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Changes to USMLE Procedures for Reporting Scores: Elimination of the 2-digit Score on or about April 1, 2013
March 22, 2013
Filed under: Step 1, Step 2 CK, Step 3, USMLE Score Reporting

As previously reported in 2011, the USMLE® program began the process of eliminating the reporting of results on the 2-digit score scale to parties other than the examinee and any state licensing authority to which the examinee sends results. This process began on July 1, 2011 with elimination of 2-digit scores from USMLE transcripts reported through the Electronic Residency Application Service (ERAS®).

The USMLE program will extend this change in reporting to include all score recipients (e.g., examinees, state medical boards). This means that scores on the 2-digit scale will no longer be calculated or reported. The USMLE Program expects to eliminate the 2-digit score on or about April 1, 2013. This change pertains to the Step 1, Step 2 Clinical Knowledge (CK), and Step 3 examinations only; Step 2 Clinical Skills (CS) will continue to be reported as pass or fail with no numeric score.

The full announcement is available on the USMLE website.

More about the 2-digit Score and Its Elimination

The following may be helpful in understanding the change in USMLE procedures for reporting scores, described above.

Why is the USMLE Program eliminating the 2-digit score?
The 2-digit score can be subject to misinterpretation. Some have interpreted it as a percentile (an indication of how an examinee’s performance compares to the performance of other examinees who took the same exam administration). Others have interpreted it as a percentage (an indication of how many questions an examinee answered correctly during an exam administration). The 2-digit score is neither of these things.

Additionally, unlike the 3-digit score, the 2-digit score does not allow reasonable comparisons over time. This may create challenges for score users that attempt to compare 2-digit scores that span several years. To eliminate the misuse of and confusion surrounding the 2-digit scale, the USMLE Composite Committee, the body that governs USMLE, decided that it should no longer be calculated or reported. Additional information about the relationship between the 2-digit and 3-digit score scales is available on the USMLE website.

Does this change apply to all USMLE examinations?
This change applies to Step 1, Step 2 CK and Step 3 only, since numeric scores are reported for these exams. It does not apply to Step 2 CS. Performance on Step 2 CS will continue to be reported as pass or fail with no numeric score.

Once this change takes effect, who will have access to 2-digit scores?
No one will have access to 2-digit scores. Beginning on the effective date of this change:

  • The USMLE Program will no longer report 2-digit scores to examinees on their exam score reports.
  • Two-digit scores will not be reported to any third parties via USMLE transcripts. This means that recipients of USMLE transcripts, including graduate medical education programs and state medical boards in the United States, will not receive 2-digit scores. This is true for all USMLE exam administrations, regardless of when the exam administration took place and regardless of whether a 2-digit score was reported previously.
  • Two-digit scores will no longer be calculated. As a result, the National Board of Medical Examiners® (NBME®), the entity responsible for scoring USMLE exams, will not be able to provide 2-digit scores. The entities responsible for registering examinees for USMLE and reporting their scores, including ECFMG and the Federation of State Medical Boards (FSMB), will not be able to provide 2-digit scores.

Why does the USMLE transcript I requested in April 2013 look different from the transcript I requested in December 2012, when it includes results for the same exam administration(s)?
Effective on or about April 1, 2013, the USMLE Program will stop calculating and reporting 2-digit scores. Two-digit scores reported before the effective date of this change will no longer be reported. As a result, a transcript issued prior to the effective date will include 2-digit scores for administrations of Step 1, Step 2 CK, and Step 3, while a transcript issued after the effective date will include only 3-digit scores for the same exam administrations.

Understanding the 3-digit Score

The elimination of the 2-digit score does not change the reporting or interpretation of results on the 3-digit scale. While the following information is not new, it may be helpful in understanding the 3-digit score.

What is the 3-digit score?
Since its beginning in the 1990s, the USMLE Program has reported scores for Step 1, Step 2 CK, and Step 3 on a 3-digit scale. When an examinee tests, the number of items the examinee answers correctly is converted to a score on the 3-digit scale. The 3-digit scale is considered the primary score reporting scale for USMLE exams.

What are the minimum passing scores for the exams?
The USMLE Program recommends a minimum passing level of proficiency for each exam. For Step 1, Step 2 CK, and Step 3, the USMLE Program sets a minimum passing score on the 3-digit scale. For the current minimum passing scores, visit Scores & Transcripts on the USMLE website.

The USMLE Program reviews the minimum passing level for each exam every three to four years. Since this process may result in changes, the minimum passing score for a given exam, expressed on the 3-digit scale, may change over time. The recommended minimum passing level in place on the day an examinee sits for an examination will be the level used for scoring purposes. Monitor the USMLE website for information on review of and changes to the minimum passing scores for USMLE exams.

How can I tell how well I did on the examination? How much better than passing did I do?
Your score report will include the 3-digit minimum passing score that applies to the exam administration.

On the 3-digit scale, most scores on Step 1, Step 2 CK, and Step 3 fall between 140 and 260. The mean score for first-time examinees from accredited medical school programs in the United States is in the range of 215 to 235, and the standard deviation is approximately 20. If your score is in the range of 215 to 235, your performance is on par with the average first-time examinee from an accredited medical school program in the United States. Your score report will include the mean and standard deviation for recent administrations of the examination.

Your score report will also include graphical performance profiles that summarize relative areas of strength and weakness to aid in self-assessment. The profiles are accompanied by further information on what they mean and how to interpret them.

More information on scores and score interpretation is available on the Scores FAQs page of the USMLE website at http://www.usmle.org/frequently-asked-questions/#scores.

How will U.S. GME programs be able to evaluate my 3-digit score?
The 3-digit score scale is the primary score reporting scale and has been used since the USMLE Program was established in the early 1990s. Unlike the 2-digit score, the 3-digit score is calculated using statistical procedures that ensure that scores from different years are on a common scale and have the same meaning. This means that GME programs can use the 3-digit score to make reasonable comparisons of examinees who tested at different times. Information on the meaning and interpretation of the three-digit score is included with USMLE transcripts, is available on the USMLE website, and is provided in the USMLE Bulletin of Information.

(posted December 28, 2012; updated March 22, 2013)




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