Reminder: USMLE Attempt Limit Changing Soon

To protect the integrity of the United States Medical Licensing Examination® (USMLE®) program and more closely match the USMLE attempt limits imposed by state medical boards in the majority of states, effective July 1, 2021, the USMLE attempt limit policy will change, as previously announced. The change will reduce an examinee’s total number of allowable attempts from six (6) attempts to four (4) attempts per Step exam, including incomplete attempts.

The policy change is effective for applications submitted on or after July 1, 2021. After the implementation of this policy change, examinees who have attempted any USMLE Step (including Step 2 Clinical Skills) four (4) or more times and have not passed will be ineligible to apply for USMLE Steps.

Examinees with four (4) or five (5) attempts at an exam who meet all eligibility requirements outlined in the USMLE Bulletin of Information may submit application(s) for USMLE through June 30, 2021 at 11:59 pm, Eastern Time, under the current attempt limit of six (6).

To learn more about this change, please review the FAQs on the USMLE website. If you have questions about how this change impacts you, please email the Office of the USMLE Secretariat at USMLESec@nbme.org.

ECFMG On-line Services Unavailable May 21-23

Due to scheduled maintenance, ECFMG’s on-line services are expected to be unavailable beginning at approximately 7:00 p.m. on Friday, May 21, 2021. Services are expected to be restored by 6:00 p.m. on Sunday, May 23, 2021. All times are calculated using Eastern Time in the United States.

During this maintenance period, you will be unable to access most ECFMG on-line services, including the following:

  • IWA—Interactive Web Applications
  • OASIS—On-line Applicant Status and Information System
  • Application for Pathways for ECFMG Certification for 2022 Match
  • EMSWP—ECFMG Medical School Web Portal, and its programs for medical schools and other institutions:
    • Status Verification
    • Credentials Verification
    • Performance Data
    • EMSWP ERAS
    • GEMxSM for Partner Institutions
  • CVS ON-LINE—Certification Verification Service On-line
  • EVNet—Exchange Visitor Network (for staff of U.S. training programs that host ECFMG-sponsored exchange visitor physicians)
  • EPICSM—Electronic Portfolio of International Credentials
    • Physician Portal
    • Report Portal
  • GEMx on-line services for students
  • MyECFMG mobile app

The World Directory of Medical Schools also will be unavailable during this maintenance period.

Thank you for your patience and cooperation as we work to maintain high-quality on-line services.

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: https://www.usmle.org/incus/#decision.

USMLE Policy Updates Following Step 2 CS Discontinuation

Step 3 Eligibility Requirements Reinstated; New Information Added to USMLE Transcripts; Attempt Limits Set at Four

The United States Medical Licensing Examination® (USMLE®) Composite Committee, the governing body of USMLE comprised of medical educators, regulators, and members of the public, recently met to determine how the discontinuation of the Step 2 Clinical Skills examination (Step 2 CS) will impact certain USMLE policies. The Composite Committee’s role is to ensure that the program fulfills its mission to support medical licensing authorities in the United States by providing them with meaningful information from assessments of physician competencies—including medical knowledge and skills—that are important to the provision of safe and effective patient care. The decisions surrounding these policies reflect that mission.

The policy decisions made regarding Step 3 eligibility requirements, reporting Step 2 CS results, and attempt limits are described below.

Step 3 Eligibility Requirements

During the Step 2 CS suspension, the USMLE program announced temporary Step 3 eligibility requirements. Since the Step 2 CS exam has been discontinued, these temporary requirements are no longer needed.

Step 3 eligibility requirements will conform with criteria established before Step 2 CS became part of the USMLE. The requirements, which can be found here, are:

  • Passing scores on Step 1 and Step 2 Clinical Knowledge (CK), and
  • An MD degree or DO degree from an LCME- or COCA-accredited U.S. or Canadian medical school, or
  • The equivalent of the MD degree from a medical school outside the U.S. and Canada that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, and obtain ECFMG Certification.
  • Meets all other eligibility criteria as listed in the USMLE Bulletin of Information.

