Effect of USMLE Step 1 Pass/Fail Shift on Publication Behaviors Among Successfully Matched Integrated Plastic Surgery Residency Applicants

Document Type

Conference Proceeding

Publication Date

6-2025

Publication Title

Plastic and Reconstructive Surgery - Global Open

Abstract

BACKGROUND: Until 2024, USMLE Step 1 scores played a significant role in integrated plastic surgery residency (IPSR) applicant selection. The Class of 2024 was the first to match without metric-based Step 1 scores, coinciding with a reported 22.2% increase in research output, an aggregate measure of abstracts, presentations, and publications. Little is known regarding the specific publication behaviors and trends of applicants in the wake of the Step 1 score change. This study aims to characterize the publication profiles of successfully matched applicants across the last 3 cohorts of residents comparing the most recent class without a Step 1 score to the previous 2 cohorts. METHODS: U.S. IPSR programs were identified via the ACGME Advanced Program Search. Resident information for the previous three year’s cohorts, including the first cohort without numeric Step 1 scores (PGY-1, 2, & 3), was obtained from program websites including program ranking (Top 20) as well as resident IMG status. Publication metrics were obtained via PubMed. Variables included were total publications, authorship position (1st & 2nd), and journal specifics like name and impact factor (2- and 5-yr). Publications were then categorized by article type. RESULTS: Of the 89 programs identified on the ACGME website, 85 (95.5%) had program webpages with resident information and were included in the study. 4,144 publications authored by 555 residents were recorded and analyzed. Initial observation revealed that there may be some merit to shifts in the perceptions of publication metrics as the number of publications declined slightly from 1,385 in PGY-3 to 1,238 in PGY-2 but jumped to 1,521 in the PGY-1 cohort. Additionally, this was accompanied by a shift in the type of article published. This appears to be a slight shift away from Letters to the Editor and case reports in the PGY-3 year; 60 (4.3%) and 115 (8.3%) compared to 31 (2%) and 83 (5.5%) in PGY-1, respectively. This shift appears to be slightly in favor of clinical publications with PGY-3 having 544 (39.3%) and PGY-1 with 650 (42.7%) but more dramatically for systematic reviews and meta-analyses with PGY-3 showing 205 (14.8%) but PGY- publishing 298 (19.6%). Ongoing analysis are underway to observe other collected variables especially to further characterize the publication profiles of IMGs and applicants accepted into Top 20 programs. CONCLUSION: These initial results when compared to a study of similar nature conducted for the 2020 and 2021 cohorts reveal bench research has plummeted from 21% to 11%. In its place, review articles have grown in popularity. This may be indicative of applicants avoiding labor intensive, time-consuming research projects for those with faster turnarounds. Results from this investigation will provide valuable insight and potentially observe the first stages of behavioral change for applicants and educators following the shift in Step 1 score reporting for those pursuing IPSRs.

Volume

13

Issue

S4

First Page

5

Last Page

6

Comments

American Council of Educators in Plastic Surgery ACEPS 12th Annual Meeting, February 20-23, 2025, Las Vegas, NV

DOI

10.1097/01.GOX.0001123592.70236.38

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