美国医师执照考试第 1 步通过/失败评分对耳鼻喉 residency 申请流程的影响。
The Effects of Pass/Fail USMLE Step 1 Scoring on the Otolaryngology Residency Application Process.
机构信息
Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, District of Columbia, U.S.A.
出版信息
Laryngoscope. 2021 Mar;131(3):E738-E743. doi: 10.1002/lary.29072. Epub 2020 Sep 3.
OBJECTIVES
To investigate how the decision to report United States Medical Licensing Examination (USMLE) Step 1 score as pass/fail will influence future otolaryngology residency application and match processes.
STUDY DESIGN
Survey study.
METHODS
An anonymous and voluntary survey approved by the Otolaryngology Program Directors Organization was administered to academic faculty members from April 24, 2020 through May 19, 2020.
RESULTS
Two hundred fifty-seven surveys were received from department chairs (17.5%), program directors (24.1%), associate program directors (12.5%), and department faculty (45.9%). USMLE Step 1 has been the most heavily weighted metric for offering interviews (44.0%), and it has correlated with residents' medical knowledge (77.0%) and in-service performance (79.8%) but not with surgical skills (57.6%) or patient care (47.1%). In total, 68.1% disagreed with the decision to make USMLE Step 1 pass/fail. This change is anticipated to lead to an increase in significance of USMLE Step 2 CK (89.1%), core clerkship grades (80.9%), elective rotation at the respective institutions (65.7%), Alpha Omega Alpha and other awards (64.6%), and letters of recommendation (63.8%). The new scoring is also anticipated to especially benefit students from top-ranked schools (70.8%), increase medical students' anxiety/uncertainty regarding obtaining interview invites (59.1%), and negatively affect international (51.4%), doctor of osteopathic medicine (45.9%), and underrepresented students (36.9%). Indication that USMLE Step 2 CK will significantly increase in weight varied according to department position (P = .049), geographic region (P = .047), years of practice (P < .001), and residency program size (P = .002).
CONCLUSION
Most academic otolaryngologists disagreed with changing USMLE Step 1 scoring to pass/fail and believe that it will increase other objective/subjective metrics' weight and put certain student populations at a disadvantage.
LEVEL OF EVIDENCE
N/A. Laryngoscope, 131:E738-E743, 2021.
目的
研究美国医师执照考试（USMLE）第 1 步成绩报告为通过/失败的决定将如何影响未来耳鼻喉 residency 申请和匹配过程。
研究设计
调查研究。
方法
2020 年 4 月 24 日至 2020 年 5 月 19 日，向耳鼻喉项目主任组织批准的学术教师成员进行了一项匿名自愿调查。
结果
从系主任（17.5%）、项目主任（24.1%）、副主任（12.5%）和系教员（45.9%）处共收到 257 份调查。USMLE 第 1 步是提供面试的最重要指标（44.0%），它与居民的医学知识（77.0%）和实习表现（79.8%）相关，但与手术技能（57.6%）或患者护理（47.1%）无关。总的来说，68.1%的人不同意将 USMLE 第 1 步成绩报告为通过/失败的决定。这一变化预计将导致 USMLE 第 2 步 CK（89.1%）、核心实习成绩（80.9%）、各自机构的选修轮转（65.7%）、阿尔法欧米茄阿尔法和其他奖项（64.6%）以及推荐信（63.8%）的重要性增加。新的评分方式也预计将特别有利于排名靠前学校的学生（70.8%），增加医学生获得面试邀请的焦虑/不确定性（59.1%），并对国际学生（51.4%）、骨科医生（45.9%）和代表性不足的学生（36.9%）产生负面影响。USMLE 第 2 步 CK 重要性增加的迹象因部门职位（P = 0.049）、地理位置（P = 0.047）、实践年限（P < 0.001）和 residency 项目规模（P = 0.002）而异。
结论
大多数耳鼻喉科学术教师不同意将 USMLE 第 1 步评分改为通过/失败，并且认为这将增加其他客观/主观指标的权重，并使某些学生群体处于不利地位。
证据水平
无。喉镜，131：E738-E743，2021。
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