Factors That Predict Success in the General Surgery Match With a Pass/Fail USMLE Step 1 Exam

Abstract

Introduction

Matching into a residency program is an intricate process, including holistic application review, selection for interview, and ranking of interviewed candidates for the match. This study aims to determine potential predictors of a successful match into general surgery (GS) residency.

Methods

We retrospectively reviewed data of applicants interviewed and ranked at a single GS program between 2018 and 2024. We created 2 groups: Matched (MG) and Unmatched (UMG). We performed correlational analyses between applicants’ demographic characteristics, academic achievements, performance during the interview days, and the matching results. We performed univariate and multivariable logistic regression analyses to determine the predictors of matching with/without USMLE Step-1 scores.

Results

A total of 419 applicants were included, of which 375 (89.5%) matched into categorical GS postgraduate year-1 (PGY1) positions, while 44 (10.5%) did not match. The MG had a higher median USMLE Step-1 and Step-2 scores, attended USA medical school, and ranked higher in the Rank Order List (ROL). During the interview, MG received higher scores. We found a correlation between candidates’ characteristics and academic performance and matching. Multivariable logistic regressions with/without USMLE Step 1 score showed that increased USMLE Step-1 scores, better performance during interview, were associated with increased likelihood of matching into categorical GS.

Conclusion

While academic performance is important in selecting candidates, the applicants should be cognizant of the role of interpersonal/communication skills during the interview for successful match. The shift from numerical to pass/fail reporting for USMLE Step-1 scores emphasizes the need for a more holistic approach to candidate evaluation.