Predicting successful general surgery matching in a Step 1 pass/fail era: Analysis of the Texas STAR database - 18/11/25

Doi : 10.1016/j.amjsurg.2025.116718

Liam R. Kugler ^a , Griffin P. Stinson ^a , Victoria E. Bindi ^a , Yuriy Stukov ^a , Angela P. Mihalic ^b , Janice A. Taylor ^a,^⁎
^a College of Medicine, University of Florida, 1600 SW Archer Road, PO Box 100119, Gainesville, FL, 32610, USA
^b Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9006, USA

^⁎Corresponding author. Division of Pediatric Surgery, University of Florida, 1600 SW Archer Road, PO Box 100119, Gainesville, FL, 32610, USA.Division of Pediatric SurgeryUniversity of Florida1600 SW Archer RoadPO Box 100119GainesvilleFL32610USA

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 18 November 2025

Abstract

Background

General surgery residency is a competitive match. USMLE Step1 became pass/fail in 2022. We sought to compare matched general surgery applicants between scored and pass/fail Step1 eras to elucidate possible shifts in residency applications.

Methods

The Texas Seeking Transparency in Application to Residency database was queried from 2017 to 2024. Academic, extracurricular, geographic, and away rotation data were analyzed.

Results

1861 scored and 302 pass/fail Step1 applicants matched in general surgery. More pass/fail applicants scored ≥250 on Step2 (p = 0.03). Pass/fail applicants had more honored clerkships (p = 0.01). More pass/fail applicants completed away rotations; more away rotations were associated with more interviews (p = 0.003), but not with matching at that program. Pass/fail applicants applied to more programs (p < 0.001); they did not attend more interviews.

Conclusions

Pass/fail applicants demonstrated higher Step2 performance. They applied to more programs, did more away rotations, with similar interview success. This early analysis helps inform applicants into general surgery in the Step1 pass/fail era.

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Highlights

•	Step 1 is pass/fail (PF), affecting advising of general surgery (GS) applicants.
•	Survey data was analyzed for scored and PF matched GS applicants.
•	PF matched GS applicants were more likely to score higher on Step 2.
•	PF matched GS applicants applied to more programs, did not attend more interviews.
•	PF applicants did more aways but were not more likely to match at those programs.