Bird Cole, Godbe Kerilyn N, Nazir Niaman, Braun Sterling, Farmer Rebecca, Korentager Richard
University of Kansas School of Medicine, Kansas City, Kansas.
Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas.
J Surg Educ. 2025 Sep;82(9):103625. doi: 10.1016/j.jsurg.2025.103625. Epub 2025 Jul 21.
The United States Medical Licensing Exam® (USMLE®) Step 1 exam implemented pass/fail scoring to "create a more holistic residency application selection process." We aimed to assess whether this transition favored holistic review or redirected emphasis to other metrics.
Quantifiable data from 330 Plastic Surgery Common Applications (PSCAs) submitted to a single academic center were collected. Applicants were stratified into 2 groups based on numeric or pass/fail Step 1 score. Logistic regression was performed for each group to assess the odds of matching based on quantifiable application components.
2023-2024 Match cycle.
330 integrated plastic surgery applicants.
A total of 137 applications reported numeric Step 1 scores, while 193 reported pass/fail scores. For applicants with a numeric Step 1 score, the factors most predictive of matching were Step 2 score >265 (OR 159 [95% CI, 6.6-999], Step 1 Score between 240 and 250 (OR 21.8 [95% CI, 4.8-98.6]), and being a U.S. citizen (OR 21.1 [95% CI, 3.9-116]). Letter of recommendation numeric strength (OR 11.0 [95% CI, 2.7-45.6]) was also a significant match predictor, followed by more than 16 podium presentations (OR 10.8 [95% CI, 2.6-45.5]). In comparison, for students with pass/fail Step 1 scores, there were only 3 significant factors that predicted a successful match: strength of recommendation letters (OR 3.7 [95% CI, 1.8-7.6]), Alpha Omega Alpha society membership (OR 3.2 [95% CI, 1.3-7.7]), and graduation from a U.S News and World Report top 40 medical school in research (OR 3.0 [95% CI, 1.5-6.1]).
For applicants with a numeric Step 1 score, Step 1 and 2 scores remained the most critical match factors. In comparison, letter of recommendation strength and graduation from a top 40 medical school were most important for applicants with pass/fail scoring, indicating a shift toward other application metrics following the scoring change.
美国医师执照考试（USMLE）第一步考试采用通过/失败计分制，以“创建一个更全面的住院医师申请选拔过程”。我们旨在评估这一转变是有利于全面评估，还是将重点重新转向其他指标。
收集了提交给一个学术中心的330份整形外科通用申请（PSCA）的可量化数据。申请人根据第一步考试的数字分数或通过/失败分数分为两组。对每组进行逻辑回归分析，以评估基于可量化申请组成部分匹配的几率。
2023 - 2024年的匹配周期。
330名综合整形外科申请人。
共有137份申请报告了第一步考试的数字分数，193份报告了通过/失败分数。对于第一步考试有数字分数的申请人，最能预测匹配的因素是第二步考试分数>265（比值比[OR]159[95%置信区间，6.6 - 999]），第一步考试分数在240至250之间（OR 21.8[95%置信区间，4.8 - 98.6]），以及是美国公民（OR 21.1[95%置信区间，3.9 - 116]）。推荐信的数字强度（OR 11.0[95%置信区间，2.7 - 45.6]）也是一个显著的匹配预测因素，其次是超过16次讲台展示（OR 10.8[95%置信区间，2.6 - 45.5]）。相比之下，对于第一步考试采用通过/失败计分的学生，只有3个显著因素预测成功匹配：推荐信的强度（OR 3.7[95%置信区间，1.8 - 7.6]），美国医学荣誉协会会员资格（OR
