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Preserve That Narrative! Supporting and Differentiating Applicants in an Increasingly Distanced and Stressful World

Published:August 11, 2022DOI:https://doi.org/10.1016/j.acra.2022.07.010
      The Covid-driven advent of the remote interview season enabled students to cast far wider nets, applying to and interviewing at far more programs without the time and expense of real-life travel. That drove a sharp increase in the number of applications, per opening seen by most programs. How do we weigh and triage the avalanche of Radiology Residency ERAS applications each fall? Recent surveys showed the top three selection criteria, both pre- and post-COVID, to be the USMLE Step One score, Medical Student Performance Evaluation, and the Letter of Recommendation (LOR) (
      • Jones HM
      • Ankem A
      • Seroogy EA
      • Kalatar A
      • Goldsmith DC
      • Ritzenbergs KC
      • Van Meter TL.
      Impact of COVID-19 on Radiology Residency Selection Process: A Survey of Radiology Residency Programs in the US.
      ). However, as of January 2022, Step One –for better or worse a very popular first screen for programs to winnow the mountains of applications–went Pass/Fail. While the goal was to decrease junior student stress and burn-out, it seems likely this move instead simply will transfer that stress to Step Two and other possible metric substitutes (
      • Zhang RV
      • Awan OA
      • Resnik CS
      • Hossain R.
      Potential Impact of a Pass or Fail United States Medical Licensing Exam Step 1 Scoring System on Radiology Residency Applications.
      ). While the Step One ritualistic stress of increasingly-long preparation and subsequent stratification of students had definite downsides, there were also some positives. As with any test, the feedback helped the student assess the efficacy and effort of study methods, therefore possibly improving the approach to studying. It may have helped the student identify relative strengths and weaknesses, as well as realistically estimate likely overall position in the pre-Match food chain. Early feedback of this sort helps with reality testing; perhaps one should reconsider potential field choices if one's profile is a poor fit, or perhaps one might be reassured that current study habits and overall performance are on track. Perhaps a system where only the student received the Step One score, therefore benefitting by the feedback, while ERAS and the SOM received Pass/Fail, might have more realistically addressed the real issue of student stress in the process of reviewing and then being tested on one's medical education to date.
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