1) With the advent of true P/F at many schools across the country, residencies are relying more on Step 1 scores to help them distinguish applicants. It's always hard to distinguish between schools because some schools have ranks, some have true P/F, most have P/F with some form of high pass/honors. So Step 1 is the one standardized thing they can use to compare applicants in terms of pre-clin performance. But in competitive specialties, small things like where you went (if you're applying to top programs), research, who puts in a call for you, who writes your letters, etc. all matter.
2) Step 1 isn't transitioning to P/F soon. There's no way that they can roll that out without extensive testing/data to ensure that anybody who is applying in the cohort that takes the P/F exam won't be disadvantaged relative to their peers who may have taken it earlier but are applying in the same cycle. It would cause chaos if PDs had to compare P/F scores to scaled scores. It's impossible to compare and I would think they would rather err on the side of choosing someone with a high Step score than someone with just a "P" even if that "P" was all that they could have gotten. So there will be some sort of rollout period. Even after that, I would think that the other small things would start to matter more because if you take away the one thing that can be used to distinguish students is taken away, then other things have to be used - and those other things are less objective than Step 1 so people will probably like that even less. One thing that people who want Step 1 to be P/F don't think about, IMO, is what happens when it's P/F? Are you going to be okay with PDs relying more on the name of the school their applicants went to, the people they know/put in calls for them, etc.?
