American Council of Academic Plastic Surgeons

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Impact Assessment from Medical School Deans on the Upcoming Pass/Fail USMLE Step 1 Score Reporting
Samuel M Manstein, MD; Darya D Kazei, MD; Elizabeth Laikhter, BA; Carly D Comer, MD; Eric Shiah, BA; Samuel J Lin, MD
Beth Israel Deaconess Medical Center, Boston, MA, USA

Background: The decision to change the USMLE Step 1 examination to pass/fail has been met with mixed reviews. Although there are compelling arguments from both sides, the impact on medical student education and residency match is unknown. To better understand how this transition will affect medical students, we surveyed medical school student affairs deans regarding their thoughts on the upcoming transition of Step 1 to Pass/Fail
Methods: A questionnaire was developed and emailed to medical school deans across the country. Deans were asked to rank the importance of the following after the Step 1 reporting change: Step 2 CK, clerkship grades, letters of recommendation, personal statement, medical school reputation, class rank, Medical Student Performance Evaluation (MSPE), and research. They were asked how the score change will affect the school curriculum, learning, diversity, and student mental health. Deans were asked to select 5 specialties they thought would be most affected
Results: 278 deans were emailed, and 46 submitted responses (16.5%). When ranking their perceived importance of a studentís residency application following the Step 1 change to Pass/Fail, the most frequent number 1 choice was Step 2 CK and the most frequent number 2 and 3 choices were clerkship grades. Research was most frequently selected as the least important. The majority of deans (93.48%, n = 43) felt that the change to Pass/Fail would benefit medical student education/learning environment; however, most (68.2%, n = 30) did not believe their school curriculum would change. Students applying to dermatology, neurosurgery, orthopedic surgery, ENT, and plastic surgery were felt to be most affected by the scoring change. The majority (95.65%, n=44) felt the scoring change would encourage opportunities for students outside of the classroom, however, 58.7% (n=27) felt it would not adequately address future diversity
Conclusion: The majority of deans feel the USMLE Step 1 change to pass/fail would benefit medical student education. Deans feel that students applying to traditionally more competitive specialties (i.e. programs with fewer overall residency positions available) will be most affected by this change, which is likely due to the importance those specialties currently place on Step 1 for the residency match.


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