Reporting Step 2 CS Results

As a medical licensing examination, the USMLE program has the responsibility to produce transcripts that report to state medical boards a complete exam history for each examinee. Accordingly, all Step 2 CS results will continue to be reported on the USMLE transcript.

To facilitate the interpretation of transcripts with either Step 2 CS fails or no Step 2 CS attempts, the following statement will be included on all transcripts:

“The USMLE Step 2 CS examination was suspended on March 16, 2020 and formally discontinued on January 26, 2021. Due to the exam’s discontinuation, examinees with a failing Step 2 CS outcome may not have had an opportunity to retest and remediate their performance. The USMLE defines successful completion of its examination sequence as passing Step 1, Step 2 CK, and Step 3.”

Attempt Limits

Beginning with applications submitted on or after July 1, 2021, examinees will be limited to four attempts per Step exam rather than the six allowed under the current policy. This policy decision is designed to protect the integrity of the exam and more closely match the attempt limits imposed by state medical boards for USMLE in the majority of states.

Once the change to the attempt limit policy is effective, examinees who have attempted a USMLE Step four or more times and have not passed will be ineligible for other USMLE Steps.

If you have any questions about these policies, please contact the USMLE program by using the form available here.

Want to Know More About the Decision to Discontinue Step 2 CS?

Listen to a New Podcast: In the March 4, 2021 episode of USMLE Connection, David Johnson, the Chief Assessment Officer at the Federation of State Medical Boards, and Chris Feddock, Executive Director for the Clinical Skills Evaluation Collaboration, discuss the discontinuation of the Step 2 CS exam, the reasons behind the decision, and next steps.

Announcement Regarding Eligibility Period Extensions for USMLE Step 1 and Step 2 CK

In early 2020, in conjunction with the United States Medical Licensing Examination® (USMLE®) program, ECFMG®|FAIMER® elected to automatically extend eligibility periods for international medical students/graduates (IMGs) who were registered for USMLE Step 1 and Step 2 Clinical Knowledge (CK) and to temporarily waive the fee for eligibility period extensions. These accommodations were made in order to give examinees flexibility in scheduling examinations during the COVID-19 (Coronavirus) pandemic. Since the start of the pandemic, Prometric indicates it has resumed operations in more than 90 percent of its global test center network. While temporary closures and unforeseen events may still occur, the direct impact of the pandemic on scheduling for examinees has declined. As a result, the automatic extension of eligibility periods and temporary fee waiver will end, effective April 1.

Effective April 1, 2021, IMGs who are registered for USMLE Step 1 and/or Step 2 CK and are unable to take the exam in the eligibility period that they are currently assigned may request a one-time, contiguous three-month eligibility period extension (EPEx) using ECFMG’s Interactive Web Applications (IWA) and pay the associated $90 fee.

Announcement Regarding Fee for Requests to Change Testing Regions for USMLE Step 1 and Step 2 CK

In March 2020, ECFMG|FAIMER elected to temporarily waive the fee associated with testing region changes for Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination® (USMLE®) in order to give examinees flexibility in scheduling examinations during the COVID-19 (Coronavirus) pandemic. Since then, individuals and organizations have made significant adjustments in order to resume activities. Prometric indicates that it has resumed testing in more than 90 percent of its global test centers and operationalized COVID-19 safety protocols. As availability and administration of the COVID-19 vaccine increases around the world, ECFMG|FAIMER expects a corresponding decline in the direct impact of the pandemic and a reduction in examinee need for scheduling flexibility.

Effective April 1, 2021, ECFMG|FAIMER will reinstate the $85 fee to change testing regions for Step 1 and Step 2 CK. International medical students/graduates who are registered for Step 1 or Step 2 CK and are unable to take the exam in the testing region that they selected may request to change their testing region using Form 312. International test delivery surcharges also may apply. For more information, visit the ECFMG website.

