Step 1 Pass/Fail Score Reporting Implementation Date

United States Medical Licensing Examination® (USMLE®) Step 1 score reporting will transition to pass/fail outcomes only for administrations on or after January 26, 2022. Step 1 examinations administered before January 26 will include a three-digit numeric score.

Outcomes for Step 1 administrations occurring before January 26, 2022 will continue to include a three-digit score and pass/fail. Step 2 Clinical Knowledge and Step 3 examinations will continue to be reported as a three-digit score and pass/fail.

On February 12, 2020, the USMLE program announced it would change Step 1 score reporting to a pass/fail outcome no earlier than January 1, 2022. In taking this action, the USMLE’s co-sponsors—the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®)—considered the broad range of input received from the Invitational Conference on USMLE Scoring (InCUS), the subsequent InCUS report and its preliminary recommendations, and the extensive feedback and national conversation that preceded and followed the conference.

Additional information regarding the change to reporting Step 1 outcomes as pass/fail can be found here:

ECFMG Statement on USMLE Policy Changes

The United States Medical Licensing Examination® (USMLE®) program has announced three future changes to its examination program. One of these changes, a change in score reporting for Step 1 from a numeric score to a Pass/Fail designation, is designed to improve the transition of examinees from undergraduate medical education (UME) to graduate medical education (GME) programs (i.e., to residency programs). Two additional changes, a further limit on the number of times an examinee can take each Step or Step Component and the requirement that an examinee pass Step 1 before taking Step 2 Clinical Skills, will help to enhance exam security. Enhancing security is essential to maintaining the integrity of the examination, ensuring it remains an equitable assessment process for all examinees.

These changes are part of the USMLE program’s continuous process of improvement to ensure a high-quality assessment for all physicians who plan to train and practice in the United States. ECFMG is supportive of this process and of the thoughtful and inclusive approach employed by the USMLE program in arriving at these changes. ECFMG also supports the USMLE’s focus on the examinee experience and the goal of improving the transition from UME to GME—a transition that can present unique challenges for international medical graduates (IMGs) who seek to train in the United States.

ECFMG is a strong advocate for the role of IMGs in the U.S. health care system. IMGs comprise approximately 25% of the U.S. physician workforce and are vital to our ability to provide accessible, high-quality health care. Many IMGs who train in the United States stay to practice, frequently serving in primary-care specialties and in underserved areas. Others return home, where they benefit local communities by building physician capacity and providing care in much-needed specialties.

ECFMG is committed to the continued ability of IMGs to enter U.S. GME and offers programs that support IMGs along the continuum from international UME to U.S. GME and practice. ECFMG Certification is at the beginning of this pathway. The USMLE is an important component of ECFMG’s program of certification, the process by which IMGs demonstrate their readiness to engage in U.S. GME. An effective, high-quality assessment is essential for IMGs who wish to demonstrate their qualifications; compete for U.S. residency positions; and continue to contribute to the U.S. health care system through their talents, diversity, and international perspectives.

For more information on the upcoming changes, please read the USMLE program’s announcement at As more information on these changes becomes available, please monitor the ECFMG website for details on how these changes will affect IMGs who pursue ECFMG Certification and U.S. GME.

Possible Changes to USMLE Scores – Continuing the Discussion

A podcast featuring two members of the Invitational Conference on USMLE Scoring (InCUS) planning committee, Dr. Michael Barone, Vice President of Licensure Programs for the National Board of Medical Examiners (NBME), and Dave Johnson, Senior Vice President, Assessment Services for the Federation of State Medical Boards (FSMB), is now available on the USMLE website. They discuss themes from the public comments, upcoming improvements to USMLE, and insight into the vision for the program.

You can listen to the podcast on the USMLE website here.

InCUS Webinar Now Available

You can now access a recording of the June 24, 2019 webinar, Exploring Possible Changes to USMLE Score Reportinghere.

More than 150 questions were submitted prior to the broadcast. Representatives from the five organizations sponsoring the Invitational Conference on USMLE Scoring (InCUS) answered many of these, as well as fielding questions during the live recording. All questions will be used to develop FAQs, which will be posted on

Sponsors of InCUS are the Association of American Medical Colleges (AAMC), the American Medical Association (AMA), the Educational Commission for Foreign Medical Graduates (ECFMG), the Federation of State Medical Boards (FSMB), and the National Board of Medical Examiners (NBME).

The USMLE encourages the submission of feedback about the recommendations until the public comment period closes on July 26.

USMLE score reporting is a complex issue. Updates and information will be made available on the website.

Preliminary Recommendations for USMLE Score Reporting Now Available

Public comment period runs until July 26, 2019.

Preliminary recommendations on USMLE score reporting from the convening organizations of the Invitational Conference on USMLE Scoring (InCUS) are now available online. From now until July 26, 2019, individuals and organizations interested in this United States Medical Licensing Examination® (USMLE®) topic can review the recommendations, hear podcasts about InCUS, sign up for a webinar, and submit comments about the recommendations.