Letter to the Editor Regarding “Characterizing the Effect of Pass/Fail U.S. Medical Licensing Examination Step 1 Scoring in Neurosurgery: Program Directors' Perspectives” (original) (raw)

More than a year has elapsed since the United States Medical Licensing Examination (USMLE) Step 1 was announced to be changing to a pass/fail examination in 2022, with a significant body of research having been published in the meanwhile. 1,2 Considering the long-standing value of Step 1 score in both screening and selection of candidates, this change has significantly impacted both residency programs and applicants. Several considerations for all stakeholders in the neurosurgery match can be found in the work of Kumar et al, which is a subgroup analysis of their landmark work published in the New England Journal of Medicine that looked at over 2000 program directors (PDs) of all specialties. 1,3 We add to considerations discussed by them below. Further Perspectives of Program Directors Firstly, their work needs to be put together with the quite similar work by Huq et al of the perspectives of neurosurgery PDs regarding the pass/fail change, which was published prior. This survey, which captured responses of 59 PDs and 16 associate PDs (APDs) in neurosurgical residencies, found that 77% of them have 'always' screened candidates using Step 1 scores and nearly 79% disagree with this change. 4 These findings are similar to those of Kumar et al. Of the 48 neurosurgery PDs who responded to the latter's survey, nearly 78.7% disagreed with the change, and 85% agreed that it would make objectively comparing applicants more difficult. 3

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