Physical Medicine and Rehabilitation Program Directors' Perspectives on USMLE Step 1 Scoring Changes

Am J Phys Med Rehabil. 2021 Apr 8. doi: 10.1097/PHM.0000000000001700. Online ahead of print.


In response to increasing dependence on USMLE Step 1 scores for resident selection, and to improve medical student wellbeing and education, the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) announced that no sooner than 2022, Step 1 score reporting would change from numeric to pass/fail. To gauge the impact this change will have on the residency application process in Physical Medicine and Rehabilitation (PM&R), an anonymous survey was electronically distributed to program directors (PDs) of all accredited PM&R residency programs in the United States. A response rate of 49% was obtained. In total, 13% of PDs agreed that the scoring change was a good idea. 80% of PDs felt the change would increase emphasis on Step 2 CK in the application process, and that it will be more difficult to objectively compare applicants. Among free text responses to the survey, 70% disapproved, 10% approved, and the remaining 20% were neutral to the change. The results of this survey show that many PM&R PDs are concerned about the implications of the Step 1 score reporting change. These data can serve as a helpful guide to PDs and students preparing for a pass/fail Step 1.