USMLE Step 1 Pass/Fail is Here: Are Plastic Surgery Applicants Really Better Off?

OBJECTIVE: As of January 26, 2022, the United States Medical Licensing Examination(USMLE) Step 1 score reporting will be changed from a numeric scoring sys-tem to pass/fail. Although the new scoring policy is expected to benefit medical students, there is concern that it will also amplify preexisting disadvantages and worsen disparities for students applying in the already-competitive plastic surgery match. Whether the report -ing change will tangibly benefit applicants to plastic sur-gery has yet to be elucidated. DESIGN: A cross-sectional survey was distributed to medical students and graduates via social media plat-forms. Data were analyzed using Student t test and Chi-squared statistic, with an alpha level set at 0.05.SETTING: Data collection and analysis was performed at Johns Hopkins University School of Medicine.PARTICIPANTS: This study included a sample of 120 American Medical Trainees (AMTs) and International Medical Trainees (IMTs) who are interested in plastic surgery.RESULTS: The plurality of respondents were against the new Step 1 score reporting (AMT: 40.7%; IMT: 44.3%), but differences existed between AMTs when compared to IMTs, especially regarding opinions about the report -ing change on stress levels and competitiveness of highly competitive specialties. Regardless of training status, respondents felt that the pass/fail scoring system would increase their likelihood to engage with more research, dual apply, prioritize studying for Step 2 CK, and con -sider a dedicated research year.CONCLUSIONS: While a pass/fail reporting system for Step 1 may alleviate some stress for medical trainees, other issues arise that may perpetuate disparities and bias against students with little resources in the field of plastic surgery. Residency programs should offer antici-patory guidance regarding prioritization of aspects of application to ease this psychosocial and financial pres -sure, as well as help students reorganize their con-strained time. (c) 2022 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.