Change in Number of Items / Delay in Score Reporting for Step 2 CK

Starting on or around August 3, a transition period will begin in which the number of items in current forms of the Step 2 CK examination will change from 352 items to 346 items. Because of this change, as well as routine modifications to the test item pool, there will be a delay in score reporting for most Step 2 CK examinations administered from August 3 through mid-September.

View full announcement.

Changes to USMLE Procedures for Reporting Scores

Starting July 1, 2011, USMLE transcripts reported through the ERAS reporting system will no longer include score results on the two-digit score scale. USMLE results will continue to be reported on the three-digit scale. This affects the Step 1, 2 CK, and 3 examinations only; Step 2 CS will continue to be reported as pass or fail. These changes do not alter the score required to pass or the difficulty of any of the USMLE Step examinations.

Since its beginning in the 1990s, the USMLE program has reported two numeric scores for the Step 1, Step 2 CK, and Step 3 examinations, one on a three-digit scale and one on a two-digit scale. The three-digit score scale is considered the primary reporting scale; it is developed in a manner that allows reasonable comparisons across time. The two-digit scale is intended to meet statutory requirements of some state medical boards that rely on a score scale that has 75 as the minimum passing score. The process used to convert three-digit scores to two-digit scores is designed in such a way that the three-digit minimum passing score in effect when the examinee tests is associated with a two-digit score of 75.

The USMLE program requires its governing committees to reevaluate the minimum passing score every three to four years. This process has, at times, resulted in changes in the minimum passing score, expressed on the three-digit scale, and an accompanying change in the score conversion process, to ensure that a two-digit score of 75 is associated with the new minimum passing requirement. A by-product of the adjustment of the score conversion system over time has been a shift in the relationship between the two score scales. This shift has no impact for USMLE score users who use the three-digit scoring scale or for those using the two-digit scale with a primary interest in whether the examinee has a passing two-digit score of at least 75. However, it may create challenges in interpretation for score users who are focusing on two-digit scores, other than 75, and are doing so for purposes of comparing USMLE scores that span several years.

To simplify matters and make interpretation of USMLE information more convenient for score users, the USMLE Composite Committee has asked staff to report two-digit scores only to those score users for whom the scale is intended, i.e., the state medical boards. The Committee also asked that examinees continue to receive scores on both scales so that they are fully informed about the information that will be reported when they ask that results be sent to a state medical board. When examinees request that their results be sent to other score users, only the three-digit score will be reported. Current plans call for these changes to begin with the elimination of the two-digit score from USMLE transcripts reported through the ERAS reporting system starting July 1, 2011. Other systems and procedures for reporting results will be similarly modified as soon as possible after the July 1, 2011 date.

Step 2 CS Examinees Will Be Required to Type Patient Notes on a Computer Beginning July 17, 2011

As of July 17, 2011, all examinees taking the Step 2 Clinical Skills (CS) examination will be required to type the patient note. Examinees will not be permitted to handwrite the note unless technical difficulties make the patient note typing program unavailable. A simulation of the computerized patient note program, which examinees may use to practice typing the patient note, is available on the USMLE website.

View full announcement.

(posted March 24, 2010; updated January 20, 2011, April 19, 2011)

Delay in USMLE Step 1 Score Reporting

Most score reporting of Step 1 results occurs within four weeks of testing. However, because of necessary modifications to the test item pool, there will be a delay in reporting for some examinees testing beginning in mid-May 2011. The target date for reporting Step 1 scores for most examinees testing from May 17 through late June will be Wednesday, July 13, 2011.

Examinees should monitor the USMLE website for the latest information.

Comprehensive Review of USMLE (CRU): March 2011 Update

Updated information on the Comprehensive Review of USMLE (CRU) is available. Access the March 2011 update on the USMLE website.

CRU was initiated in 2004. The goal of this review was to determine whether the mission and purpose of USMLE are effectively and efficiently supported by the current design, structure, and format of the USMLE. This review resulted in recommendations for changes. In 2009, the proposed changes were approved by the USMLE parent organizations, the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards of the United States, Inc. (FSMB). Research, planning, and implementation of the changes have begun.

Changes resulting from CRU are planned for all USMLE Steps and Step Components. These changes may affect both content and item formats. As changes are implemented, the orientation and practice materials available on the USMLE website at may be updated to reflect these changes.

