholar, Embase, PsycInfo, ERIC, Cochrane Reviews, Cochrane Trials, CINAHL, Scopus, and PROSPERO electronic databases to identify relevant studies published through January 2022. They screened all titles and abstracts for relevance and read full-text articles to identify articles reporting reliable data describing the outcomes of interventions to improve racial and ethnic diversity among trainees. FINDINGS Twenty-seven articles were included in this review. Two studies reported on fellowship programs. The most common interventions included holistic review (48%), decreased emphasis on United States Medical Licensing Examination Step 1 scores (48%), and explicit institutional messaging regarding the importance of diversity (37%). A combination of interventions was associated with an increased number of URiM applicants, interviewees, and matriculants across various medical and surgical specialties. CONCLUSIONS AND RELEVANCE In this scoping review, approaches and interventions associated with increased diversity in residency and fellowship programs were identified. Continued efforts are necessary to sustain such efforts and assess long-term outcomes.
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Affiliation(s)
- Russyan Mark Mabeza
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York
| | - Sophia A. Ederaine
- Department of Dermatology, University of California Irvine School of Medicine, Irvine
| | - Emily J. Glenn
- McGoogan Health Sciences Library, University of Nebraska Medical Center, Omaha
| | | | - Jasmine R. Marcelin
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha
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Schulz AE, Nussbaum JE, Loloi J, Sankin A, Abraham N. The Impact of Holistic Review of Urology Residency Applications on Selection for Interview During the COVID-19 Pandemic. Urology 2022; 173:34-40. [PMID: 36513217 PMCID: PMC9734066 DOI: 10.1016/j.urology.2022.11.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/02/2022] [Accepted: 11/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the impact of a holistic review of urology residency applications on interview selection at our institution during the COVID-19 pandemic. METHODS In the 2019-2020 cycle, applicants were filtered by a Step 1 score of 230 and whether they applied from selected east coast medical schools. For the 2020-2021 and 2021-2022 cycles, we implemented a scoring system which focused on desirable attributes based on our program training needs and resources. We compared applicant and interviewee demographics and United States Medical Licensing Examination (USMLE) scores using descriptive statistics and 1-way analysis of variance tests. RESULTS A total of 282, 300, and 367 students applied to our residency program with 50, 45, and 52 selected for interviews during the 2019-2020, 2020-2021, and 2021-2022 cycles, respectively. Compared to 2019-2020, the 2020-2021 and 2021-2022 interviewee cohorts comprised of more non-tri-state applicants (36%, 55.6%, and 46.2%, respectively). Underrepresented minority representation increased for the 2020-2021 interviewee cohort; however, this was not observed in 2021-2022 (16%, 24.4%, 15.4%, respectively). Additionally, USMLE Step 1 and 2 scores were similar between interviewee cohorts in 2019-2020, 2020-2021 and 2021-2022, respectively (Step 1: 244.2 ± 8.8, 242 ± 12.1, 242.8 ± 12.4, P = .624) (Step 2: 249.1 ± 11.5, 251.5 ± 10.5, 254.4 ± 10.8, P = .143). CONCLUSION Utilizing a comprehensive review resulted in a geographically diverse interview pool and no significant difference in academic performance among interviewees. Holistic review provides an alternative, balanced evaluation of residency applicants which may increase diversity in urology.
