Wallach Sara L, Williams Christopher, Chow Robert T, Jadhav Nagesh, Kuehl Sapna, Raj Jaya M, Alweis Richard
Department of Medicine, St. Francis Medical Center, Trenton, NJ, USA.
Department of Medicine, Hackensack Meridian School of Medicine, Nutley, NJ, USA.
J Community Hosp Intern Med Perspect. 2020 Sep 3;10(5):381-385. doi: 10.1080/20009666.2020.1796366.
The scoring rubric on the USMLE Step 1 examination will be changing to pass/fail in January 2022. This study elicits internal medicine resident perspectives on USMLE pass/fail scoring at the national level.
To assess internal medicine resident opinions regarding USMLE pass/fail scoring and examine how variables such as gender, scores on USMLE 1 and 2, PGY status and type of medical school are associated with these results.
In the fall of 2019, the authors surveyed current internal medicine residents via an on-line tool distributed through their program directors. Respondents indicated their Step 1 and Step 2 Clinical Knowledge scores from five categorical ranges. Questions on medical school type, year of training year, and gender were included. The results were analyzed utilizing Pearson Chi-square testing and multivariable logistic regression.
4012 residents responded, reflecting 13% of internal medicine residents currently training in the USA. Fifty-five percent of respondents disagreed/strongly disagreed with pass/fail scoring and 34% agreed/strongly agreed. Group-based differences were significant for gender, PGY level, Step 1 score, and medical school type; a higher percentage of males, those training at the PGY1 level, and graduates of international medical schools (IMGs) disagreed with pass/fail reporting. In addition, high scorers on Step 1 were more likely to disagree with pass/fail reporting than low scoring residents.
Our results suggest that a majority of internal medicine residents, currently training in the USA prefer that USMLE numerical scoring is retained and not changed to pass/fail.
美国医师执照考试第一步（USMLE Step 1）的评分标准将于2022年1月改为通过/未通过制。本研究旨在了解内科住院医师对全国范围内USMLE通过/未通过评分的看法。
评估内科住院医师对USMLE通过/未通过评分的意见，并研究性别、USMLE 1和2的成绩、住院医师培训阶段（PGY）状态以及医学院类型等变量与这些结果之间的关联。
2019年秋季，作者通过项目主任分发的在线工具对现任内科住院医师进行了调查。受访者指出了他们第一步和第二步临床知识考试成绩的五个分类范围。问卷还包括了关于医学院类型、培训年份和性别的问题。结果采用Pearson卡方检验和多变量逻辑回归进行分析。
4012名住院医师做出了回应，占目前在美国接受培训的内科住院医师的13%。55%的受访者不同意/强烈不同意通过/未通过评分，34%的受访者同意/强烈同意。基于性别的差异、PGY水平、第一步考试成绩和医学院类型的差异具有统计学意义；男性、处于PGY1培训阶段的人员以及国际医学院（IMG）的毕业生中，不同意通过/未通过评分报告的比例更高。此外，第一步考试高分者比低分住院医师更有可能不同意通过/未通过评分报告。
我们的结果表明，目前在美国接受培训的大多数内科住院医师更倾向于保留USMLE数字评分，而不是改为通过/未通过制。