If you plan to take USMLE examinations, you should monitor the USMLE and ECFMG websites for the latest information on changes related to CRU. Comprehensive information on CRU is available on the USMLE website at

(posted June 30, 2010; updated April 1, 2011, October 20, 2011)

IMG Performance in the 2011 Match

For the ninth consecutive year, the number of first-year (PGY-1) residency positions offered through the Match increased. A total of 23,421 first-year positions were offered in the 2011 Match, held earlier this month. This represents an increase of 612 positions compared to last year and an increase of more than 2,800 positions since 2002.

The number of IMGs, including Fifth Pathway participants, who matched to first-year positions decreased by 60 compared to 2010. Of the 10,477 IMGs who participated in the 2011 Match, 4,626 (44.2%) matched. In the 2010 Match, 4,686 (42.4%) IMGs were matched to first-year positions.

Of the 6,659 IMG participants who were not U.S. citizens, 2,721 (40.9%) obtained first-year positions. The number of non-U.S. citizen IMGs who obtained positions in 2011 decreased by 160 compared to last year.

Of the 3,769 U.S. citizen IMG participants, 1,884 (50.0%) were matched to first-year positions, an increase of 135 over last year. This is the eighth consecutive year that there has been an increase in the number of U.S. citizen IMGs matching to first-year positions.

Of the 49 Fifth Pathway participants in the Match, 21 (42.9%) were matched to first-year positions.

It is important to note that the total number of IMGs who will fill PGY-1 positions for the 2011-2012 academic year will be higher than the number obtaining positions through the 2011 Match. Although the majority of PGY-1 positions in the United States are filled through the Match, a significant number of IMG applicants obtain positions outside of the Match. For example, while 4,796 IMGs obtained PGY-1 positions through the 2009 Match, 7,335 IMGs entered PGY-1 for the 2009-2010 academic year.

The 7,335 IMGs entering PGY-1 for the 2009-2010 academic year is an increase of 59 over the prior year and an increase of 1,262 since the 2002-2003 academic year.

About the Match

The annual NRMP Match is the system by which applicants are matched with available residency positions in U.S. programs of graduate medical education (GME). Participants submit to the NRMP a list of residency programs, in order of preference. Ranked lists of preferred residency candidates are likewise submitted by U.S. GME programs with available positions. The matching of applicants to available positions is performed by computer algorithm. The Match results announced in March of each year are typically for GME programs beginning the following July.

Additional Resources on the Match and Match Results

The preceding data are taken from the Advance Data Tables for the 2011 Main Residency Match compiled by the NRMP. These tables provide detailed information on the positions offered and filled by the Match in 2011 and prior years. To access these tables, or to obtain further information on the NRMP, visit

The June issue of Academic Medicine, the journal of the Association of American Medical Colleges, usually offers an analysis of Match results from the preceding March. For more information, visit your medical school’s library or

The September issue of JAMA: The Journal of the American Medical Association traditionally provides an in-depth analysis of graduate medical education in the United States. This analysis includes the number of IMGs entering and continuing in U.S. GME programs and a breakdown of IMG resident physicians by specialty and subspecialty. Visit your medical school’s library or

IMGs Participating in 2012 Match Should Apply for Step 2 CS Now

International medical students/graduates and graduates of Fifth Pathway programs who plan to participate in the 2012 Main Residency Match (in March 2012) are reminded that they must take Step 2 Clinical Skills (CS) by December 31, 2011. As published in the 2011 Schedule for Reporting Step 2 CS Results, if you do not take Step 2 CS by December 31, 2011, your result will not be available in time to participate in the 2012 Match.

IMPORTANT NOTE: This deadline applies only to participation in the 2012 Main Residency Match. For updated information on deadlines to participate in the Supplemental Offer and Acceptance Program (SOAP), which is expected to replace the post-Match Scramble in 2012, monitor the NRMP website and the ECFMG website.

If you need to pass Step 2 CS to participate in the 2012 Match, you are strongly encouraged to apply for Step 2 CS now. If you do not register early and schedule a test date as soon as possible, you may not be able to obtain a test date in 2011.

At the time of this writing, the earliest available test date at any test center is in March 2011. It is expected that demand for testing appointments in the period from June through December will be high. Additionally, test sessions at all test centers may be subject to scheduling restrictions that may limit the number of test dates available to you.

To maximize your chances of obtaining a test date in 2011,

  • Apply for Step 2 CS now, provided you meet the eligibility requirements.
  • Once registered, schedule your testing appointment as soon as possible. Scheduling conditions are expected to be most favorable from March through June.

