Are Residency Programs Placing Too Much Emphasis on Standardized Exam Scores?
by Abigail Bennett, D.O.; Sara Maria Jensen, M.D.; Peter Muscarella II, M.D. | June, 2025 | June 12, 2025
Article Citation: Jones A, Benns M, Farmer R. Using resident performance on Step 2 to predict surgical residency success. Surgery 2025; 179:108801. DOI: 10.1016/j.surg.2024.07.058
What is this article about?
This article examined the relationship between Step 2 CK (S2CK) scores and adverse educational outcomes (AEOs) in general surgery residency. Specific AEOs were chosen and included failure of the Qualifying Examination (QE), failure of the Certifying Examination (CE), ABSITE scores <25% rank, low clinical evaluation scores, early withdrawal from the program, and failure of mock oral examination in PGY4 and PGY5 years. The authors collected data from 92 successfully matched categorical residents at the University of Louisville Department of Surgery from 2012 to 2022. Their analysis found that lower S2CK scores demonstrated an increased likelihood of lower ABSITE performance (<25%) but did not demonstrate a correlation with other AEOs.
Why should you read the article?
Determining which candidates will be successful in a general surgery training program is a challenging task faced by Program Directors. Historically, programs relied on USMLE Step 1 scores to stratify residency applicants. However, when the exam moved to a Pass/Fail scoring system, the S2CK exam became the sole objective metric for candidates. Although S2CK provides objective data about candidates and predicting future success on the ABSITE exam, successful completion of general surgery training is not solely determined by ABSITE scores.
How can you use this article?
There is ongoing controversy about the emphasis placed on standardized test scores. In January 2025, the American Board of Surgery In-Training Examination (ABSITE) discontinued reporting percentiles. One of their concerns was that the scores were used to make high-stakes decisions for fellowship selection, which was not the original intent of the exam. ABSITE and S2CK were created as formative tools to assess trainees’ clinical knowledge and track their progress through their education/training. This article emphasizes the importance of implementing a holistic approach when reviewing residency applications and placing more emphasis on comprehensive assessments of students.
Review Authors: Abigail Bennett, D.O., Surgery PGY-2, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY (Co-authored with Drs. Sara Marie Jensen and Peter Muscarella). Organization: Association for Surgical Education