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Affiliation(s)
| | | | - Justin Loloi
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Alex Sankin
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Nitya Abraham
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
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Asserson DB, Sarac BA, Janis JE. A 5-Year Analysis of the Integrated Plastic Surgery Residency Match: The Most Competitive Specialty? J Surg Res 2022; 277:303-309. [DOI: 10.1016/j.jss.2022.04.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 03/15/2022] [Accepted: 04/08/2022] [Indexed: 11/24/2022]
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Chakraverty D, Cavazos JE, Jeffe DB. Exploring reasons for MD-PhD trainees' experiences of impostor phenomenon. BMC MEDICAL EDUCATION 2022; 22:333. [PMID: 35490228 PMCID: PMC9055705 DOI: 10.1186/s12909-022-03396-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/30/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Acceptance into U.S. MD-PhD dual-degree programs is highly competitive, and the lengthy training program requires transitioning between multiple phases (pre-clinical-, PhD-research-, and clinical-training phases), which can be stressful. Challenges faced during MD-PhD training could exacerbate self-doubt and anxiety. Impostor phenomenon is the experience of feeling like a fraud, with some high-achieving, competent individuals attributing their successes to luck or other factors rather than their own ability and hard work. To our knowledge, impostor phenomenon among MD-PhD trainees has not been described. This study examined impostor phenomenon experiences during MD-PhD training and reasons trainees attributed to these feelings. METHODS Individuals in science and medicine fields participated in an online survey that included the 20-item Clance Impostor Phenomenon Scale (CIPS); higher scores (range 20-100) indicate more frequent impostor phenomenon. Some respondents who reported experiencing impostor phenomenon also voluntarily completed a semi-structured interview, sharing experiences during training that contributed to feelings of impostor phenomenon. Interview transcripts were coded and analysed using the constant comparative method and analytic induction to identify themes. RESULTS Of 959 survey respondents (students and professionals in science and medicine), 13 MD-PhD students and residents completed the survey, nine of whom (five male, four female; four white, five other race-ethnicity) also completed an interview. These participants experienced moderate-to-intense scores on the CIPS (range: 46-96). Four themes emerged from the interview narratives that described participants' experiences of IP: professional identity formation, fear of evaluation, minority status, and, program-transition experiences. All reported struggling to develop a physician-scientist identity and lacking a sense of belonging in medicine or research. CONCLUSIONS Impostor experiences that MD-PhD participants attributed to bias and micro-aggressions in social interactions with peers, faculty, and patients challenged their professional identity formation as physician-scientists. It is important to further examine how MD-PhD-program structures, cultures, and social interactions can lead to feelings of alienation and experiences of impostor phenomenon, particularly for students from diverse and underrepresented populations in medicine.
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Affiliation(s)
- Devasmita Chakraverty
- Ravi J. Matthai Centre for Educational Innovation, India Institute of Management Ahmedabad, KLMDC# 36, Old Campus, Ahmedabad, Gujarat, 380 015, India.
| | - Jose E Cavazos
- South Texas Medical Scientist Training Program, University of Texas Health San Antonio, San Antonio, TX, 78229, USA
| | - Donna B Jeffe
- Washington University School of Medicine, St. Louis, MO, 63110, USA
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Lucey CR, Davis JA, Green MM. We Have No Choice but to Transform: The Future of Medical Education After the COVID-19 Pandemic. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:S71-S81. [PMID: 34789658 PMCID: PMC8855762 DOI: 10.1097/acm.0000000000004526] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Medical education exists to prepare the physician workforce that our nation needs, but the COVID-19 pandemic threatened to disrupt that mission. Likewise, the national increase in awareness of social justice gaps in our country pointed out significant gaps in health care, medicine, and our medical education ecosystem. Crises in all industries often present leaders with no choice but to transform-or to fail. In this perspective, the authors suggest that medical education is at such an inflection point and propose a transformational vision of the medical education ecosystem, followed by a 10-year, 10-point plan that focuses on building the workforce that will achieve that vision. Broad themes include adopting a national vision; enhancing medicine's role in social justice through broadened curricula and a focus on communities; establishing equity in learning and processes related to learning, including wellness in learners, as a baseline; and realizing the promise of competency-based, time-variable training. Ultimately, 2020 can be viewed as a strategic inflection point in medical education if those who lead and regulate it analyze and apply lessons learned from the pandemic and its associated syndemics.
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Affiliation(s)
- Catherine R. Lucey
- C.R. Lucey is professor of medicine, executive vice dean, and vice dean for education, University of California, San Francisco School of Medicine, San Francisco, California
| | - John A. Davis
- J.A. Davis is professor of medicine, associate dean for curriculum, and interim associate dean for students, University of California, San Francisco School of Medicine, San Francisco, California
| | - Marianne M. Green
- M.M. Green is Raymond H. Curry, MD Professor of Medical Education, professor of medicine, and vice dean for education, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Raborn LN, Janis JE. Current Views on the New United States Medical Licensing Examination Step 1 Pass/Fail Format: A Review of the Literature. J Surg Res 2022; 274:31-45. [PMID: 35121548 DOI: 10.1016/j.jss.2022.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/20/2021] [Accepted: 01/02/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Residency programs have historically used numerical Step 1 scores to screen applicants, making it a career-defining, high-stakes examination. Step 1 scores will be reported as pass/fail starting in January 2022, fundamentally reshaping the residency application review process. This review aimed to identify opinions of physicians and medical students about the new format, identify arguments in support of or against the change, and determine the implications of this change on the residency selection process. METHODS A comprehensive PubMed review was performed in May 2021 to identify articles that discussed the new Step 1 format. Non-English and duplicate articles were excluded. Data collected from each article included publication year, specialty, subjects, and key findings. RESULTS A total of 81 articles were included, 26 of which discussed the impact of the new format within surgical fields (32.1%). Remaining articles discussed the implications within the medical community as a whole (n = 33, 40.7%) and nonsurgical fields (n = 22, 27.2%). Studies suggest Program Directors will rely on Step 2 Clinical Knowledge (CK) scores, medical school reputation, applicant familiarity, Dean's letters, recommendation letters, and research in lieu of numerical Step 1 scores. In addition, concerns have been raised that the new format will disadvantage international, osteopathic, and minority applicants while increasing stress surrounding Step 2 CK. CONCLUSIONS Within the medical community, there are concerns that Step 2 CK will be used to substitute Step 1 and that resident diversity will diminish due to the new Step 1 format. Holistic candidate consideration will be increasingly important.
