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Pritzker News
“The debate about changing the scoring system for the Step 1 exam is both
Rethinking how medical students are evaluated for residency BY SARAH RICHARDS
“ I am a Black student taking the USMLE Step 1 exam on Thursday, June 11. I have not had time to grieve, I have not had time to feel, and I have not had time to hurt — because in order for me to pass this exam I am required to be hyper focused and undistracted. A luxury that I do not have.” Jasmine Solala, MA, MS3 University of Illinois College of Medicine
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a manifestation of dysfunction in the medical education pathway and an opportunity to address this dysfunction.” From “A Shared Evaluation Platform for Medical Training” New England Journal of Medicine
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o develop the most skilled, innovative, adaptable and compassionate physicians, leaders in academic medicine continuously review and adjust the methods used to teach, train and evaluate medical students and residents. The civil rights protests last summer, along with the stark health disparities exposed by the COVID-19 pandemic, added urgency to this practice, with many students and faculty stressing the need for medical education to better address structural racism. Several University of Chicago Pritzker School of Medicine faculty members have emerged as thought leaders in this environment. Their suggestions for improving medical student evaluation have appeared in leading journals, and their actions are placing the University at the forefront of modernizing medical education. “The University of Chicago Medicine is a well-known medical training institution, and we can be an example for others to follow,” said Alisa McQueen, MD, Associate Chair for Education and Program Director of the pediatric residency program and the fellowship in pediatric emergency medicine program.
Embracing the move to pass/fail for Step 1
In a letter titled “Why We Can’t Wait,” published in the Journal of Graduate Medical Education in February, 11 UChicago Medicine residency program directors announced they would no longer use U.S. Medical Licensing Examination (USMLE) Step 1 scores when selecting medical students for their residencies. Beginning with the 2020 recruitment season, Step 1 numerical scores will be masked when programs
THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION
select applicants for interviews or rank applicants for the match. The Federation of State Medical Boards (FSMB) and the NBME (National Board of Medical Examiners) decided last year to replace numerical scores with a pass/ fail ranking to reduce the overemphasis on students’ performance on the test. The change doesn’t go into effect until 2022, however — making UChicago Medicine one of the first institutions in the U.S. to adopt it. “There is no evidence that being able to score well on a standardized exam makes you a better physician, researcher or educator, and for many equity-seeking groups, standardized exams and particularly board exams have been an obstacle for reaching certain specialized fields in medicine,” said Monica Vela, MD’93, Associate Dean for Multicultural Affairs. The authors of “Why We Can’t Wait” include Jasmine Solala, MS3, a University of Illinois College of Medicine student who wrote an essay about her experiences studying for Step 1 during the George Floyd protests; Victoria Okuneye, PhD’20, MS2, who brought the essay to the attention of Pritzker leadership; Rochelle Naylor, MD, Associate Program Director of the pediatric residency program; McQueen; and Vela. The letter urges other institutions to immediately adopt Step 1 pass/fail grading in light of the structural inequities emphasized by the pandemic and Black Lives Matter protests. The authors contend that embracing this change early recognizes historic discrimination and injustices in medicine suffered by Blacks, Latinos, women and people of non-conforming genders and sexualities. At least some of
