Medical Students’ Attitudes Towards Research Participation After the United States Medical Licensing Examination Step 1 Scoring Change

TL;DR

Medical students see research as more important for residency applications after the USMLE Step 1 scoring change, but lack of time is a major barrier.

Contribution

This study explores how the USMLE Step 1 scoring change affects medical students' attitudes and experiences with research.

Findings

Most students believe research is now more important for residency competitiveness due to the scoring change.

Lack of time is the most common barrier to research participation.

Research participation correlates with research output, but not with the competitiveness of the specialty of interest.

Abstract

The recent transition of scoring for the United States Medical Licensing Examination (USMLE) Step 1 exam from a numerical grading system to pass/fail system has significant implications for residency applicants. It is anticipated that research productivity will gain greater importance in the evaluation process. To understand how medical institutions can best support students, we seek to understand medical students’ motivations and experience conducting research in medical school after the USMLE Step 1 scoring change.

This is a mixed-methods, cross-sectional study that examines the motivations and barriers that medical students face in conducting academic or clinical research. A survey study based on a modified questionnaire for medical students was distributed to second-year medical students at a single institution. Mann–Whitney tests were used to analyze differences in attitudes across various subgroups and Pearson correlations quantified the strength of relationships. A thematic analysis was used to examine the qualitative data set.

68 students completed the survey, 35 male and 32 female, and one failed to select an option. 39 students (57.3%) indicated that the USMLE Step 1 transition to pass/fail has influenced their attitudes and beliefs about conducting research in medical school. The most frequently endorsed motivation for medical student research participation was to be more competitive for residency applications [(65/68), 95.6%]. The most frequently endorsed barrier was lack of time [(59/68), 86.8%]. Research participation is correlated with research output (r = 0.49, p < 0.001). Competitiveness of specialty of interest was correlated with research participation (r = 0.36, p < 0.01) but not research output (p > 0.05). There is no difference in research output, participation, or attitudes between genders (p > 0.05).

Medical students perceive research participation and productivity as an increasingly important differentiating factor in competitive residency applications as USMLE Step 1 transitions to pass/fail. However, lack of time to engage in research poses a barrier for many students. Efforts that support student endeavors in academic or clinical research are a crucial aspect of the medical school curriculum and should focus on streamlining student research participation as the preclinical curriculum shortens across medical schools.

The online version contains supplementary material available at 10.1007/s40670-025-02508-3.