USMLE Step 1 Updates on Score Reporting and Standard Setting

Two United States Medical Licensing Examination® (USMLE®) Step 1 changes may coincide in early 2022. First, Step 1 score reporting will transition to pass/fail only for administrations on or after January 26, 2022. Second, as part of best practices for licensing and certification examinations, the USMLE program reviews the minimum passing score of each Step exam every three to four years. The standard review process for the Step 1 minimum passing score is currently underway, which includes substantial input from licensing authorities, medical educators, and subject matter experts. If any change to the minimum passing score is determined appropriate by the USMLE Management Committee, it will become effective for examinees who take Step 1 on or after January 26, 2022. While the timing may overlap, the standard review process is unrelated to the upcoming transition to pass/fail score reporting.

Pass/Fail Score Reporting
The pass/fail reporting change is in alignment with the Invitational Conference on USMLE Scoring (InCUS) recommendations, which were based on a broad range of input from state medical board members, physicians, medical educators and examinees. To support this transition, USMLE Step 1 score reports for administrations on or after January 26, 2022 will be updated in the following ways:

  • Passing outcome reports will only display the notification of “Pass.” This change is intended to reduce the overemphasis of USMLE Step 1 scores on secondary uses while retaining the ability to use the exam for its primary purpose of medical licensure eligibility.
  • Failing outcome reports will display “Fail” and have 1) a visual illustration showing the distance between the examinee’s overall score and the minimum passing standard and 2) content area feedback that shows whether the examinee scored lower, about the same, or higher than examinees with a low pass (ie, above but near the passing standard) for each content category. This additional information is intended to guide study plans for future exam attempts.

Sample score reports for USMLE Step 1 examinations taken on or after January 26, 2022 are available here. USMLE transcripts will be similarly revised to display only a “Pass” or “Fail” for Step 1 exams taken on or after January 26, 2022. USMLE transcripts for Step 1 exams taken January 25, 2022 or earlier will continue to report a numeric score along with a “Pass” or “Fail” outcome.

Minimum Passing Score Review
The USMLE program reviews the minimum passing score for each Step examination every three to four years with extensive input from faculty and subject matter experts. This ensures that the standard is aligned with the potentially changing expectations within medicine.

Based on its routine schedule, the review of the Step 1 minimum passing score was originally scheduled to occur in December 2020 but was postponed as a result of the COVID-19 pandemic. Instead, the review will occur in December 2021, and any change to the minimum passing score will be made effective with Step 1 administrations beginning on or after January 26, 2022. This review is consistent with USMLE’s standard operating procedures and is not connected to the upcoming transition to pass/fail score reporting. For reference, the last reviews of the minimum passing scores for Steps 1, 2 Clinical Knowledge (CK) and 3 resulted in changes that ranged between 0 and 2 points.

Four types of data are considered:

  • Results of content-based standard-setting exercises conducted with three independent groups of physicians;
  • Results of surveys of various stakeholders (e.g., samples of examinees, state licensing representatives, medical school faculty) concerning the appropriateness of current pass/fail standards for Step examinations;
  • Trends in examinee performance;
  • Score precision and its effect on the pass/fail outcome.

Changes to the minimum passing score, if any, are determined by the USMLE Management Committee. This committee is comprised of a diverse national group of medical professionals from undergraduate and graduate medical education as well as state medical boards. Two public members and a resident member also serve on the committee.

An additional announcement that reports the outcome of the minimum passing standard review, whether there is a change or not, will be made on December 9, 2021.

Examinees should monitor the USMLE website for the latest information.

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.

Step 2 CK – Delay in Score Reporting

Most 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, there will be a delay in reporting for some examinees who test beginning on or after the week of June 27, 2021.

If you need to receive Step 2 CK scores before August 25, 2021, the United States Medical Licensing Examination® (USMLE®) program recommends that you take the exam before Friday, June 25, 2021.

The target date for reporting Step 2 CK scores for most examinees testing the week of June 27, 2021, through Friday, August 13, 2021, will be Wednesday, August 25, 2021.

Examinees should visit the USMLE website for the latest information.

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.

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.

USMLE Score Reporting Policy Updates

The following announcements provide details on new score reporting policies set by the United States Medical Licensing Examination® (USMLE®) Composite Committee for the Step 1 examination and the Step 2 Clinical Skills (CS) examination. As a medical licensing examination, the USMLE program has a responsibility to produce transcripts that report a complete exam history for each examinee. The following announcements provide details on new score reporting policies set by the USMLE Composite Committee for the Step 1 examination and the Step 2 CS examination.

USMLE Step 1 Examination

Step 1 results will be reported as Pass/Fail no earlier than January 1, 2022. All scores for Step 1 exams taken prior to the date of the policy change will continue to be reported using the three-digit numeric score on all USMLE transcripts. The USMLE program does not retroactively alter transcripts.

