Objective: This study sought to evaluate the perspectives of surgical program directors regarding the change of USMLE Step 1 to pass/fail grading.
Design: Validated electronic survey.
Setting: Vanderbilt University Medical Center Department of Plastic Surgery.
Participants: Program directors of all ACMGE-accredited General Surgery, Integrated Vascular Surgery, Integrated Thoracic Surgery, and Integrated Plastic Surgery residency programs.
Results: The overall response rate was 55.5%. Most PDs (78.1%) disagreed with the scoring change. Only 19.6% believe this change will improve medical student well-being. For 63.5% of PDs, medical school pedigree will become more important, and 52.7% believe it will place international medical graduates at a disadvantage. Only 6.2% believe Step 2 CK should also be pass/fail, while 88.7% will increase the weight of Step 2 CK and 88.4% will now require Step 2 CK score submission with the electronic residency application service.
Conclusions: While well-intentioned, changing USMLE Step 1 to pass/fail may have unintended consequences and may disadvantage certain groups of applicants. The emphasis on Step 1, and resulting test-taking apprehension, will likely shift to Step 2 CK. Proponents of equitable evaluation should direct their efforts toward increasing, not decreasing, the number of objective measures available for student assessment.
Keywords: Fail; Medical Knowledge; Pass; Patient Care; Professionalism; Program director; Step 1; USMLE.
Published by Elsevier Inc.