Residency Program Director Perspectives on Changes to US Medical Licensing Examination.
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ABSTRACT:
SUBMITTER: Wang A
PROVIDER: S-EPMC8520127 | biostudies-literature | 2021 Oct
REPOSITORIES: biostudies-literature
Publications
Residency Program Director Perspectives on Changes to US Medical Licensing Examination.
Wang Andrew A Karunungan Krystal L KL Story Jacob D JD Ha Edward L EL Braddock Clarence H CH
JAMA network open 20211001 10
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Project description:Background Beginning January 26, 2022, the U.S. Medical Licensing Exam (USMLE) Step 1 changed from a numerical score to pass/fail (P/F). The purpose of this study was to determine the perspective of ophthalmology program directors regarding this change in evaluating applicants. Methods After institutional review board approval, a survey was sent out to program directors of all 125 ophthalmology programs accredited by the Accreditation Council for Graduate Medical Education. Survey questions asked for program demographics, the utility of USMLE Step 1 and 2 Clinical Knowledge scores in assessing applicants, and the importance of 16 different applicant metrics before and after Step 1 becomes P/F. The metrics examined were: letters of recommendation; clerkship grades; class ranking; Alpha Omega Alpha Membership; Gold Humanism Honor Society Membership; Dean's Letter; involvement and leadership; personal statement; number of abstracts, presentations, and publications; mean number of research experiences in the specialty; Step 2 Clinical Knowledge score; volunteering; preclinical grades; away rotation in the specialty; the applicant having another graduate degree; and graduation from a top 40 National Institutes of Health-funded program. Data were analyzed using nonoverlapping 95% confidence intervals. Results The survey was completed by 50 (40%) program directors. Sixty-eight percent of respondents stated a student's ranking would be considered more after USMLE Step 1 scores become P/F, and 60% stated medical schools should share clerkship shelf exam scores with residency programs. There were no significant differences in program directors' rankings of applicant metrics following the transition to P/F Step 1. Conclusion Based on our data, program directors will likely not place a greater emphasis on Step 2 scores, despite it being the only remaining objective measure for all applicants following the switch to a P/F Step 1. Nevertheless, program directors expressed an interest in receiving other objective measures, such as shelf exam scores and class ranking, as part of the application process. Notably, we found no significant changes in the rankings of various applicant metrics before and after the transition to P/F Step 1, indicating that the metrics that were important to program directors prior to the change remain just as critical in the new era of admissions.
| S-EPMC10645543 | biostudies-literature
Project description: Not available
| S-EPMC9240899 | biostudies-literature
Project description:BackgroundThe increase in applications to residency programs, known as "application inflation," creates challenges for program directors (PDs). Prior studies have shown that internal medicine (IM) PDs utilize criteria, such as United States Medical Licensing Examination (USMLE) Step examination performance, when reviewing applications. However, little is known about how early these filters are utilized in the application review cycle.ObjectiveThis study sought to assess the frequency and types of filters utilized by IM PDs during initial residency application screening and prior to more in-depth application review.MethodsA web-based request for the 2016 Internal Medicine In-Training Examination (IM-ITE) PD Survey was sent to IM PDs. Responses from this survey were analyzed, excluding non-US programs.ResultsWith a 50% response rate (214 of 424), IM PDs responded that the most commonly used data points to filter applicants prior to in-depth application review were the USMLE Step 2 Clinical Knowledge score (32%, 67 of 208), USMLE Step 1 score (24%, 50 of 208), and medical school attended (12%, 25 of 208). Over half of US IM PD respondents (55%, 114 of 208) indicated that they list qualifying interview criteria on their program website, and 31% of respondents (50 of 160) indicated that more than half of their applicant pool does not meet the program's specified interview criteria.ConclusionsResults from the 2016 IM-ITE PD Survey indicate many IM PDs use filters for initial application screening, and that these filters, when available to applicants, do not affect many applicants' decisions to apply.
