In this preliminary study to test what effects this scoring change may have, it was found that: “After the removal of USMLE step 1 points, 40% of all applicants decreased in rank, 35% remained the same, and 24% increased.” The conclusion from the study is that removing the Step 1 score allowed for room to judge based more on the core values of a residency program.
If you’re a first year medical student starting this fall, residency applications might look very different for you than they have for many years. Ideally, these major shifts will catalyze changes in both the UME and GME cultures. It’s likely in the first several cycles following this change that Step 2 scores will simply replace Step 1 scores in the weight they carry in residence-placement but the hope is that other factors such as the inclusion of shelf examinations into application material or the requirement and standardized evaluation of sub-internships will gain greater importance. The ultimate goal, however, is to move the residency admission process away from a nearly unifactorial decision in Step 1 towards a multivariate one. This was apparently part of the goal, as Step 1 had initially been planned to be pass/fail in hopes of placing greater emphasis on the more clinical-science-based testing of Step 2 CK. This will presumably make your Step 2 score the golden-child of residence placement as it’s now the first one you can be numerically judged on, but that’s only speculation at this point. Now, imagine he’s the Federation of State Medical Boards (FSMB) and the stakes of the game are your future as a physician!Īs you may know by now, the FSMB recognized the long time emphasis placed on Step 1 of the USMLE and the overemphasis placed on the USMLE as a whole and in an attempt to make what they believe will be positive change, they voted to change Step 1 to pass/fail starting January 2022. He warns you your folly was in neglecting the middle cup. But, alas! He noticed your leanings and switched it to the middle cup. Fourth game, you guess the left cup because you’re no fool. You play once, twice, three times, and every time it’s in the left cup. You decide to engage in a friendly game with a street vendor guessing where a stone is hidden in his cups. For a moment, let’s imagine it’s a beautiful sunlit day somewhere very far from your computer screen.
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