Abstract
Purpose This article investigates the perspectives of ophthalmology residency program directors
(PDs) regarding the impact of the United States Medical Licensing Examination (USMLE)
Step 1 change from graded to pass-fail scoring on ophthalmology resident selection
and medical education.
Methods The PDs of all United States ophthalmology residency programs accredited by the Accreditation
Council for Graduate Medical Education were identified using a public, online database.
An anonymous web-based survey constructed using REDCap was emailed to each PD in February
2020.
Results Surveys were completed by 64 (54.2%) PDs, with the majority (81.2%) disagreeing with
the change to pass-fail scoring. The majority of PDs believe this change will negatively
impact the ability to evaluate residency applicants (92.1%) and achieve a fair and
meritocratic match process (76.6%), and will decrease medical students' basic science
knowledge (75.0%). The factors identified most frequently by PDs as becoming more
important in evaluating residency applicants as a result of the Step 1 scoring change
include clerkship grades (90.6%), USMLE Step 2 Clinical Knowledge score (84.4%), and
a rotation in the PD's department (79.7%). The majority of PDs believe the Step 1
grading change to pass-fail will benefit applicants from elite medical schools (60.9%),
and disadvantage applicants from nonelite allopathic schools (82.8%), international
medical graduate applicants (76.6%), and osteopathic applicants (54.7%).
Conclusion The majority of ophthalmology PDs disagree with the change in USMLE Step 1 scoring
from graded to pass-fail and believe this change will negatively impact the ability
to evaluate residency applicants and achieve a fair and meritocratic match process,
and will decrease medical students' basic science knowledge.
Keywords
ophthalmology match - Step 1 - United States Medical Licensing Examination - USMLE
- pass-fail - Step 2 - Step 2 Clinical Knowledge - residency match - ophthalmology
resident - medical student - residency program director - medical education