I know, I know – I missed the 2024 rewind lists by a couple of months. But whatever. A lazy Sunday afternoon seems as good a time as any to review the top Sheriff of Sodium content from the past year.
In an effort to share the message in a way that’s more durable, searchable, and substantive than Xitter, I again focused on making video podcasts in 2024. Here’s what viewers watched the most.
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HONORABLE MENTION #1
Journal Club: Do USMLE scores really predict patient care outcomes?
Can a physician’s USMLE score really predict their future patients’ length of stay or risk of in-hospital mortality? According to the NBME, it can.
I’m beyond unconvinced. (In fact, this study has so many flaws that it makes for an instructive review of critical appraisal of observational data.)
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HONORABLE MENTION #2
This one was actually a sequel to the video that I felt was the most important one I made in 2024, on the Electronic Residency Application Service (ERAS) and financial conflict of interest at the AAMC – which itself didn’t even crack the Top 15.
Already, we’ve seen some of the predictions in this video come to pass.
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#10
Coming in at #10 in 2024 is a video that was made in 2023. Preference signaling is the new high-stakes minigame in residency selection. Applicants who do it well will benefit; those who don’t will suffer.
(With the release of new signaling data from the 2024-2025 application season, I’m planning to freshen this one up this summer.)
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#9
OH NO!!! Have you heard? The pass rate for USMLE Step 1 plummeted after the test went pass/fail! Now, more students are failing the test than ever before, and up to 50% of students have to delay the test because they’re unprepared!
Sigh.
There’s a lot of sky-is-falling and self-interested misinformation out there. Time for the Fact Police to set the record straight on the Step 1 pass rate.
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#8
In 2020, a resident sent an email to a state medical board. Attached was a copy of his USMLE score report, which showed that he passed Step 3.
There was just one problem. The score report was fake.
This is the incredible-but-true story of how that resident beat the NBME in court and received a medical license without ever passing the USMLE.
(Long term readers will recognize this as a story I’ve been following for years… suffice to say, the ending was not at all what I expected.)
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#7
The NRMP released new Charting Outcomes data in August. All told, there were 799 pages of charts and data highlighting important trends in residency selection; what qualifications program directors really care about; and some just plain fun stuff about biostatistics.
So you know what that means.
Yup, it’s time to break it down, Winners & Losers style.
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#6
Interview Day is where an applicant’s rank position is determined. And after all the time and toil applicants put into polishing their application, I’m always surprised by how many under-prepare for the interview, make avoidable mistakes, or fall into traps. So in response to viewer questions, I made a video explaining how to put your best foot forward.
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#5
In January 2024, the ACGME notified the Crozer Chester Medical Center that their general surgery residency program had to shut down – in four days.
But this isn’t just a story about one residency program. It’s a story about power and greed that highlights a number of things that are wrong about residency training, the American health care system, and maybe even America at large.
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#4
The top of the 2024 list is dominated by one story: the USMLE Cheating Scandal, which resulted in three Sheriff of Sodium videos.
Part II came out a few days after the announcement and touched on topics including, but not limited to:
- whether there was a security breach at Prometric centers in the United States
- how it’s mathematically detect cheating even when examinees are scoring very highly (i.e., answering almost all questions correctly)
- a conceptual introduction to agreement analysis (the method the NBME used to identify cheaters)
- why people defending those with invalidated scores don’t understand math
- whether it’s really wrong to use USMLE recalls… and how legitimate test prep companies sanitize recalls
- just how high many test scores from Nepali examinees had become (with a bonus extended analogy comparing to the steroid era in baseball)
- my suspicion that the USMLE’s announcement occurred more rapidly than it otherwise would have due to questions from a reporter
- whether the scandal will lead to USMLE Step 2 CK becoming pass/fail
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#3
Coming in at #3 was Part III on the USMLE Cheating Scandal. This one covers:
- the methods the NBME disclosed using to catch the cheaters, revealed in their court filings
- how agreement analysis works (using a real-life example from a surgical certifying examination)
- the data that explain why the USMLE’s investigation centered on Nepal
- how answer response times damned some of the cheaters
- whether the examinees with invalidated scores knew they were cheating or not
- the chance that the ringleaders of this scheme could face legal consequences (using the infamous Optima University case as a case study)
- whether we should bring back USMLE Step 2 CS
- whether we should restrict USMLE Step 1 and Step 2 CK administration to the centers in the United States
- whether the USMLE will invalidate scores for examinees from other countries in the future (hint: three letter answer)
- the GoFundMe to support legal fees to “stop defamation of Nepali doctors”
- a lesson on cheating from a senior physician
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#2
Always a perennial favorite, the breakdown of the 2024 Match was the most popular video on the site… except for one.
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#1
The most-watched video of 2024 was the first video on the USMLE Cheating Scandal. It was published right after the NBME’s announcement, and although some details (such as the method I initially predicted the USMLE had used to identify cheaters) proved incorrect, the vast majority held up pretty well as more details were revealed. This one covers:
- what are “USMLE recalls”
- how test-making authorities can identify cheaters by comparing performance on compromised vs. non-compromised items (with a case study from the Canadian MCCQE Part 1 exam)
- an overview of USMLE scoring, and whether USMLE scores will be adjusted for non-cheaters because cheaters raised the curve (hint: two-letter answer)
- how much the scandal will hurt IMGs who didn’t cheat
- whether everyone with invalidated scores is screwed… or whether some will land on their feet
- what the NBME can do to make the USMLE more resistant to cheating in the future
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The Sheriff of Sodium 