Pass/Fail Medical Licensing Exam Scores Anticipated for Residency Applications

A change in radiology residency scorings is likely on the horizon as the United States Medical Licensing Examination (USMLE) Step 1 transitions from a numerical score to pass/fail.

In a poster presented during the 2021 ARRS Virtual Annual Meeting, Rebecca Zhang, a medical student at the University of Maryland School of Medicine, explained that radiology residency program directors will most likely begin to rely on USMLE Step 2 Clinical Knowledge (CK) scores as early as January 2022. These scores are considered an objective and standardized metric for screening applicants.

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The timing of when these scores will be needed, though, remains in question.

“Program directors remain unsure whether they will require Step 2 CK scores at the time of application or before interviewing applicant,” she said.

Zhang’s team conducted a 14-item anonymous, voluntary electronic survey of 308 active members of the Association of Program Directors in Radiology to determine the importance and potential impact of this pivot to pass/fail. They also performed a secondary analysis that compared responses based on the current Step 1 scoring screen.

Of those survey, 29 percent responded, and 64 percent said an applicant’s Step 2 CK score will likely rank as one of the top three factors in evaluating applicants. The score was followed by class ranking (51 percent) and the Medical Student Performance Evaluation or Dean’s Letter (37 percent).

In addition, 90 percent of respondents predicted their programs may or will require the Step 2 scores before application review with 50 percent anticipating the scores will be required after interview invitations are extended.

More research could potentially help identify other objective metrics for more holistic evaluations, Zhang’s team said.

“These results did not significantly differ between programs who currently use a Step 1 scoring screen and those who do not,” they said.

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