| S-EPMC6919169 | biostudies-literature
Project description:BackgroundResidency programs have experienced a trend toward decreased work hours and case volumes, negatively affecting the perception of graduating residents' competence. Subspecialty tracks have been proposed to help address these issues.ObjectiveWe evaluated the perceptions of obstetrics and gynecology (ob-gyn) residency program directors (PDs) on subspecialty tracking during training.MethodsIn 2017, a web-based, anonymous survey with Likert scale and open-ended items was e-mailed to US ob-gyn PDs.ResultsOf 250 PDs surveyed, 169 (68%) responded. More than half (54%) reported tracking would positively affect training of future ob-gyn physicians; 80% agreed it would increase resident preparedness for fellowship. Nearly half (49%) indicated it should be available for interested residents. However, some respondents expressed concerns this would negatively affect resident training (38%) and could decrease the number of ob-gyn generalists (50%). Most (88%) believed that tracking, if implemented, should not be mandatory, and 84% agreed that a tracking curriculum should be accompanied by Accreditation Council for Graduate Medical Education (ACGME) and American Board of Obstetrics and Gynecology changes. Only 31% of PDs felt tracking could be successfully implemented in their programs. Barriers to implementation included too few residents to divide into tracks, challenging administrative logistics, and concerns about meeting ACGME case volume requirements.ConclusionsPDs have defined but diverse opinions on the implementation of tracking in ob-gyn. Slightly more than half of responding PDs reported tracking would positively affect the training of future ob-gyn physicians, and less than one-third indicated that their program could successfully implement tracking.
| S-EPMC6314374 | biostudies-literature
Project description:Beginning 26 January 2022, the United States Medical Licensing Examination Step 1 changed from a numerical score to Pass/Fail. Historically, residency programs have used Step 1 scores as a valuable metric in assessing the competitiveness of applicants. We assessed how residency program criteria will change when evaluating applicants after Step 1 becomes Pass/Fail. A survey was distributed to the program directors of all 144 pathology residency programs accredited by Accreditation Council for Graduate Medical Education. Survey questions evaluated the importance of using Step 1 and Step 2 Clinical Knowledge (CK) scores when assessing applicants. Participants were asked to rank a list of applicant criteria used before and after Step 1 becomes Pass/Fail. Data were analyzed using chi-squared and paired t-tests with significance at P < 0.05. A total of 34 residency program directors (23.6%) responded to the survey. 76.5% (P< 0.001) of responders believed Step 1 scores were able to predict a resident's ability to pass their board exams, while 41.2% believed Step 2 CK could predict a resident's ability to pass board exams and perform clinically in pathology (P = 0.282). 61.8% of responders agreed that an applicant's medical school ranking would become more important (P = 0.001). There were no significant differences in the relative importance of 16 selection criteria after the change of Step 1 to Pass/Fail. It does not appear that Step 2 CK will become more important. Although results are constrained by a 23.6% response rate, it can be a start to guiding future students through residency applications.
| S-EPMC10164826 | biostudies-literature
Project description:Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors' (PDs') perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs' perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: "advanced degrees," "interest in academics," "reputation of undergraduate and medical school," "prior unsuccessful attempts to match," and "number of publications." Conclusions. Our survey provides up-to-date factual data on dermatology PDs' perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process.
| S-EPMC3977115 | biostudies-literature
Project description:Interviews for the integrated plastic surgery residency match took place in a virtual format for the 2020-2021 application cycle. Current literature lacks the perspectives of program directors (PDs) on virtual interviews compared with traditional in-person interviews.MethodsFollowing institutional review board approval, an anonymous 17-question survey was distributed by email to 82 program directors of integrated plastic surgery residency programs in the United States. Participants were asked baseline program information, the number of positions and interview invites offered, and their perspectives on various aspects of the virtual interview process.ResultsSixty-two (75.6%) PDs completed the survey. Thirty-seven percent reported increasing the number of interview offers per available residency spot. On a five-point Likert scale (1, not well at all; 5, extremely well), PDs showed no significant differences in their ability judge an applicant's professionalism (3.1 ± 1.1), interpersonal and communication skills (3.2 ± 1.1), and "fit" with their program (2.9 ± 0.9) during virtual interviews (P = 0.360). Sixty-eight percent reported being satisfied (15.3% extremely satisfied, 52.5% somewhat satisfied) with the virtual interview process, though 76.3% preferred in-person interviews.ConclusionsThis study is the first to provide insight into PDs' impressions of virtual residency interviews. Although most reported being satisfied with the virtual interview process, the majority still preferred in-person interviews. Further long-term studies evaluating the pros and cons of each interview modality may provide more information on whether virtual interviews could become a sustainable alternative to the traditional in-person residency interview.
