From Scores to Scholarship: Evolving Metrics in Vascular Surgery Residency Admissions

BackgroundIn 2022, the United States Medical Licensing Examination (USMLE) Step 1 transitioned to a pass/fail format, removing a long-standing objective measure from residency applications. This shift led applicants and/or residency program directors to place increased emphasis on alternative metrics such as research output (RO), though how much programs value this remains unclear. This study explores RO trends among vascular surgery applicants from 2014-2024 and compares them by applicant type and across other competitive surgical specialties.MethodsNRMP Charting Outcomes in the Match reports (2014-2024) were reviewed. The mean number of abstracts, presentations, and peer-reviewed publications (RO) was collected for matched and unmatched U.S. MD seniors applying to vascular surgery. RO data for Doctor of Osteopathic Medicine (DO) and non-U.S. international medical graduate (IMG) applicants were also reviewed for completeness.ResultsRO among matched U.S. MD vascular surgery applicants rose by 54.7%, from 7.0 in 2014 to 12.8 in 2024. The most marked increase occurred between 2018 and 2022 (8.3 to 12.4; +67%), with growth plateauing thereafter after 2022. In contrast, RO among matched DO and IMG applicants declined: DO applicants dropped from 21.3 in 2022 to 9.0 in 2024, and IMG applicants from 60.3 in 2020 to 38.3 in 2024. However, 2024 sample sizes were small, 137 matched U.S. MDs vs only 3 DOs and 6 IMGs, limiting direct comparisons.ConclusionWhile RO among vascular surgery applicants surged after Step 1 became pass/fail, the recent plateau suggests a transient response rather than ongoing growth, differing from trends in other surgical subspecialties. These findings raise concerns about equity and added pressure on underrepresented applicants. Further research is needed to clarify RO's actual role in residency selection and inform fairer evaluation practices.