American Council of Academic Plastic Surgeons

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Integrated Plastic Surgery Applicants Perspectives' on USMLE Step 1 Change to Pass/Fail: Implications for A Successful Match
Lawrence O. Lin, MD1, Paige N. Hackenberger, MD1, Anna R. Schoenbrunner, MD, MS1, Alan T. Makhoul, BA2, Nishant Ganesh Kumar, MD3, Matthew E. Pontell, MD4, Brian C. Drolet, MD, FACS5, Jeffrey E. Janis, MD, FACS1
1Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA, 2Vanderbilt University School of Medicine, Nashville, Tennessee, USA, 3Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA, 4Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA, 5Department of Plastic Surgery, Department of Biomedical Informatics, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Background: In 2022, the USMLE will begin reporting Step 1 licensing examination results as pass/fail, rather than the current three-digit numeric score. This paradigm shift will likely have significant ramifications for the highly-competitive integrated plastic surgery residency application process. This study surveys the perspectives of applicants to United States-based integrated plastic surgery residencies regarding this change in score reporting
Methods: A 24-item anonymous survey was developed and distributed among applicants to integrated plastic surgery residency programs from the 2018-19 and 2019-20 application cycles. Data were analyzed using summary tables and marginal homogeneity tests
Results: 164 respondents (33.2%) completed the survey. Most (60.3%) respondents did not feel the score reporting change is a good idea. As a result of binary score reporting, a majority of respondents felt that plastic surgery residency programs will use Step 2CK to screen applicants (95.7%), prioritize students from higher-ranked medical schools (91.5%), and that dedicated research time will become more important (87.9%). Most respondents (66.4%) agreed there will be an increase in the number of future plastic surgery applicants. Respondents anticipate that the top three metrics programs consider when deciding to offer a residency interview will change as a result of the new Step 1 score reporting (p=0.005)
Conclusion: Applicants to integrated plastic surgery residency programs view the change in USMLE Step 1 score reporting to pass/fail unfavorably. Most feel the Step 2CK numeric score, research, and the reputation of an applicant’s medical school will replace the numeric Step 1 score. Applicant perspectives’ need to be investigated longitudinally to further assess the ultimate outcomes of this score reporting change.


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