Title
The USMLE Step 1 Pass/Fail Reporting Proposal: Another View
Publication Date
2019
Journal Title
ACADEMIC RADIOLOGY
Abstract
© 2019 The Association of Program Directors in Radiology recently issued a statement endorsing continued reporting of results of the United States Medical Licensing Examination (USMLE) as a three-digit score. While this position was approved by the Association of Program Directors in Radiology Board of Directors, it does not reflect the opinions of all radiology program directors. Here, we present an argument in support of reporting USMLE results as pass/fail. As a psychometric instrument, the USMLE Step 1 is designed to assess basic science knowledge and intended to inform a binary decision on licensure. Due to a steadily-increasing burden of applications to review, program directors have increasingly relied upon scores for candidate screening. Such use has multiple adverse consequences. Student focus on Step 1 systematically devalues educational content not evaluated on the exam, and the reliance on Step 1 scores almost certainly works against efforts to increase workforce diversity. Moreover, the increasing pressure of “Step 1 Mania” has negative consequences for trainee mental health and wellness. Despite the widespread use of Step 1 scores to select applicants, there are little data to correlate scores to meaningful outcomes related to patient care or clinical practice. We find the current situation untenable, and believe a necessary first step toward reform is making Step 1 a pass/fail only examination.
Volume Number
26
Issue Number
10
Pages
1403 - 1406
Document Type
Article
Status
Faculty
Facility
School of Medicine
Primary Department
Radiology
PMID
31296373
DOI
10.1016/j.acra.2019.06.002
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