Background: Step 1 is an exam required of medical students as part of licensing which assesses knowledge and application of basic science concepts relating to medicine, and assigns students a numerical score, with 194 as the minimum to pass. Recently, the USMLE announced that Step 1 reports will change from a numerical grade to pass/fail.

Goal: To assess the opinions of urology residency directors toward this scoring change.

Methods: Program directors were contacted through their contact information listed by the AUA and FREIDA. Using a Likert scale, respondents were asked 14 questions about their current use of Step 1 scores in resident selection, their opinions about the switch to pass/fail scoring, and anticipated changes to their residency match process

Results: 38 of 145 program directors responded to the survey (26% response rate). 76% of respondents strongly or somewhat agreed when asked if USMLE scores played an important role in ranking applicants. 63% of programs reported using Step 1 cutoffs, with the average reported at 230.5. 70% of respondents strongly or somewhat agreed that a high Step 2 CK score can increase the chances of selection despite a low Step 1 score. 66% of respondents believed that the prestige of an applicant’s medical school would become more important. 84% of respondents strongly or somewhat agreed that selecting applicants would be more difficult without a numerical Step 1 score. Only one respondent marked an anticipated Step 2 CK score cutoff, set to 240. 45% of respondents indicated that they would institute a cutoff but had not selected a value, while 53% indicated that they would not implement a cutoff.

Conclusions: The Step 1 score is currently an important metric used by residencies. Program directors expressed some concern that the change to pass/fail may make resident selection more difficult.