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Recent studies have brought forth potential downstream implications of a binary reporting of the United States Medical Licensing Examination (USMLE) Step 1 score. 1, 2 Potential issues such as applicant selection for interviews, shifted focus to Step 2 CK, additional paradoxical stresses, and added barriers to international medical graduates compound the inherent stresses in applying to competitive surgical residencies. While many articles detail the difficulties that surgical programs may face in objectively measuring applicants against one another in light of this impending change, there are no recommendations for addressing this concern. 3, 4 The National Board of Medical Examiners Clinical Science Subject Exams,“shelf exams,” are standardized exams taken after a clinical rotation and could be used as an objective metric to assess applicants longitudinally. While the third-year clinical grades have historically …