E1608. Potential Impact of a Pass or Fail United States Medical Licensing Exam Step 1 Scoring System on Radiology Residency Applications
  1. Rebecca Zhang; University of Maryland School of Medicine
  2. Omer Awan; University of Maryland School of Medicine
  3. Charles Resnik; University of Maryland School of Medicine
  4. Rydhwana Hossain; University of Maryland School of Medicine
Currently, performance on the United States Medical Licensing Examination (USMLE) Step 1 is frequently used by program directors (PDs) of radiology residency programs to assess applicants’ medical knowledge and screen applicants prior to offering an interview. As early as January 2022, score reporting for the USMLE Step 1 exam will change from a numeric score to pass or fail, thus eliminating an objective and standardized metric to compare applicants. The purpose of this study was to assess the anticipated impact of this change in Step 1 scoring on the future selection of radiology residents and to identify various application metrics that may increase in importance.

Materials and Methods:
An anonymous and voluntary electronic survey was distributed to 308 active members of the Association of Program Directors in Radiology. The 14-item survey evaluated PDs’ views on the anticipated importance of various application metrics when Step 1 becomes pass or fail. Secondary analyses were performed to compare responses based on the current use of a Step 1 scoring screen.

28.6% of PDs completed the online survey. The majority (64%) of survey respondents noted that the applicant’s USMLE Step 2 Clinical Knowledge (CK) score will likely be one of the top three most important factors in assessing applicants, followed by class ranking or quartile (51%) and the Medical Student Performance Evaluation (MSPE)/Dean’s Letter (37%). Over 90% of respondents predicted their programs may or definitively will require Step 2 Clinical Knowledge (CK) scores before reviewing an application, and 50% of respondents anticipate extending interview invites at a later date to receive Step 2 CK scores. These results did not significantly differ between programs who currently use a Step 1 scoring screen and those who do not.

As USMLE Step 1 transitions from a numerical score to pass or fail, radiology residency PDs will likely rely on USMLE Step 2 CK scores as an objective and standardized metric to screen applicants. However, PDs remain unsure whether they will require Step 2 CK scores at the time of application or before interviewing applicants. Other important metrics our survey identified include class ranking/quartile, grades in required clerkships, and the MSPE/Dean’s Letter. Further investigation is needed to identify other objective metrics that can holistically evaluate applicants before Step 1 scoring becomes pass or fail.