• Faith C Quenzer, Christopher J Coyne, Londyn Grey, Jorge Fernandez, Peter Witucki, Binh Ly, Leslie C Oyama, and Stephen R Hayden.
• Department of Emergency Medicine, UHS Southern California Medical Education Consortium Emergency Medicine Residency Program, Temecula, California; Division of Epidemiology and Biostatistics, San Diego State University, School of Public Health, San Diego, California. Electronic address: fquenzer@gmail.com.
• J Emerg Med. 2023 Jun 1; 64 (6): 730739730-739.

BackgroundThe U.S. Medical Licensing Examination (USMLE) Step 1 has been used as a screening tool for residency selection. In February 2020, Step 1 numerical scoring changed to pass/fail.ObjectiveOur aim was to survey emergency medicine (EM) residency program attitudes towards the new Step 1 scoring change and to identify important applicant screening factors.MethodsA 16-question survey was distributed through the Council of Residency Directors in Emergency Medicine listserv from November 11 through December 31, 2020. Given the Step 1 scoring change, the survey questioned the importance of EM rotation grades, composite standardized letters of evaluation (cSLOEs), and individual standardized letters of evaluation, using a Likert scale. Descriptive statistics of demographic characteristics and selection factors were performed along with a regression analysis.ResultsOf the 107 respondents, 48% were program directors, 28% were assistant or associate program directors, 14% were clerkship directors, and 10% were in other roles. Sixty (55.6%) disagreed with pass/fail Step 1 scoring change and, of those, 82% believed that numerical scoring was a good screening tool. The cSLOEs, EM rotation grades, and interview were the most important selection factors. Residencies with 50 or more residents had 5.25 odds (95% CI 1.25-22.1; p = 0.0018) of agreeing with pass/fail scoring and those who ranked cSLOEs as the most important selection factor had 4.90 odds (95% CI 1.125-21.37; p = 0.0343) of agreeing with pass/fail scoring.ConclusionsMost EM programs disagree with pass/fail scoring of Step 1 and will most likely use Step 2 score as a screening tool. The cSLOEs, EM rotation grades, and interview are considered the most important selection factors.Copyright © 2023 Elsevier Inc. All rights reserved.

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