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Affiliation(s)
- Layne N Raborn
- Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Jeffrey E Janis
- Department of Plastic and Reconstructive Surgery, Wexner Medical Center, Ohio State University, Columbus, Ohio.
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Zhang RV, Awan OA, Resnik CS, Hossain R. Potential Impact of a Pass or Fail United States Medical Licensing Exam Step 1 Scoring System on Radiology Residency Applications. Acad Radiol 2022; 29:158-165. [PMID: 33162317 DOI: 10.1016/j.acra.2020.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES To assess the anticipated impact of the change in United States Medical Licensing Examination Step 1 scoring from numerical to pass or fail on the future selection of radiology residents. MATERIALS AND METHODS An anonymous electronic 14-item survey was distributed to 308 members of the Association of Program Directors in Radiology and included questions regarding the anticipated importance of various application metrics when Step 1 becomes pass or fail. Secondary analyses compared responses based on the current use of a Step 1 scoring screen. RESULTS Eighty eight respondents (28.6% [88/308]) completed the survey. Most (64% [56/88]) noted that the United States Medical Licensing Examination Step 2 Clinical Knowledge (CK) score will likely be one of the top three most important factors in assessing applicants, followed by class ranking or quartile (51% [45/88]) and the Medical Student Performance Evaluation/Dean's Letter (42% [37/88]). Over 90% (82/88) of respondents anticipate potentially or definitively requiring Step 2 CK scores before application review, and 50% (44/88) of respondents anticipate extending interview invites at a later date to receive Step 2 CK scores. These results did not significantly differ between programs who currently use a Step 1 scoring screen and those who do not. CONCLUSION As Step 1 transitions from a numerical score to pass or fail, radiology residency program directors will likely rely on Step 2 CK scores as an objective and standardized metric to screen applicants. Further investigation is needed to identify other objective metrics to evaluate applicants before Step 1 becomes pass or fail.
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Maxfield CM, Montano-Campos JF, Chapman T, Desser TS, Ho CP, Hull NC, Kelly HR, Kennedy TA, Koontz NA, Knippa EE, McLoud TC, Milburn J, Mills MK, Morgan DE, Morgan R, Peterson RB, Salastekar N, Thorpe MP, Zarzour JG, Reed SD, Grimm LJ. Factors Influential in the Selection of Radiology Residents in the Post-Step 1 World: A Discrete Choice Experiment. J Am Coll Radiol 2021; 18:1572-1580. [PMID: 34332914 DOI: 10.1016/j.jacr.2021.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Reporting of United States Medical Licensing Examination Step 1 results will transition from a numerical score to a pass or fail result. We sought an objective analysis to determine changes in the relative importance of resident application attributes when numerical Step 1 results are replaced. METHODS A discrete choice experiment was designed to model radiology resident selection and determine the relative weights of various application factors when paired with a numerical or pass or fail Step 1 result. Faculty involved in resident selection at 14 US radiology programs chose between hypothetical pairs of applicant profiles between August and November 2020. A conditional logistic regression model assessed the relative weights of the attributes, and odds ratios (ORs) were calculated. RESULTS There were 212 participants. When a numerical Step 1 score was provided, the most influential attributes were medical school (OR: 2.35, 95% confidence interval [CI]: 2.07-2.67), Black or Hispanic race or ethnicity (OR: 2.04, 95% CI: 1.79-2.38), and Step 1 score (OR: 1.8, 95% CI: 1.69-1.95). When Step 1 was reported as pass, the applicant's medical school grew in influence (OR: 2.78, 95% CI: 2.42-3.18), and there was a significant increase in influence of Step 2 scores (OR: 1.31, 95% CI: 1.23-1.40 versus OR 1.57, 95% CI: 1.46-1.69). There was little change in the relative influence of race or ethnicity, gender, class rank, or clerkship honors. DISCUSSION When Step 1 reporting transitions to pass or fail, medical school prestige gains outsized influence and Step 2 scores partly fill the gap left by Step 1 examination as a single metric of decisive importance in application decisions.
