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Breeding T, Amin Q, Wright DD, Elkbuli A. Program Signaling in the New Era of Residency Applications: An Asset or Liability? Am Surg 2024; 90:518-520. [PMID: 37906128 DOI: 10.1177/00031348231212584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Affiliation(s)
- Tessa Breeding
- Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA
| | - Quratulain Amin
- Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA
| | - D-Dre Wright
- John A. Burns School of Medicine, University of Hawai, Honolulu, HI, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, FL, USA
- Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA
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Currie M, Hammond C, Martinez OP, Lane-Cordova A, Cook J. The Impact of United States Medical Licensing Examination Step 1 Transitioning To Pass/Fail on Medical Student Perception of Research Needed to Match Into One's Preferred Specialty. Cureus 2024; 16:e57395. [PMID: 38694632 PMCID: PMC11061812 DOI: 10.7759/cureus.57395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/04/2024] Open
Abstract
Purpose To evaluate how the transition of United States Medical Licensing Examination (USMLE) Step 1 to a pass/fail scoring influenced medical student perceptions of the importance of research required to match into their preferred residency specialty. Methods A 14-item survey was distributed by e-mail to medical students at one medical school in the southeastern United States in November of 2021. Responses were compared between medical students taking USMLE Step 1 pass/fail in the future and medical students taking USMLE Step 1 for a three-digit score. Results A total of 168 medical students responded to the survey with 98 respondents who planned on taking USMLE Step 1 pass/fail (45 first-year medical students (MS1) and 53 MS2) and 70 respondents who took USMLE Step 1 for a numerical score (37 MS3 and 33 MS4). There were no differences in how each cohort scored the level of importance of research in matching into their preferred residency specialty (p=0.10); however, those taking USMLE Step 1 pass/fail believe an average of 4.6 research experiences are necessary to match into their preferred residency, compared to only 3.4 research experiences for those who took it for a numerical score (p=0.04). Conclusion No statistically significant difference in the perceived importance of research in matching into one's preferred residency specialty was found between cohorts. However, the pass/fail cohort believes they will need more research experiences to match their chosen specialty than the numerical score cohort. Results could indicate that students participate in more research and extracurricular activities to be more competitive for residency applications.
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Affiliation(s)
- Madisyn Currie
- School of Medicine, University of South Carolina, Columbia, USA
| | - Carly Hammond
- School of Medicine, University of South Carolina, Columbia, USA
| | | | - Abbi Lane-Cordova
- School of Public Health, University of South Carolina, Columbia, USA
| | - James Cook
- Department of Obstetrics and Gynecology, Prisma Health Richland Hospital, Columbia, USA
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Kindler R, Kahn J, Uddin A, Petersen KH. Underrepresented Applicants Post-USMLE Pass/Fail: A National Survey of Competitive Residency Directors. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241254161. [PMID: 38827029 PMCID: PMC11141208 DOI: 10.1177/23821205241254161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/19/2024] [Indexed: 06/04/2024]
Abstract
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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Affiliation(s)
- Rebecca Kindler
- New York Medical College, School of Medicine, Valhalla, NY, USA
- Class of 2025 (MS3), New York Medical College, School of Medicine, Valhalla, NY, USA
| | - Julia Kahn
- New York Medical College, School of Medicine, Valhalla, NY, USA
- Class of 2025 (MS3), New York Medical College, School of Medicine, Valhalla, NY, USA
| | - Anaz Uddin
- New York Medical College, School of Medicine, Valhalla, NY, USA
- Class of 2025 (MS3), New York Medical College, School of Medicine, Valhalla, NY, USA
| | - Kristina H Petersen
- New York Medical College, School of Medicine, Valhalla, NY, USA
- Department of Biochemistry and Molecular Biology, New York Medical College, School of Medicine, Valhalla, NY, USA
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Lipman JM, Colbert CY, Ashton R, French J, Warren C, Yepes-Rios M, King RS, Bierer SB, Kline T, Stoller JK. A Systematic Review of Metrics Utilized in the Selection and Prediction of Future Performance of Residents in the United States. J Grad Med Educ 2023; 15:652-668. [PMID: 38045930 PMCID: PMC10686656 DOI: 10.4300/jgme-d-22-00955.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/26/2023] [Accepted: 09/05/2023] [Indexed: 12/05/2023] Open
Abstract
Background Aligning resident and training program attributes is critical. Many programs screen and select residents using assessment tools not grounded in available evidence. This can introduce bias and inappropriate trainee recruitment. Prior reviews of this literature did not include the important lens of diversity, equity, and inclusion (DEI). Objective This study's objective is to summarize the evidence linking elements in the Electronic Residency Application Service (ERAS) application with selection and training outcomes, including DEI factors. Methods A systematic review was conducted on March 30, 2022, concordant with PRISMA guidelines, to identify the data supporting the use of elements contained in ERAS and interviews for residency training programs in the United States. Studies were coded into the topics of research, awards, United States Medical Licensing Examination (USMLE) scores, personal statement, letters of recommendation, medical school transcripts, work and volunteer experiences, medical school demographics, DEI, and presence of additional degrees, as well as the interview. Results The 2599 identified unique studies were reviewed by 2 authors with conflicts adjudicated by a third. Ultimately, 231 meeting inclusion criteria were included (kappa=0.53). Conclusions Based on the studies reviewed, low-quality research supports use of the interview, Medical Student Performance Evaluation, personal statement, research productivity, prior experience, and letters of recommendation in resident selection, while USMLE scores, grades, national ranking, attainment of additional degrees, and receipt of awards should have a limited role in this process.
