The Effect of Numeric Versus Pass/Fail USMLE Step 1 Scores in the Integrated Plastic Surgery 2023-2024 Match Cycle: A Single Institution Study.

OBJECTIVE

The USMLE Step 1 exam, an important metric in the integrated plastic surgery match, transitioned to pass/fail scoring in January 2022. No previous studies have investigated the impact of this new scoring system on the process of ranking applicants in the integrated plastic surgery match.

DESIGN

330 Plastic Surgery Common Applications (PSCAs) were submitted to a single academic center in the 2023-2024 match cycle. Applicants were sorted into tiers via a holistic review process, and quantifiable data, including USMLE Step 1 scores, were then compared between tiers.

SETTING

Our Institution's Integrated Plastic Surgery Residency Program.

PARTICIPANTS

Integrated Plastic Surgery applicants in the 2023-2024 match cycle.

RESULTS

317 of 330 PSCAs were analyzed in this study, excluding applicants who did an elective rotation at our institution. Applicants were sorted into 3 tiers: high (n = 100), middle (n = 118) and low (n = 99), with a significant difference in match rate per tier, respectively (88.0%, 58.5%, 30.3%, p < 0.0001). The majority of USMLE Step 1 scores were reported as pass/fail (186/317, 58.7%). There was a significant difference (p < 0.0001) between the average USMLE Step 1 score between the high (mean 250.5, SD 10.4), middle (mean 241, SD 14.6), and low tiers (mean 235.5, SD 16.5). More applicants in the low tier (50%) and high tier (40%) reported numeric USMLE Step 1 scores than those in the middle tier (35%, p = 0.0734). Stepwise logistic regression revealed USMLE Step 1 score to be an independent predictor of tier placement between the high and middle tier (p = 0.0030) and high and low tier (p = 0.0001). Lastly, 3 applicants reported their USMLE Step 1 score as 'pass' instead of their given numeric score.

CONCLUSIONS

Comparing applicants with numeric USMLE Step 1 scores to those with pass/fail scores can have a significant impact on the ranking of those applicants and should be carefully considered during the plastic surgery match process.