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Affiliation(s)
- Charles M Maxfield
- Vice-Chair of Education, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
| | - J Felipe Montano-Campos
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Teresa Chapman
- Residency Program Director, Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Terry S Desser
- Department of Radiology, Stanford University Medical Center, Stanford, California
| | - Christopher P Ho
- Residency Program Director, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Nathan C Hull
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Hillary R Kelly
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Tabassum A Kennedy
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Nicholas A Koontz
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Emily E Knippa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Theresa C McLoud
- Vice-Chair of Education, Residency Program Director, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - James Milburn
- Residency Program Director, Department of Radiology, Ochsner Health System, New Orleans, Louisiana
| | - Megan K Mills
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Desiree E Morgan
- Vice-Chair of Education, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Rustain Morgan
- Residency Program Director, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ryan B Peterson
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Ninad Salastekar
- Department of Radiology, SUNY Upstate Medical University, Syracuse, New York
| | | | - Jessica G Zarzour
- Radiology Residency Program Director, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Shelby D Reed
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Lars J Grimm
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
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Santos-Parker KS, Morgan HK, Katz NT, Marzano DA, Strand EA, Winkel AF, Hammoud MM. Can Standardized Dates for Interview Offers Mitigate Excessive Interviewing? JOURNAL OF SURGICAL EDUCATION 2021; 78:1091-1096. [PMID: 33153934 DOI: 10.1016/j.jsurg.2020.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/28/2020] [Accepted: 10/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To determine the impact of specialty-specific guidelines for standardized interview offers on residency applicant behavior towards excessive interviewing. DESIGN In 2019 to 2020, the Association of Professors of Gynecology and Obstetrics and the Council on Resident Education in Obstetrics and Gynecology (OBGYN) outlined standard dates for residency interview offers. A cross-sectional survey of applicants queried adherence to standardized interview offers, the number of interviews offers received, interviews completed, and application characteristics. Based on data that applicants in OBGYN with a mean number of 12 contiguous ranks are highly likely to match, factors associated with accepting an excessive percentage of interview offers were investigated in applicants with at least 12 interviews, using multiple logistic regression. SETTING All OBGYN applicants were sent an anonymous electronic survey distributed through the Electronic Residency Application Service in February 2020, with the subset of US MD senior respondents selected for this analysis. PARTICIPANTS There were a total of 1292 US MD senior applicants into OBGYN in 2020, with 505 (39%) providing their interview information through the survey. Three hundred and sixty (71%) of US MD senior respondents received at least 12 interviews. RESULTS Applicants receiving at least 12 interview offers completed a median of 83% of their interviews, and excessive interviewing was defined as completing greater than this median percentage. Receiving most interview offers on standardized interview offer dates resulted in less excessive interviewing despite controlling for number of programs applied to, applying as a couple, and United States Medical Licensing Exams Step 1 score. CONCLUSIONS The standardization of interview offer dates may mitigate interview inflation by altering applicant behavior. This promising pilot data suggests that applicants may be able to make more informed decisions about which interview offers to accept when all offers are received on predetermined dates.
