Analyzing Predictors of Interviews Across Surgical and Nonsurgical Specialties in the Context of the Step 1 Pass/Fail Change: A Retrospective Study

This study examines how the transition of the United States Medical Licensing Examination (USMLE) Step 1 to pass/fail (P/F) scoring has affected residency interview predictors across surgical and non-surgical specialties. Using Texas Seeking Transparency in Application to Residency (STAR) data from 2018 to 2024, we evaluated trends in Step 2 Clinical Knowledge (CK) scores, clerkship honors, research output, and extracurricular factors. Step 2 CK scores were consistently predictive of interviews across all specialties. Clerkship honors were the strongest predictors for most fields, especially surgical specialties. Research publications had significant predictive value in neurological surgery, orthopedic surgery, otolaryngology, and urology. A logistic regression model for surgical match success identified the number of interviews, clerkship honors, and Step 2 CK scores as significant predictors, with interviews showing the strongest effect. These findings suggest that academic metrics remain central to residency selection and highlight the need for advising strategies that reflect post-Step 1 scoring changes.