Assessing the effect of USMLE step 1 pass/fail grading on dermatology match rates and residency application disparities between institutions with and without home programs

Summary: Abstract Body: Prior studies indicate that students without a home dermatology program match at a lower rate compared to those with a home program. A comparative retrospective cohort study was conducted to examine if the change in Step 1 scoring in 2022, intended to increase equity amongst residency applicants, reduced disparities between schools with and without home programs. Match data were collected from the NRMP, medical school, and residency program websites. 109 U.S. MD medical schools with match data for the years 2019, 2022 (numerical Step 1 scores) and 2023, 2024 (Step 1 Pass/Fail) were included. A two-way ANOVA tested the effects of home dermatology programs (1 = yes, 0 = no) and Step 1 scoring format (scored vs. pass/fail) on match rates. Medical schools with home dermatology programs demonstrated a statistically significant improvement in match rates pre/post Step 1 P/F (p<0.0001). Pre-transition (2020 and 2022), the match rate was 6.93 matches per school (74%) for schools with home programs compared to 2.32 matches per school (26%) for those without. Post-transition (2023–2024), the match rate was 7.01 matches per school (73%) for schools with home programs and 2.54 matches per school (27%) for those without. While the match rate difference increased, the interaction between the presence of a home program and the scoring period was not statistically significant (p = 0.34). The change to Pass/Fail Step 1 did not decrease disparities in dermatology match rates for schools without home programs, possibly due to programs placing greater emphasis on other metrics like Step 2 scores, letters of recommendation, or familiarity with home students. Donna Pham¹, Sheehan Parvez², Ameena Ali³, Kelly Kaon⁵, Jonathan Liao⁵, Dominique DiGiacomo⁶, Robert Dorschner⁴ 1. University of California Riverside School of Medicine, Riverside, CA, United States. 2. University of Louisville, Louisville, KY, United States. 3. Mercer University School of Medicine, Macon, GA, United States. 4. Dermatology, University of California San Diego Department of Medicine, La Jolla, CA, United States. 5. Stony Brook Medicine, Stony Brook, NY, United States. 6. The University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States. Clinical Research: Epidemiology and Observational Research