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Affiliation(s)
| | - Helen Kang Morgan
- Departments of Obstetrics and Gynecology and Learning Health Sciences, University of Michigan, Ann Arbor, Michigan
| | - Nadine T Katz
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York
| | - David A Marzano
- Departments of Obstetrics and Gynecology and Learning Health Sciences, University of Michigan, Ann Arbor, Michigan
| | - Eric A Strand
- Division of General Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
| | - Abigail F Winkel
- Department of Obstetrics and Gynecology and Institute for Innovations in Medical Education, New York University Grossman School of Medicine, New York, New York
| | - Maya M Hammoud
- Departments of Obstetrics and Gynecology and Learning Health Sciences, University of Michigan, Ann Arbor, Michigan
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Mun F, Scott AR, Cui D, Lehman EB, Jeong S, Chisty A, Juliano PJ, Hennrikus WL, Hennrikus EF. A comparison of orthopaedic surgery and internal medicine perceptions of USMLE Step 1 pass/fail scoring. BMC MEDICAL EDUCATION 2021; 21:255. [PMID: 33941167 PMCID: PMC8091716 DOI: 10.1186/s12909-021-02699-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/23/2021] [Indexed: 06/07/2023]
Abstract
BACKGROUND United States Medical Licensing Examination Step 1 will transition from numeric grading to pass/fail, sometime after January 2022. The aim of this study was to compare how program directors in orthopaedics and internal medicine perceive a pass/fail Step 1 will impact the residency application process. METHODS A 27-item survey was distributed through REDCap to 161 U.S. orthopaedic residency program directors and 548 U.S. internal medicine residency program directors. Program director emails were obtained from the American Medical Association's Fellowship and Residency Electronic Interactive Database. RESULTS We received 58 (36.0%) orthopaedic and 125 (22.8%) internal medicine program director responses. The majority of both groups disagree with the change to pass/fail, and felt that the decision was not transparent. Both groups believe that the Step 2 Clinical Knowledge exam and clerkship grades will take on more importance. Compared to internal medicine PDs, orthopaedic PDs were significantly more likely to emphasize research, letters of recommendation from known faculty, Alpha Omega Alpha membership, leadership/extracurricular activities, audition elective rotations, and personal knowledge of the applicant. Both groups believe that allopathic students from less prestigious medical schools, osteopathic students, and international medical graduates will be disadvantaged. Orthopaedic and internal medicine program directors agree that medical schools should adopt a graded pre-clinical curriculum, and that there should be a cap on the number of residency applications a student can submit. CONCLUSION Orthopaedic and internal medicine program directors disagree with the change of Step 1 to pass/fail. They also believe that this transition will make the match process more difficult, and disadvantage students from less highly-regarded medical schools. Both groups will rely more heavily on the Step 2 clinical knowledge exam score, but orthopaedics will place more importance on research, letters of recommendation, Alpha Omega Alpha membership, leadership/extracurricular activities, personal knowledge of the applicant, and audition electives.
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Affiliation(s)
- Frederick Mun
- Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
| | - Alyssa R Scott
- Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - David Cui
- Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Erik B Lehman
- Public Health Sciences at Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Seongho Jeong
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA
| | - Alia Chisty
- Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Internal Medicine, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Paul J Juliano
- Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - William L Hennrikus
- Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Eileen F Hennrikus
- Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Internal Medicine, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Mullen M, Barnard A, Gavard JA, Miller C, Thomure M. Residency match interview scheduling: quantifying the applicant experience. Postgrad Med J 2021; 98:e12. [PMID: 33707292 DOI: 10.1136/postgradmedj-2020-139514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/07/2021] [Accepted: 02/20/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The process of offering and scheduling residency interviews varies widely among programmes. Applicants report distress and have advocated for reform. However, there is a paucity of quantitative data to characterise applicant concerns. OBJECTIVE We quantified the interview scheduling experience for US allopathic medical students in the 2020 main residency match. METHODS An anonymous, 13 question survey was sent to student representatives from each Association of American Medical Colleges member institution. Recipients were asked to forward the survey to their entire fourth-year class. RESULTS Of 4314 applicants to whom the survey was sent, 786 (18.2%) responded. Overall, 20.4% reported missing the opportunity to interview at a programme because they did not have adequate time to respond to an invitation; applicants into surgical specialties were significantly more likely than their non-surgical peers to report this experience (26.4% vs 18.4%, p<0.05). Most (57.4%) respondents scheduled an interview knowing they would likely cancel it in the future. The most commonly cited reason for this behaviour was concern that applicants would not receive invitations from other programmes (85.6%). A majority (56.4%) of respondents did not believe the match interview process functions based on equity and merit. CONCLUSIONS About one in five respondents missed the opportunity to interview at a programme because they did not respond to an invitation in time. Most respondents scheduled interviews knowing that they were likely to cancel them in the future. Standardisation of the interview invitation timeline would address these concerns.
