Pass/Fail Scoring of USMLE Step 1 and the Need for Residency Selection Reform

Otolaryngol Head Neck Surg. 2020 Aug 25;194599820951166. doi: 10.1177/0194599820951166. Online ahead of print.


The Federation of State Medical Boards and the National Board of Medical Examiners recently announced a change in the United States Medical Licensing Examination Step 1 scoring convention to take effect, at the earliest, on January 1, 2022. There are many reasons for this change, including decreasing medical student stress and incentivizing students to learn freely without solely focusing on Step 1 performance. The question remains how this will affect the future of the otolaryngology-head and neck surgery match. By eradicating Step 1 grades, other factors, such as research, may garner increased importance in the application process. Such a shift may discriminate against students from less well-known medical schools, international medical graduates, and students from low socioeconomic backgrounds, who have fewer academic resources and access to research. Residency programs should try to anticipate such unintended consequences of the change and work on solutions heading into 2022.

Keywords: NRMP; Step 1; USMLE; education; match; medical education; otolaryngology; residency; residency selection.