The Top 10 from 2020

It’s been a heck of a year.

From the USMLE Step 1 pass/fail announcement to the far-reaching effects of the COVID-19 pandemic on medical education, it’s been a wild ride. I’ve covered a lot of it here – so just for fun, I queried the web traffic to the Sheriff of Sodium site.

Here are the posts that have generated the most traffic in 2020.

Honorable Mention

The NBOME, Part 2: Osteopathic Medicine’s Vestigial Organ

I’m sure this one didn’t win me any friends at the National Board of Osteopathic Medical Examiners. But it did get viewed by a lot of people – just not quite enough to make the Top 10.

Virtual Interviews: Winners and Losers Edition

This was posted in May, right after the announcement that the 2020-2021 residency interview season would be virtual. (It may deserve a follow up in 2021 to see which predictions came true.)

The Top 10

10. The Match, Part 1 – Why do we have a Match?

The first part of what will ultimately be a six-part series on the Match. (To everyone who asks when the next parts of this – and many other incomplete series – are coming out… bro, I don’t know. I have over a dozen pieces in various stages of completion, but new topics keep coming up that deserve commentary – so some keep getting bumped for more urgent issues.)

9. Mailbag: Virtual Interview Advice, Interview Caps, and USMLE Pass/Fail Updates

The first Sheriff of Sodium “mailbag” – a format that proved to quite popular. I’ve written two more mailbags since (here and here) – and thanks to the generosity of my readers, I’ve got more than enough good questions for many more in 2021.

8. Step 2 CS, Part 1: How did we get here?

It was a big year for the USMLE Step 2 CS exam. In January, it was the most hated part of the USMLE series; in December, it’s an afterthought. But with a new ‘virtual’ CS format in the works, I’ve got a feeling that this series is not over.

7. The new USMLE score report

This is an old piece – from February 2019. In contrast to most of the posts on The Sheriff of Sodium, which receive a majority of their referrals from social media or people e-mailing the articles to each other, almost everyone who found this piece did so with the help of Google. This was actually the #1 most viewed post in 2019 for that very reason. (This year, although the #1 post is different, it’s again a piece that’s been viewed almost entirely from search engine traffic.)

6. The Residency Selection Arms Race, Part 1: On Genghis Khan, Racing Trophies, and USMLE Score Creep

Sometimes, when I post things, I feel like I’m just screaming into the void. But this one actually generated some thoughtful correspondence from a couple of program directors who said it changed the way they review USMLE scores for their applicants. Reminds me of why I do this stuff.

5. ECFMG Finances, Part II: By the Numbers

The implementation of the Educational Commission for Foreign Medical Graduates’ (ECFMG) new ‘pathways’ for IMG certification led me into another financial investigation. And let me tell you, I was put off by what I found – and the ECFMG’s stonewalling about it. This topic is one I plan to revisit in the future.

4. #USMLEPassFail: A Brave New Day

From February 13, 2020 – the day the USMLE announced that the Step 1 examination would become pass/fail in 2022.

3. Preference Signaling: Winners and Losers

From August, after the Otolaryngology Program Directors Association announced the implementation of formal preference signaling for their applicants.

I say it was a courageous move and look forward to reviewing their data and learning from their experience (even though I argued against preference signaling in a debate this fall).

2. Step 2 CS, Part Two: The Resistance

Not exactly a feel-good kind of piece… but still received more views than almost anything I posted.

1. How is the three-digit USMLE score calculated?

This is the other post with an overwhelming majority of traffic directed by search engines. (This is also the post that receives by far the greatest proportion of traffic from outside the United States.)

I’ve got a feeling that this post isn’t typically being discovered by people I’m really trying to reach – that is, people interested in reforming medical education and residency selection. But one thing that I’ve learned since starting this site is that when you keep talking about something, every now and then your words have a way of finding the ears of the people who need to hear them.

So as 2020 draws to a close, I want to thank everyone who has taken the time to read the words I put on my site. Whether you agree with me or not, we all have a role to play in making the system better – and I wish you all my best for a healthy 2021.


Why Does the USMLE Use Experimental Items?

Why Do We Have Residency Training?

Grand Rounds: The Rise and Fall of USMLE Step 1