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Affiliation(s)
- Mark Mullen
- Department of Psychiatry, Creighton University, Omaha, Nebraska, USA
| | - Amanda Barnard
- Saint Louis University School of Education, Saint Louis, Missouri, USA
| | - Jeffrey A Gavard
- Department of Obstetrics and Gynecology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Chad Miller
- Office of Curricular Affairs, Saint Louis University, Saint Louis, Missouri, USA
| | - Michael Thomure
- Department of Obstetrics and Gynecology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
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Blamoun J, Hakemi A, Armstead T. Perspectives on Transitioning Step 1 of the United States Medical Licensing Examination to a Pass/Fail Scoring Model: Defining New Frameworks for Medical Students Applying for Residency. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:149-154. [PMID: 33603533 PMCID: PMC7886099 DOI: 10.2147/amep.s296286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/23/2021] [Indexed: 06/12/2023]
Abstract
For years, the USMLE Step 1 has acted as an unofficial "concours" for medical students applying to residency positions in the United States. The three-digit numeric score has been used to rank thousands of applicants without any evidence of validity. The USMLE will soon change score reporting to a pass/fail outcome. The main reason given was to address the concerns about its effects on the well-being of the students and medical education. It is argued that time for change has come. The authors discuss the various viewpoints of the stakeholders and the effects of this change on applicants and potential changes on the undergraduate medical curriculum. Furthermore, this article discusses several metrics that can be utilized in the application process in lieu of the USMLE Step 1. Additionally, some novel key metrics in the application process are identified, and their unique dynamic and adaptive characteristics are deliberated. Finally, the benefits of a transparent and holistic process are strongly advocated.
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Affiliation(s)
- John Blamoun
- Central Michigan University, College of Medicine, Mt Pleasant, MI, 48859, USA
- Physician Assistant Program, MidMichigan Health, Midland, MI, 48670, USA
| | - Ahmad Hakemi
- Central Michigan University, College of Health Professions, Mt Pleasant, MI, 48859, USA
| | - Teresa Armstead
- Central Michigan University, College of Education and Human Services, Mt Pleasant, MI, 48859, USA
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Chowdhary M, Parikh SD, Lee A, Tendulkar RD, Royce TJ. Radiation Oncology Resident Quality by National Resident Matching Program Metrics From 2007 to 2018. Int J Radiat Oncol Biol Phys 2021; 109:324-328. [PMID: 32891796 DOI: 10.1016/j.ijrobp.2020.08.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/21/2020] [Accepted: 08/31/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To quantify how the quality of US medical students accepted to radiation oncology (RO) training programs, as defined by National Resident Matching Program (NRMP) metrics, has changed over time. METHODS AND MATERIALS We examined NRMP data of senior US medical students matched into RO training programs from 2007 to 2018. Metrics include United States Medical Licensing Exam (USMLE) Step 1 and 2-Clinical Knowledge scores, research output, percentage with PhD, and percentage in Alpha Omega Alpha (AOA), among others. Linear regression analysis assessed the statistical significance of changes in available metrics of matched RO residents over time. The Student t test and χ2 test compared quality metrics between matched students in RO versus all other specialties. RESULTS From 2007 to 2018, the mean USMLE Step 1 and 2-Clinical Knowledge for RO residents significantly increased from 235 to 247 (1.0 point/year; 95% confidence interval [CI], 0.70-1.52; P = .002) and from 237 to 253 (1.3 points/year; 95% CI, 1.27-1.62; P <.001), respectively. The mean number of research experiences and abstracts/presentations/publications increased from 3.7 to 6.1 (0.2/year; 95% CI, 0.12-0.29; P = .003) and from 6.3 to 15.6 (0.78/year; 95% CI, 0.60-1.04; P <.001), respectively. The percentage of RO residents inducted into AOA increased from 24.2% to 35.2%, whereas those with a PhD remained stable (∼21%). Matched RO residents had statistically superior metrics versus all other specialties for USMLE Step 1 scores (mean +13.5 points; 95% CI, 7.26-19.67; P <.001), research experience (mean +2.04; 95% CI, 1.11-2.97; P <.001), abstracts/presentations/publications (mean +6.80; 95% CI, 3.38-10.22; P = .001), percentage with a PhD (22.2% vs 4.1%; P <.001), and percentage in AOA (29.5% vs 15.8%; P <.001). CONCLUSIONS RO resident quality, defined by routinely reported NRMP metrics, increased from 2007 to 2018. Furthermore, RO resident quality is significantly higher than in all other specialties combined for most metrics. Whether the recent decline in medical student interest in RO will correlate with reduced NRMP quality metrics is unknown.
