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Video

Professional and Personal Development

(A1010) Impact of Step1 Transition to Pass/Fail on Medical Students’ Decision to Take ENT Research Years​

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Jaehee Kim, BA

    Medical Student
    Case Western Reserve University School of Medicine
    Cleveland, Ohio, United States

    • Co-Author(s)

  • Kelsey Limage, BS

    Research Fellow
    Thomas Jefferson University
    Washington, DC, United States

  • Shreya Mandloi, Bs

    Research Fellow
    Thomas Jefferson University Hospital Systems
    Princeton, New Jersey, United States

  • Kathryn L. Nunes, BA

    Medical Student
    Sidney Kimmel Medical College
    Plymouth Meeting, PA, United States

  • PK

    Praneet Kaki, BS

    Thomas Jefferson University, United States

    • Senior Author(s)

  • MR

    Mindy Rabinowitz, MD

    Jefferson Otolaryngology, United States

Disclosure(s):
Jaehee Kim, BA: No relevant relationships to disclose.
Kelsey Limage, BS: No relevant relationships to disclose.


Introduction: The transition of Step 1 of the United States Medical Licensing Examination (USMLE) to a pass/fail (P/F) grading system raises questions regarding its impact on medical students' decisions to pursue competitive specialties like otolaryngology (ENT). This study explores how this change has influenced students' perceptions of their competitiveness for ENT residency and their decisions to pursue dedicated research years.

Methods: A 26-item survey was distributed to medical students who participated in ENT research programs in 2023 and 2024. Participants provided information on demographics, academic achievements, and motivations for taking a research year. Specific questions assessed the influence of Step 1 P/F on their decision-making.

Results: Among 34 respondents (41.2% White, 41.2% Asian, 2.9% Black, 14.7% Other), 94.1% took Step 1 P/F and 6.3% attempted Step 1 twice. Of these, 30.3% indicated that Step 1 becoming P/F influenced their decision to take a research year, while 51.5% disagreed. Other motives for taking a research year included uncertainty of competitiveness (33.4%), desire to build connections (96.9%), and solidifying interest in ENT (57.5%).

Students without a home ENT program (n=10) were more likely to report uncertainty about their competitiveness due to Step 1 P/F and to report Step 1 P/F influenced their decision to take a research year (40.0% vs 26.1%). Students with non-research-intensive home programs (n=13) were most likely to disagree that Step 1 P/F influenced their decision to take a research year (69.2%) or affected their perception of their competitiveness (53.8%).

Conclusions: The shift to a P/F Step 1 grading system influenced research year decisions, particularly for students without home ENT programs, while those without “research-focused” home programs reported minimal impact. Encouraging students to pursue ENT research opportunities early may be increasingly important in the context of a P/F Step 1. Further evaluations can help identify impacted students such that adequate support is provided and diversity is promoted among aspiring ENTs.