The Effects of Single Accreditation and Pass/Fail Licensing Exams on Osteopathic Medical Students Applying to Surgical Residency Programs

Abstract

Objective: To examine the effects of single accreditation and pass/fail licensing exams on osteopathic (DO) medical students applying for surgical residency.

Design: Electronic surveys were distributed to 1509 program directors (PD) in 10 surgical specialties. PDs were separated into 2categories based on their program's accreditation status prior to single accreditation: formerly accredited by the American Osteopathic Association (AOA) or not accredited by the AOA. Separate chi-squared and binomial tests were used to determine statistical differences between PDs in each category and within each surgical specialty.

Setting: Voluntary, anonymous, electronic survey.

Participants: Three hundred survey responses were received (response rate 19.8%) and 234 responses were included in statistical analyses. Sixty-six responses were excluded because the survey was incomplete, the survey was not completed by a PD, or the PD indicated disqualification of DO applicants from matching at that program.

Results: The majority of PDs in both categories recommend or require that DO students take both United States Medical Licensing Examination (USMLE) Step1 [Χ² (2, N = 234) = 8.939, p = 0.011] and USMLE Step 2 CK [Χ² (2, N = 234) = 4.161, p = 0.125] despite pass/fail outcomes only on Step 1 and Level 1. When deciding whom to interview, PDs in both categories highly ranked USMLE Step 2 CK scores and letters of recommendation (LOR). Formerly-AOA-accredited programs highly ranked COMLEX-USA Level 2 scores (p = < 0.001) and completion of an audition rotation (p = 0.001). Non-AOA-accredited programs highly ranked the Medical Student Performance Evaluation (MSPE) (p = < 0.001) and clerkship grades/evaluations (p = 0.001).

Conclusions: Significant differences exist in programs despite single accreditation. DO applicants should take both USMLE Step 1 and Step 2 CK to be considered competitive for any surgical specialty. Additionally, DO students should prioritize formerly-AOA-accredited programs for audition rotations.

Keywords: COMLEX; USMLE; education; medical student; residency application; surgery.