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Affiliation(s)
- Mudit Chowdhary
- Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois.
| | - Simul D Parikh
- Department of Radiation Oncology, Banner MD Anderson Cancer Center, Glendale, Arizona
| | - Anna Lee
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas
| | | | - Trevor J Royce
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Markham TH, de Haan JB, Guzman-Reyes S, Brollier LD, Campbell AN, Pivalizza EG. Potential Harm of Elimination of Score Reporting for the United States Medical Licensing Examination Step 1 Examination to Anesthesiology Residency Selection. Anesth Analg 2021; 132:275-279. [PMID: 33031347 DOI: 10.1213/ane.0000000000005235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Travis H Markham
- From the Department of Anesthesiology, UTHealth McGovern Medical School, Houston, Texas
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Goshtasbi K, Abouzari M, Tjoa T, Malekzadeh S, Bhandarkar ND. The Effects of Pass/Fail USMLE Step 1 Scoring on the Otolaryngology Residency Application Process. Laryngoscope 2020; 131:E738-E743. [PMID: 32880975 DOI: 10.1002/lary.29072] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/04/2020] [Accepted: 08/13/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To investigate how the decision to report United States Medical Licensing Examination (USMLE) Step 1 score as pass/fail will influence future otolaryngology residency application and match processes. STUDY DESIGN Survey study. METHODS An anonymous and voluntary survey approved by the Otolaryngology Program Directors Organization was administered to academic faculty members from April 24, 2020 through May 19, 2020. RESULTS Two hundred fifty-seven surveys were received from department chairs (17.5%), program directors (24.1%), associate program directors (12.5%), and department faculty (45.9%). USMLE Step 1 has been the most heavily weighted metric for offering interviews (44.0%), and it has correlated with residents' medical knowledge (77.0%) and in-service performance (79.8%) but not with surgical skills (57.6%) or patient care (47.1%). In total, 68.1% disagreed with the decision to make USMLE Step 1 pass/fail. This change is anticipated to lead to an increase in significance of USMLE Step 2 CK (89.1%), core clerkship grades (80.9%), elective rotation at the respective institutions (65.7%), Alpha Omega Alpha and other awards (64.6%), and letters of recommendation (63.8%). The new scoring is also anticipated to especially benefit students from top-ranked schools (70.8%), increase medical students' anxiety/uncertainty regarding obtaining interview invites (59.1%), and negatively affect international (51.4%), doctor of osteopathic medicine (45.9%), and underrepresented students (36.9%). Indication that USMLE Step 2 CK will significantly increase in weight varied according to department position (P = .049), geographic region (P = .047), years of practice (P < .001), and residency program size (P = .002). CONCLUSION Most academic otolaryngologists disagreed with changing USMLE Step 1 scoring to pass/fail and believe that it will increase other objective/subjective metrics' weight and put certain student populations at a disadvantage. LEVEL OF EVIDENCE N/A. Laryngoscope, 131:E738-E743, 2021.
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Affiliation(s)
- Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
| | - Mehdi Abouzari
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
| | - Tjoson Tjoa
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
| | - Sonya Malekzadeh
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, District of Columbia, U.S.A
| | - Naveen D Bhandarkar
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
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West CP, Durning SJ, O'Brien BC, Coverdale JH, Roberts LW. The USMLE Step 1 Examination: Can Pass/Fail Make the Grade? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1287-1289. [PMID: 32841991 DOI: 10.1097/acm.0000000000003537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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24
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Odei B, Das P, Pinnix C, Raval R, Holliday EB. Potential Implications of the New USMLE Step 1 Pass/Fail Format for Diversity Within Radiation Oncology. Adv Radiat Oncol 2020; 6:100524. [PMID: 33490722 PMCID: PMC7807134 DOI: 10.1016/j.adro.2020.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Bismarck Odei
- Department of Radiation Oncology, James Cancer Center and Solove Research Institute at Ohio State University, Columbus, Ohio
- Corresponding author: Bismarck Odei, MD
| | - Prajnan Das
- Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chelsea Pinnix
- Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Raju Raval
- Department of Radiation Oncology, James Cancer Center and Solove Research Institute at Ohio State University, Columbus, Ohio
| | - Emma B. Holliday
- Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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