(A003) Early Impact of the Step 1 Transition to Pass/Fail on the Otolaryngology Match

Introduction: Otolaryngology is a very competitive specialty to match into. This study examines the impact of the 2022 transition of USMLE Step 1 to pass/fail on otolaryngology residency applications, reflected in the 2024 match cycle.

Methods: A retrospective analysis used data from the Texas Seeking Transparency in Application to Residency (STAR) database. The study included matched otolaryngology residency applicants between 2023 and 2024 and looked at the differences between the years for curricular and non-curricular metrics.

Results: There were 115 and 97 applicant responses in 2023 and 2024, respectively, reflecting an average response rate of 28.11% of all applicants. Step 2 scores remained stable between 2023 (257.24±9.79) and 2024 (259.23±7.67; p=0.23). The average number of clerkship honors increased from 3.75±2.62 in 2023 to 4.81±2.12 in 2024 (p < 0.005), while publications declined (2023: 6.92±3.91 to 2024: 4.49±3.63; p< 0.001). Additionally, volunteer experiences decreased significantly (2023: 7.90±3.16 to 2024: 4.00±2.59; p< 0.001).

Conclusions: The impact of changing step 1 to pass/fail, a heavily weighted objective metric by residency programs, is uncertain. Our results show that objective measures such as step 2 scores remained stable, and research output has decreased. It also suggests a compensatory increase in clerkship honors, possibly indicating a shift in how residency programs weigh different academic performance factors. The drop in volunteer experience is likely due to the changes in the 2024 application cycle, which limited the number of experiences applicants could submit. More longitudinal analysis will help understand the impact of the step 1 transition on the otolaryngology match.