Step 1 – Delay in Score Reporting

Most Step 1 scores are reported within 3-4 weeks of testing. However, because of necessary annual modifications to the test item pools, there will be a delay in reporting for some examinees who test beginning on or after the week of May 3, 2021.

If you need to receive Step 1 scores before July 7, 2021, the United States Medical Licensing Examination® (USMLE®) program recommends that you take the exam before May 3, 2021.

The target date for reporting Step 1 scores for most examinees testing the week of May 3, 2021 through mid-June 2021 will be Wednesday, July 7, 2021.

Examinees should monitor the USMLE website for the latest information.

Fee Increases for 2021

Effective January 1, 2021, fees for the following ECFMG applications/service requests will increase:

  • The fee for Application for ECFMG Certification will be $150.
  • The examination fees for United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) will be $975 for each exam registration.
  • The fee for a Certification Verification Service (CVS) request will be $60.
  • The fee for an application for J-1 visa sponsorship will be $360.
  • The fee to establish an Electronic Portfolio of International Credentials (EPICSM) account and confirm identity will be $130.
  • The fee to verify a credential through EPIC will be $100.
  • The fee to request an EPIC Report will be $50.
    • For credentials submitted to EPIC on or after January 10, 2018, the first report requested for each credential will remain free.
    • For credentials submitted to EPIC prior to January 10, 2018, the first report requested for each credential will remain $15.
    • For a previously verified credential, reports will be $50.

The new fees will be assessed for all applications/requests submitted to ECFMG on or after January 1, 2021 (Eastern Time in the United States). All fees are listed in U.S. dollars.

For more information on the fees associated with applying for ECFMG Certification and for USMLE Step 1 and Step 2 CK, refer to the ECFMG 2021 Information Booklet and the Fees page of the ECFMG website.

For more information on the fees associated with EPIC, refer to the Fees page on the EPIC website.

Moving Forward: The Step 1 Pass/Fail Score Reporting Policy Change and Revitalization of Step 2 Clinical Skills Examination

The United States Medical Licensing Examination® (USMLE®) program recognizes that the upcoming score reporting change for Step 1 pass/fail (P/F) and the suspension of the Step 2 Clinical Skills (CS) examination have created new questions for medical students, faculty, and state board members. The USMLE program appreciates everyone’s patience and understanding as they work diligently on these two important issues.  As work progresses, the USMLE program is committed to providing monthly updates on these and other topics that are important to their stakeholders.

Step 1 P/F Score Reporting

The transition to Step 1 pass/fail score reporting is on track to be implemented in January 2022. Should this schedule change, the USMLE program will post an updated timeline. Specific dates and information will be made available in advance of the implementation date.

Information about the Step 1 P/F score reporting policy change can be found here.

Revitalization of Step 2 Clinical Skills Examination

As co-owners of the USMLE, the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB) collected valuable input over the summer from state medical boards, medical school faculty, and examinees about the prior Step 2 CS exam, including feedback on which skills are important to assess to inform medical licensure decisions. This feedback is greatly appreciated and will be essential in the development of a revitalized exam. An update on next steps and future developments will be shared by the end of November.

Information about the revitalization of Step 2 CS can be found here.

Examinees should monitor the USMLE website for the latest information.

Step 1 and Step 2 CK – Score Delays in 2021

Most United States Medical Licensing Examination® (USMLE®) Step 1 and Step 2 Clinical Knowledge (CK) scores are reported within 3-4 weeks of testing. However, because of necessary annual modifications to the test item pools, delays occur for examinees who test at certain times of the year.

Please be aware that examinees testing during the following dates may experience delays in score reporting:

  • Step 1 examinees testing early May through early July 2021 – more specific information will be posted January 2021
  • Step 2 CK examinees testing early July through late August 2021 – more specific information will be posted March 2021

Why is this important to know?
If you need to receive a score before a certain date, plan to take that exam before the projected score delay windows to avoid missing deadlines.

Examinees should monitor the USMLE website for the latest information.