The future of graduate medical education is here. In a move designed to introduce change in the critical transition from undergraduate to graduate medical education the Federation of State Medical Boards (FSMB) and National Board of Medical Examiners (NMBE) have announced and implemented a number of changes to the United States Medical Licensing Examination (USMLE). 

Step 1
Score reporting for USMLE Step 1 will move to a pass/fail model for tests administered on or after January 26, 2022. Step 2 Clinical Knowledge (CK) and Step 3 will remain as three-digit scores and pass/fail respectively. Any Step 1 exams taken before this date will be scored on a three-digit numeric scale.

Step 2 CS
The COVID-19 pandemic has touched every aspect of healthcare—including medical education. After its suspension in May 2020, the USMLE board has decided to forgo bringing back Step 2 CS. Though initially, the board had publicized their intention to review and augment the examination, after taking into account “the rapidly evolving medical education, practice, and technology landscapes” they made clear their plans to discontinue the test altogether. We’re monitoring the situation closely as the USMLE board works with state medical boards and other experts to establish future methods of reviewing the clinical skills of future physicians.

Attempt Limits
Lastly, on July 1, 2021—the day when thousands of physicians begin their residencies—applicants looking to do the same will be limited to four attempts per Step exam, a departure from the current policy that allows for six attempts. This update is intended to mirror the number of attempts that state medical boards generally allow. Starting July 1, 2021 test-takers who have attempted any single USMLE Step four or more times without passing will be ineligible for any future USMLE Step attempts.