Navigating the Transition: The Impact of Step/Level 1 Pass/Fail Grading on Dermatology Residency Match Outcomes
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Keywords
dermatology match, pass/fail, USMLE Step 1, COMLEX level 1, Exam scores, program director preferences, medical education
Abstract
Background: Competitive residencies like dermatology are becoming increasingly difficult to match into. The transition to pass/fail (P/F) grading for USMLE Step 1 and COMLEX Level 1 aimed to reduce stress by shifting focus away from numerical scores.
Objective: This study evaluates the impact of the P/F transition on dermatology residency applications.
Methods: National Resident Matching Program (NRMP) charting outcomes and program director surveys were analyzed from 2018, 2020, 2022, and 2024. This data was compiled and analyzed in December of 2024.
Results: Findings revealed increased dermatology applicants without a corresponding rise in available positions, intensifying competition. Research productivity increased significantly, with more abstracts, presentations, and publications following the P/F change, indicating a shift in application strategies. In 2024, the first cohort affected by the P/F system displayed stable USMLE Step 2 scores. Program directors increasingly prioritized holistic factors, such as interpersonal skills, letters of recommendation, and faculty interactions.
Conclusion: These trends suggest that applicants are compensating for the loss of Step 1/Level 1 numerical scoring by strengthening other aspects of their applications, particularly research. Understanding evolving selection criteria is crucial to preparing medical students for successful matches. Further research is needed to assess the long-term impacts of the P/F transition.
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