Abstract

BackgroundAt present, orthopedic surgery applicants do not universally include Step 2 Clinical Knowledge (Step 2 CK) scores on their applications and current inclusion rates are not yet reported. As Step 1 transitions to pass/fail scoring, we suspect more applicants will include Step 2 CK scores. We sought to identify what percentage of applications currently include Step 2 CK, if applicants who include Step 2 CK (Step 1+CK) score lower on Step 1 than those not including Step 2 CK (Step 1-CK), and what correlations exist between Step 1 and Step 2 CK scores among those who include the scores on their applications.MethodologyApplicants to one residency program over two application cycles (2019-2020) were analyzed. The percentage including Step 1 and Step 2 scores was recorded. Step 1 scores were compared between Step 1+CK and Step 1-CK applicants. Differences between Step 2 CK and Step 1 scores were stratified by Step 1 score.ResultsA total of 1,688 applicants applied to our institution from 2019 to 2020. Of those reporting United States Medical Licensing Examination scores, 1,316/1,660 (79%) reported a Step 2 CK score. Step 1-CK applicants scored higher on Step 1 (250.7 ± 10.9) versus Step 1+CK applicants (244.3 ± 13.1) (p < 0.0001). More applicants who scored lower on Step 1 improved upon their percentile rank between Step 1 and Step 2 CK than those who scored higher on Step 1 (χ2(8,1316) = 79.1, p < 0.0001).ConclusionsFrom 2019 to 2020, 79% of applicants included Step 2 CK. Lower Step 1 scores were more likely to include Step 2 CK and improve upon their percentile score. It is unclear how Step 1 scoring change will affect current practice.

Highlights

  • As a result of the Invitational Conference on United States Medical Licensing Examination (USMLE) Scoring (InCUS), the Federation of State Medical Boards and National Board of Medical Examiners announced that the USMLE Step 1 will be transitioning to pass/fail scoring no earlier than January 1, 2022 [1]

  • More applicants who scored lower on Step 1 improved upon their percentile rank between Step 1 and Step 2 CK than those who scored higher on Step 1 (χ2(8,1316) = 79.1, p < 0.0001)

  • Cohn et al [4] in their survey study of Orthopedic Program Directors (PDs) noted that USMLE Step 2 Clinical Knowledge (Step 2 CK) is most likely to increase in importance with this change

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Summary

Introduction

As a result of the Invitational Conference on United States Medical Licensing Examination (USMLE) Scoring (InCUS), the Federation of State Medical Boards and National Board of Medical Examiners announced that the USMLE Step 1 will be transitioning to pass/fail scoring no earlier than January 1, 2022 [1]. The impact of this decision on the resident selection process is at present unclear and may take years to fully appreciate. We sought to identify what percentage of applications currently include Step 2 CK, if applicants who include Step 2 CK (Step 1+CK) score lower on Step 1 than those not including Step 2 CK (Step 1-CK), and what correlations exist between Step 1 and Step 2 CK scores among those who include the scores on their applications

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