USMLE Step 1 Pass/Fail – The Big Change for 2022

February 13, 2020

What’s Changed with the USMLE Step 1?

The USMLE program will officially change score reporting for USMLE Step 1 from a three-digit numeric score to reporting only a pass/fail outcome as of January 1,2020. WOW! However, a numeric score will continue to be reported for Step 2 Clinical Knowledge (CK) and Step 3. Step 2 Clinical Skills (CS) will continue to be reported as Pass/Fail. This policy will take effect no earlier than January 1, 2022 with further details to follow later this year.

• The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®) used extensive feedback and national conversation that led them to make this decision.

Why the Change?

• In reaching this decision, it was reported that many different scoring schemes were considered, and ultimately it was determine that a PASS/FAIL was the best course of action. Specific consideration was placed on supporting the educational engagement and overall experience of medical students – and on increasing the dialogue about how multiple assessments of competency could best be utilized by stakeholders in medical regulation and medical education.

• Many believe that the USMLE Step 1 was overused and overemphasized in ERAS. Why place so much emphasis on a standardized test? BUT, in keeping the USMLE Step 1, and not removing it entirely, it can still ensure that all candidates reach a certain threshold of clinical competency. It was reported that “The USMLE co-sponsors also believe that moving to pass/fail reporting of Step 1 while retaining a scored Step 2 CK represents a positive step toward system-wide change, while limiting large-scale disruption to the overall educational and licensing environment.”

• “The FSMB and NBME view this change as an important first step toward facilitating broader, system-wide changes to improve the transition from undergraduate to graduate medical education.”

What does the ECFMG have to say?

“The ECFMG supports the informed decision making of the NBME and FSMB Boards on these policy changes. We are looking forward to continually advocating for international graduates as well as participating in the important future conversations on residency selection and transition.” – Dr. William W. Pinsky, President and CEO of ECFMG/FAIMER

How will I make myself stand out?

The USMLE co-sponsors recognize that an ideal system for evaluating candidates for residency is holistic. This system should feature trusted quantitative and qualitative assessments of a candidate’s competencies and unique characteristics. In such a system, USMLE would serve as just one of these objective measures and be weighted appropriately.

• Work to enhance your ERAS Application
• Work to obtain competitive clinical electives
• Work to secure excellent letters of recommendation
• Build your Research Profile
• Increase your clinical experience
• Network with physicians nationally

What about USMLE Step 2 and Step 3?

While there are changes planned for USMLE Step 1, at this point no changes will be made the the USMLE Step 2CS, 2CK or USMLE Step 3 examination.