ArticleFamily medicine2026
Clerkship Grading, USMLE Step 1, and Student Distinction: A CERA Study.
Article in Family medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- The pathology trope: How television undermines the diagnostic infrastructure of modern medicine.Academic pathologyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesThe 2022 transition of USMLE Step 1 scoring to pass/fail altered a key metric used by programs to select students to interview for residency. This study explores family medicine clerkship directors' (FMCDs') perceptions of how students now distinguish themselves, particularly in relation to clerkship grading methodologies.
methodsTen questions were included in the 2024 Council of Academic Family Medicine Educational Research Alliance survey, distributed to 173 FMCDs. Items investigated perceptions of student distinction, stress, and grading practices. Statistical analyses included descriptive statistics, Kruskal-Wallis tests, and Wilcox signed-rank tests.
resultsOf the 83 respondents (48% response rate), 59% reported using pass/fail grading in the preclerkship phase, while only 22% used pass/fail grading in the clerkship phase. A majority (58%) indicated no changes to clerkship grading systems post-2022, though 20% had changed and 22% were considering changes, predominantly toward less-tiered methodologies. Regarding the impact of Step 1 changes on the students' ability to distinguish themselves, 37% perceived harm, 14% benefit, and 48% neutrality. Despite this finding, 78% of FMCDs perceived that students were more stressed about distinguishing themselves. No significant associations were found between grading methodology and perceptions of distinction or stress.
conclusionsFMCDs perceived increased student stress following the Step 1 pass/fail transition, yet largely believe that students still can distinguish themselves. Neither tiered nor pass/fail grading was viewed as a definitive solution. These findings underscore the need for standardized, competency-based assessment and clearer communication of distinguishing features in residency applications.
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