USMLE Step 2 CS Examination

Step 2 CS was suspended in March 2020. All Step 2 CS results from exam administrations prior to the suspension will be reported on USMLE transcripts. Due to the Step 2 CS suspension, a significant number of individuals applying for residency in the 2020-2021 cycle will not have a Step 2 CS result or an opportunity to retest after a Step 2 CS failure. Information on the timing of this suspension will be clearly communicated to residency programs through ERAS. While Step 2 CS is suspended, the ECFMG has posted requirements for Certification for the 2021 residency Match, available here.

USMLE Timeline for Step 1 Pass/Fail Score Reporting

The co-sponsors of the United States Medical Licensing Examination® (USMLE®)—the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME)―have recently received requests from examinees and student organizations to accelerate or delay the change to pass/fail score reporting for USMLE Step 1 in light of the uncertainties caused by the COVID-19 (Coronavirus) pandemic and social movements across the country. The USMLE program’s announcement of the Step 1 score reporting policy change, posted in February 2020, said the change in score reporting would be implemented no earlier than January 2022. After careful consideration of all the recent concerns that have been brought to the USMLE program’s attention, the USMLE program remains committed to the January 2022 timeline.

For more information, please read the full announcement on the USMLE website.

USMLE Step 2 Clinical Skills (CS) Testing Suspension to Continue Through May 31, 2020

The USMLE program is closely monitoring the guidance of the World Health Organization and the Centers for Disease Control and Prevention regarding the spread of the novel Coronavirus and its associated disease, COVID-19.  We are aware that examinees are scheduled to take USMLE Step 2 Clinical Skills (CS) and of the importance of the examination to their future goals and obligations.  However, given the unique, human-to-human delivery mode of this exam, it is important to take the following precautionary steps to protect the health of examinees and test center staff.

Clinical Skills Evaluation Collaboration (CSEC) Test Center Closures
All CSEC test centers are temporarily closed.  We hope to resume operations of all centers on June 1, 2020.  Given the fluid nature of this situation, please be aware that this date is subject to change. Please monitor www.usmle.org and USMLE social media for updates.

Change to the Step 2 CS Calendar and Scheduling System and Impact to Examinees
The suspension in testing has resulted in the cancelation of a large number of testing appointments. In order to manage the large number of examinees impacted by the CSEC center closures, scheduling functionality in the Step 2 CS Calendar and Scheduling system has been temporarily suspended.

IMPORTANT NOTE: If you are an examinee impacted by the CSEC closure and USMLE Step 2 CS suspension, please direct any inquiries to Step2CS-Covid.inquiries@ecfmg.org.

  • Canceled Appointments
    If your appointment was canceled as a result of the suspension of Step 2 CS testing, you will be contacted by April 17, 2020. All examinees scheduled to test from March 16 through May 31 will have their eligibility period extended to March 31, 2021. This extension will be done automatically, requiring no action on the part of the examinee.
  • Scheduled Appointments
    If you have an appointment scheduled AFTER May 31, 2020, you can review your scheduling information and you can cancel an appointment. However, if you cancel your appointment, you will not be able to reschedule until scheduling functionality is restored. PLEASE NOTE: Before canceling your appointment, be advised that you will not be able to reschedule until scheduling functionality is restored.
  • Recently Registered
    If you recently registered for Step 2 CS but have not yet scheduled an appointment, you will not be able to schedule until scheduling functionality is restored.
  • Planning to Register
    If you plan to register for Step 2 CS but have not yet done so, please be aware that the application processing and registration continues. However, once your application is accepted, you will not be able to schedule until scheduling functionality is restored.

We do not have an estimated timeline of when scheduling functionality on the Step 2 CS Calendar and Scheduling System will be restored. As soon as we have more information, we will update examinees via the USMLE website and social media.

Score Reporting
Changes to the Step 2 CS score reporting schedule will be necessary as a result of the CSEC test center closures. Updates will be posted to the USMLE website. Results for examinees who tested before March 16, 2020 will be reported on schedule, beginning April 29, 2020 through May 27, 2020.

We appreciate your patience and understanding as we work together through this challenging time. The USMLE program is actively working with other organizations in medical education and regulation to minimize disruption to examinees during this unprecedented situation.

Additional information on USMLE’s response to COVID-19 and some frequently asked questions are available here.

For more information on the impacts of the COVID-19 pandemic on ECFMG|FAIMER programs and what we are doing in response, please visit our COVID-19 (Coronavirus) web page.

(posted March 13, 2020; updated Apr 3, 2020)

COVID-19 Updates and Resources from USMLE

The United States Medical Licensing Examination® (USMLE®) program has published a COVID-19 page to its website that includes information and FAQs about its responses to the pandemic, including information for examinees whose examination dates have been suspended or rescheduled. This information will be updated as the situation changes.

Examinees should monitor the COVID-19 page on the USMLE website for the latest information.

For more information on the impacts of the COVID-19 pandemic on ECFMG|FAIMER programs and what we are doing in response, please visit our COVID-19 (Coronavirus) web page.