Abstract
Background
The U.S. Medical Licensing Examination (USMLE) Step 1 has been used as a screening
tool for residency selection. In February 2020, Step 1 numerical scoring changed to pass/fail.
Objective
Our aim was to survey emergency medicine (EM) residency program attitudes towards
the new Step 1 scoring change and to identify important applicant screening factors.
Methods
A 16-question survey was distributed through the Council of Residency Directors in
Emergency Medicine listserv from November 11 through December 31, 2020. Given the
Step 1 scoring change, the survey questioned the importance of EM rotation grades,
composite standardized letters of evaluation (cSLOEs), and individual standardized
letters of evaluation, using a Likert scale. Descriptive statistics of demographic
characteristics and selection factors were performed along with a regression analysis.
Results
Of the 107 respondents, 48% were program directors, 28% were assistant or associate
program directors, 14% were clerkship directors, and 10% were in other roles. Sixty
(55.6%) disagreed with pass/fail Step 1 scoring change and, of those, 82% believed
that numerical scoring was a good screening tool. The cSLOEs, EM rotation grades,
and interview were the most important selection factors. Residencies with 50 or more
residents had 5.25 odds (95% CI 1.25–22.1; p = 0.0018) of agreeing with pass/fail scoring and those who ranked cSLOEs as the most
important selection factor had 4.90 odds (95% CI 1.125–21.37; p = 0.0343) of agreeing with pass/fail scoring.
Conclusions
Most EM programs disagree with pass/fail scoring of Step 1 and will most likely use
Step 2 score as a screening tool. The cSLOEs, EM rotation grades, and interview are
considered the most important selection factors.
Keywords
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Article info
Publication history
Published online: March 13, 2023
Accepted:
March 7,
2023
Received:
January 7,
2023
Publication stage
In Press Uncorrected ProofFootnotes
Second place winner at the American Academy of Emergency Medicine Young Physicians Section, Abstract Competition, St. Louis, MO, June 22, 2021.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
