Cuttica Nathan, Keith Alexander, Hedberg Stephen E, Sciarretti Nicholas, Ralph Jessica, Hedberg Peter S
College of Medicine, Northeast Ohio Medical University, Rootstown, USA.
Department of Clinical and Health Psychology, University of Florida, Gainesville, USA.
Cureus. 2025 Jun 7;17(6):e85524. doi: 10.7759/cureus.85524. eCollection 2025 Jun.
Matching into a competitive specialty has historically required extensive research, leadership, and extracurricular activities. Since the United States Medical Licensing Examination (USMLE) Step 1 exam has changed to a pass-fail grading system, it has been questioned whether medical school ranking will become a significant factor in matching into competitive medical specialties. To our knowledge, this is among the first studies to examine competitive specialty match trends following the transition to pass/fail Step 1 scoring. High-tier and low-tier medical schools were determined using the U.S. News and World Report 2024 Medical School Rankings list, and the 20 highest- and 20 lowest-ranked US-based allopathic medical schools were selected. Medical school competitiveness was determined using the mean USMLE Step 2 clinical knowledge (CK) score, mean number of research abstracts, publications, and presentations, percent of applicants that matched into said specialty, and percent of matched students that were Alpha Omega Alpha (AOA) honors society members. The most competitive specialties were determined to be dermatology, neurological surgery, plastic surgery, orthopedic surgery, and otolaryngology. Match rates into competitive specialties were compared at high- and low-tier medical schools. Secondary analysis eliminated schools that did not have an affiliated residency program, termed a "home program", to examine this as a potential confounder. High-tier medical schools demonstrated statistically greater match rates into dermatology (p=0.046), neurological surgery (p=0.008), otolaryngology (p=0.008), and competitive specialties overall (p=0.006) when compared to low-tier medical schools. A difference was not noted for plastic surgery (p=0.308) and orthopedic surgery (p=0.809) match rates. However, when accounting for whether schools had affiliated residency programs, these differences were no longer statistically significant, highlighting the potential importance of home programs over school prestige alone. Higher-tier medical schools placed more students into competitive specialties, specifically dermatology, neurosurgery, and otolaryngology, when compared to lower-tier medical schools. Thus, attending a highly ranked allopathic medical school may serve as a significant benefit when applying to some competitive specialties. However, after eliminating high- and low-tier medical schools without an affiliated residency program, no statistical significance was observed for dermatology, neurosurgery, plastic surgery, orthopedic surgery, otolaryngology, or overall. Thus, medical school ranking may be less important than attending a school with a home program when applying for one of the five competitive specialties examined.
从历史上看，进入竞争激烈的专业需要进行广泛的研究、具备领导能力并参与课外活动。自从美国医师执照考试（USMLE）第一步考试改为及格/不及格评分系统以来，医学院的排名是否会成为进入竞争激烈的医学专业的一个重要因素一直受到质疑。据我们所知，这是首批研究向第一步考试及格/不及格评分过渡后竞争激烈的专业匹配趋势的研究之一。使用《美国新闻与世界报道》2024年医学院排名榜单确定了高排名和低排名医学院，选取了美国排名最高的20所和最低的20所全科医学医学院。医学院的竞争力通过USMLE第二步临床知识（CK）平均分数、研究摘要、出版物和报告的平均数量、进入该专业的申请人百分比以及成为阿尔法欧米伽阿尔法（AOA）荣誉学会成员的匹配学生百分比来确定。确定最具竞争力的专业为皮肤科、神经外科、整形外科、骨科和耳鼻喉科。比较了高排名和低排名医学院进入竞争激烈专业的匹配率。二次分析排除了没有附属住院医师培训项目（称为“本校项目”）的学校，以检验这是否是一个潜在的混杂因素。与低排名医学院相比，高排名医学院在进入皮肤科（p = 0.046）、神经外科（p = 0.008）、耳鼻喉科（p = 0.008）以及总体竞争激烈专业（p = 0.006）方面的匹配率在统计学上显著更高。整形外科（p = 0.308）和骨科（p = 0.809）的匹配率未发现差异。然而，在考虑学校是否有附属住院医师培训项目后，这些差异在统计学上不再显著，这突出了本校项目相对于学校声望本身的潜在重要性。与低排名医学院相比，高排名医学院有更多学生进入竞争激烈的专业，特别是皮肤科、神经外科和耳鼻喉科。因此，申请一些竞争激烈的专业时，就读排名高的全科医学医学院可能会有很大优势。然而，在排除没有附属住院医师培训项目的高排名和低排名医学院后，对于皮肤科、神经外科、整形外科、骨科、耳鼻喉科或总体情况，未观察到统计学意义。因此，在申请所研究的五个竞争激烈专业之一时，医学院排名可能不如就读有本校项目的学校重要。