| S-EPMC8376389 | biostudies-literature
Project description:BackgroundPostgraduate medical education is undergoing a paradigm shift in many universities worldwide, transitioning from a time-based model to competency-based medical education (cbme). Residency programs might have to alter clinical rotations, educational curricula, assessment methods, and faculty involvement in preparation for cbme, a process not yet characterized in the literature.MethodsWe surveyed Canadian medical oncology program directors on planned or newly implemented residency program changes in preparation for cbme.ResultsPrior to implementing cbme, all program directors changed at least 1 clinical rotation, most commonly making hematology/oncology (74%) entirely outpatient and eliminating radiation oncology (64%). Introductory rotations were altered to focus on common tumour sites, and later rotations were changed to increase learner autonomy. Most program directors planned to enhance resident learning with electronic teaching modules (79%), new training experiences (71%), and academic half-day changes (50%). Most program directors (64%) planned to change assessment methods to be entirely based on entrustable professional activities. All programs had developed a competence committee to review learner progress, and most (86%) had integrated academic coaches.ConclusionsTransitioning to cbme led to major structural and curricular changes within medical oncology training programs. Identifying these commonly implemented changes could help other programs transition to cbme.
| S-EPMC7755432 | biostudies-literature
Project description:Background Osteopathic Recognition (OR) by the Accreditation Council for Graduate Medical Education single accreditation system expanded almost 7-fold from 36 programs in 2015 to 259 in 2021 but has plateaued since then. Objective To assess the interest to pursue OR, perceived barriers and values, and relationship between interest and program demographics in formerly US American Osteopathic Association (AOA)-accredited residency programs. Methods We conducted a national survey in 2023 of all formerly AOA-accredited residency programs that had not applied for OR. The anonymous survey contained 20 five-point Likert scale questions, 11 short-answer demographic questions, and 1 open-ended resource question, was informed by prior work, and was pilot tested with a few program directors for clarity and content. The relationship between levels of interest in pursuing OR and perceived barriers, values, and demographics were analyzed via contingency table analysis. Thematic analysis was performed by 2 authors on the open-ended question. Results Of 458 program directors, 178 (38.9%) responded to the survey, and the majority (103, 57.9%) expressed "Yes" or "Maybe" interest in obtaining OR. Thirteen barriers were important, including lack of interest and support from potential applicants or colleagues; lack of time, funding, or facility space; and uncertainty over administrative work; these showed differences among the groups of different levels of interest with medium to large effect sizes (0.24<Cramer's V<0.35). The groups also showed differences in their perception of the value of pursuing OR (0.21<Cramer's V<0.29). Conclusions Program directors' perceived available resources and the value of OR to attract applicants to a program influenced their level of interest in pursuing OR.
| S-EPMC11838049 | biostudies-literature
Project description:Pass/fail (P/F) grading has emerged as an alternative to tiered clerkship grading. Systematically evaluating existing literature and surveying program directors (PD) perspectives on these consequential changes can guide educators in addressing inequalities in academia and students aiming to improve their residency applications. In our survey, a total of 1578 unique PD responses (63.1%) were obtained across 29 medical specialties. With the changes to United States Medical Licensure Examination (USMLE), responses showed increased importance of core clerkships with the implementation of Step 2CK cutoffs. PDs believed core clerkship performance was a reliable representation of an applicant's preparedness for residency, particularly in Accreditation Council for Graduate Medical Education's (ACGME)Medical Knowledge and Patient Care and Procedural Skills. PDs disagreed with P/F core clerkships because it more difficult to objectively compare applicants. No statistically significant differences in responses were found in PD preferential selection when comparing applicants from tiered and P/F core clerkship grading systems. If core clerkships adopted P/F scoring, PDs would further increase emphasis on narrative assessment, sub-internship evaluation, reference letters, academic awards, professional development and medical school prestige. In the meta-analysis, of 6 studies from 2,118 participants, adjusted scaled scores with mean difference from an equal variance model from PDs showed residents from tiered clerkship grading systems overall performance, learning ability, work habits, personal evaluations, residency selection and educational evaluation were not statistically significantly different than from residents from P/F systems. Overall, our dual study suggests that while PDs do not favor P/F core clerkships, PDs do not have a selection preference and do not report a difference in performance between applicants from P/F vs. tiered grading core clerkship systems, thus providing fertile grounds for institutions to examine the feasibility of adopting P/F grading for core clerkships.
| S-EPMC10598945 | biostudies-literature