Van Benjamin W, White Micaela, Patel Om, Pina Dagoberto, Wick Joseph B, Le Hai V
Orthopaedics, UC Davis Health, Sacramento, USA.
Cureus. 2024 Feb 10;16(2):e53968. doi: 10.7759/cureus.53968. eCollection 2024 Feb.
Background The United States Medical Licensing Exam (USMLE) Step 1 was recently changed from a numerically scored grading system to a pass/fail grading system. Until late 2024, there will be no formal studies about the impact that the grading change will have on the match process. To thoroughly assess the impact that this change will have on the overall match process, it is important to look at what the trends in applicants' objective measures have been in the years before the change. We aim to systematically evaluate the rates of change and mean trend of objective metrics found in residency applications in the main residency match. Methods Objective medical student data of matched and unmatched applicants were queried from the National Matching Program's Charting Outcomes in the Match Reports for the 2007 to 2020 application cycles. Data were used to create linear regression analyses and statistical tests were performed to evaluate trends over time. Results For matched applicants, there were statistically significant positive trends for the mean number of contiguous ranks (m=0.33, p<0.01), having another non-doctoral graduate degree (m=0.67, p<0.01), membership to Alpha Omega Alpha (AOA) honor society (m=0.22, p<0.01), mean USMLE Step 1 score (m=1.01, p<0.01), mean USMLE Step 2 score (m=1.68, p<0.01), mean number of research experiences (m=0.12, p<0.01), and mean number of abstracts, presentations, and publications (m=0.34, p<0.01). Additionally, there was a statistically significant negative trend for the percentage who graduated from a top 40 National Institutes of Health-funded medical school (m=-0.41, p<0.01). For unmatched applicants, there were statistically significant positive trends for having another non-doctoral graduate degree (m=0.83, p<0.01), mean USMLE Step 1 score (m=1.26, p<0.01), mean USMLE Step 2 score (m=2.27, p<0.01), mean number of research experiences (m=0.13, p<0.01), and mean number of abstracts, presentations, and publications (m=0.33, p<0.01). Conclusion Our study shows that there have been statistically significant increases in almost all objective measures in the residency application. Recent changes to the abstracts, presentations, and publications on the Step 1 scoring system will force almost all residency programs to overhaul their application process and potentially increase reliance on Step 2, research, and other nonobjective factors. For students early in their medical education, emphasis on Step 2 and research will yield increased chances of matching into residency in the future.
背景 美国医学执照考试（USMLE）第一步最近从数字评分系统改为通过/失败评分系统。在2024年底之前，将不会有关于评分变化对匹配过程影响的正式研究。为了全面评估这一变化对整体匹配过程的影响，重要的是要看看在变化前几年申请人客观指标的趋势。我们旨在系统地评估主要住院医师匹配中住院医师申请中发现的客观指标的变化率和平均趋势。方法 从国家匹配计划的2007年至2020年申请周期的匹配报告中的图表结果中查询匹配和未匹配申请人的客观医学生数据。数据用于创建线性回归分析，并进行统计测试以评估随时间的趋势。结果 对于匹配的申请人，连续排名的平均数量（m = 0.33，p < 0.01）、拥有另一个非博士研究生学位（m = 0.67，p < 0.01）、成为阿尔法欧米伽阿尔法（AOA）荣誉协会成员（m = 0.22，p < 0.01）、USMLE第一步平均分数（m = 1.01，p < 0.01）、USMLE第二步平均分数（m = 1.68，p < 0.01）、研究经历的平均数量（m = 0.12，p < 0.01）以及摘要、报告和出版物的平均数量（m = 0.34，p < 0.01）存在统计学上显著的正趋势。此外，毕业于国立卫生研究院资助的前40名医学院的百分比存在统计学上显著的负趋势（m = -0.41, p < 0.01）。对于未匹配的申请人，拥有另一个非博士研究生学位（m = 0.83，p < 0.01）、USMLE第一步平均分数（m = 1.26，p < 0.01）、USMLE第二步平均分数（m = 2.27，p < 0.01）、研究经历的平均数量（m = 0.13，p < 0.01）以及摘要、报告和出版物的平均数量（m = 0.33，p < 0.01）存在统计学上显著的正趋势。结论 我们的研究表明，住院医师申请中几乎所有客观指标都有统计学上显著的增加。第一步评分系统中摘要、报告和出版物的近期变化将迫使几乎所有住院医师项目彻底改革其申请流程，并可能增加对第二步、研究和其他非客观因素的依赖。对于医学教育早期的学生来说，强调第二步和研究将增加未来匹配到住院医师项目的机会。
