LAUSR

OBJECTIVE To capture the perspectives of urology program directors (PDs) regarding the change in USMLE Step 1 scoring to pass/fail (binary) and the impact of this change on the urology residency application process. METHODS A validated survey was developed and distributed via email to urology PDs at all ACGME-accredited programs. RESULTS A total of 65 PDs completed the survey, for a response rate of 49.0%. Most PDs (58.7%) did not agree that binary USMLE Step 1 scoring is a good idea. The majority (84.6%) felt that this change would make it more difficult to compare applicants objectively and that the change would increase emphasis on Step 2 CK scores. Likewise, 73.8% of PDs reported that they would start requiring applicants to submit Step 2 CK scores and 78.5% of PDs felt that Step 2 CK should remain numerically scored. Free text responses highlighted concerns for students at medical schools with pass/fail grading and the potential impact this change could have on the early match. CONCLUSION Urology PDs have generally negative perspectives towards binary scoring of USMLE Step 1. They believe the change will make residency selection more arduous and less objective, without increasing medical student well-being. Program directors anticipate a heavier emphasis on USMLE Step 2 CK scores and this may alter the urology early match process. Modifications to application requirements and interview schedules may be necessary to uphold an unbiased selection of applicants with respect to the early match timeline.