Early registration and scheduling may offer a number of benefits. If you plan to apply for Step 2 CS, you should consider the following:

  • All Step 2 CS sessions are opened 12 months in advance.
  • Applicants registered for Step 2 CS can schedule and take the exam during the 12-month eligibility period that follows their registration. By registering early, applicants increase the likelihood they will be able to obtain a testing appointment for a preferred date/test center.
  • Applicants who schedule a testing appointment can change the testing appointment without cost, provided they give more than 14 days’ notice. See Rescheduling in the ECFMG Information Booklet.
  • Applicants who take Step 2 CS earlier in the year and receive a failing result are more likely to have the opportunity to retake the exam in 2011 and receive their result in time to participate in the 2012 Match.

Updated information on Step 2 CS scheduling will be posted to the ECFMG website as it becomes available. Individuals planning to take Step 2 CS should monitor the ECFMG and USMLE websites for the latest information.

UPDATE: New Fees for Changing Appointments at Prometric Test Centers Effective January 1, 2011

Effective January 1, 2011, Prometric will charge a fee if USMLE examinees change testing appointments (e.g., reschedule, cancel, change test center location) at Prometric Test Centers thirty or fewer days before their scheduled test date. No fee is charged for changing testing appointments 31 or more days prior to the first day of the scheduled test.

The date that you change your appointment, using local time at the Regional Registration Center for the Prometric Testing Region, will determine whether you pay a fee and the amount of this fee:

  • If you change your appointment 31 or more days before (but not including) the first day of your scheduled test date, there is no fee.
  • If you change your appointment fewer than 31 days but more than 5 days before (but not including) the first day of your scheduled test date, there is a $50 fee.
  • If you change your appointment 5 or fewer days before (but not including) the first day of your scheduled test date, there is a higher fee. This fee varies by Prometric Testing Region and by exam.

For complete information and a schedule of fees, visit the USMLE website.

This policy applies only to appointments for USMLE Step 1, Step 2 Clinical Knowledge (CK), and Step 3. For information on the fees associated with changing testing appointments for Step 2 Clinical Skills (CS), refer to Rescheduling in the ECFMG Information Booklet.

(posted December 22, 2010; updated December 29, 2010)

ECFMG to Require Medical School Accreditation for International Medical School Graduates Seeking Certification Beginning in 2023

In July 2010, ECFMG® determined that, effective in 2023, physicians applying for ECFMG Certification will be required to graduate from a medical school that has been appropriately accredited. To satisfy this requirement, an applicant’s medical school must be accredited through a formal process that uses criteria comparable to those established for U.S. medical schools by the Liaison Committee on Medical Education (LCME) or that uses other globally accepted criteria, such as those put forth by the World Federation for Medical Education (WFME).

View full announcement.

ECFMG Policy on Forfeiture of Funds

Effective July 1, 2010, funds in an applicant’s ECFMG financial account will be available for a period of two years to pay for requested services. Any funds not used during a two-year period will be forfeited to ECFMG; this means that the applicant will lose those funds. The two-year period will be calculated from the date that funds are received at ECFMG. For funds already in an applicant’s account on the July 1, 2010 effective date, the two-year period will be calculated from this effective date. If an applicant has funds in his/her account and makes a service request, ECFMG will use the funds with the earliest receipt date to pay for the service requested.

EXAMPLES: An applicant makes a payment of $295 to his ECFMG financial account on July 2, 2010. He makes another payment of $2,000 on July 10, 2010. On July 28, 2010, he submits an application for USMLE Step 2 CS, which costs $1,295. The $295 from his earlier payment and $1,000 from his later payment are used to pay for this exam registration. The applicant now has until July 9, 2012 to either use the remaining $1,000 balance or request a refund. If he does not, these funds will be forfeited to ECFMG.

An applicant has a balance of $1,700 in her ECFMG financial account when this policy takes effect on July 1, 2010. On December 15, 2010, the applicant submits an application for USMLE Step 1 and Step 2 CK, which costs a total of $1,480. The applicant has until June 30, 2012 to either use the remaining $220 balance or request a refund. If she does not, these funds will be forfeited to ECFMG.

It is your responsibility to monitor the status of your ECFMG financial account. You can check the status of your account, including dates on which payments were made to your account, using OASIS. A refund request should be made to claim any funds that will not be used prior to the expiration of the two-year period. Refund requests must be made in writing. (See Communicating with ECFMG in the ECFMG Information Booklet.)