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Affiliation(s)
- Jeremy M. Lipman
- Jeremy M. Lipman, MD, MHPE, is Professor of Surgery, Director of Graduate Medical Education, and Designated Institutional Official (DIO), Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Colleen Y. Colbert
- Colleen Y. Colbert, PhD, is Professor of Medicine, and Director, Office of Educator and Scholar Development, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Rendell Ashton
- Rendell Ashton, MD, is Associate Professor of Medicine, Director, Pulmonary, Critical Care Fellowship, and Associate DIO, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Judith French
- Judith French, PhD, is Associate Professor of Surgery, and Vice Chair for Education, Department of General Surgery, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Christine Warren
- Christine Warren, MD, MS, is Associate Professor of Dermatology and Associate Dean, Admissions and Student Affairs, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Monica Yepes-Rios
- Monica Yepes-Rios, MD, is Associate Professor of Medicine and Assistant Dean, Diversity Equity and Inclusion for Students, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Rachel S. King
- Rachel S. King, JD, is Director of Educational Equity and Title IX Coordinator, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - S. Beth Bierer
- S. Beth Bierer, PhD, MEd, is Professor of Medicine and Director, Assessment and Evaluation, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Theresa Kline
- Theresa Kline, MLIS, AHIP, is Medical Librarian, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA; and
| | - James K. Stoller
- Jeremy M. Lipman, MD, MHPE, is Professor of Surgery, Director of Graduate Medical Education, and Designated Institutional Official (DIO), Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
- James K. Stoller, MS, MD, is Professor of Medicine, Senior Associate Dean, and Chairman, Education Institute, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
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Ozair A, Bhat V, Detchou DKE. The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change: Overview for Applicants and Educators. JMIR MEDICAL EDUCATION 2023; 9:e37069. [PMID: 36607718 PMCID: PMC9862334 DOI: 10.2196/37069] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 10/11/2022] [Accepted: 11/29/2022] [Indexed: 06/07/2023]
Abstract
The United States Medical Licensing Examination (USMLE) Step 1, arguably the most significant assessment in the USMLE examination series, changed from a 3-digit score to a pass/fail outcome in January 2022. Given the rapidly evolving body of literature on this subject, this paper aims to provide a comprehensive review of the historical context and impact of this change on various stakeholders involved in residency selection. For this, relevant keyword-based searches were performed in PubMed, Google Scholar, and Scopus to identify relevant literature. Given the unique history of USMLE Step 1 in the US residency selection process and the score's correlation with future performance in board-certifying examinations in different specialties, this scoring change is predicted to significantly impact US Doctor of Medicine students, US Doctor of Osteopathic Medicine students, international medical graduates, and residency program directors, among others. The significance and the rationale of the pass/fail change along with the implications for both residency applicants and educators are also summarized in this paper. Although medical programs, academic institutions, and residency organizing bodies across the United States have swiftly stepped up to ensure a seamless transition and have attempted to ensure equity for all, the conversion process carries considerable uncertainty for residency applicants. For educators, the increasing number of applications conflicts with holistic application screening, leading to the expected greater use of objective measures, with USMLE Step 2 Clinical Knowledge likely becoming the preferred screening tool in lieu of Step 1.
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Affiliation(s)
- Ahmad Ozair
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, United States
- Faculty of Medicine, King George's Medical University, Lucknow, India
| | - Vivek Bhat
- St John's Medical College, Bangalore, India
| | - Donald K E Detchou
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
- Thomas William Langfitt Neurosurgical Society, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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