USMLE Step 1 to Be Pass/Fail

If you’re like me, then you’re probably wondering how pass/fail grading for Step 1 will change things for your ERAS application. On June 16, 2020 the governing body for the United States Medical Licensing Exam (USMLE) announced its continued commitment to adopt a pass/fail scoring structure for the USMLE Step 1 exam.

In order to allow programs to prepare for the change and implement the necessary updates for residency application processes, the USMLE has scheduled exclusive pass/fail scoring to begin January 2022. This means that if you are taking Step 1 late in the year in 2021, then you will likely be in the same applicant pool as others who will take Step 1 on a pass/fail basis. With that being said, there are numerous points to consider when you are preparing your academic schedule around when to take the licensing exams.

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If you are confident in your ability to do well on Step 1, then it is in your best interest to take the exam before the move to pass/fail score reporting. A strong score can help to distinguish you from your peers and will give you access to a larger number of residency programs. On the other hand, if you were to not perform at the highest level with your Step 1 score, then it may be a strategic move to wait and take the exam when it will be scored as pass/fail. For those that will be taking Step 1 sometime late 2021, or early 2022, consider these points when making your decision.  A strong Step 1 score can boost your application, but if you have other elements on your CV that are particularly strong, just receiving a passing score with the pass/fail grading system may be a safer alternative.

USMLE Step 1 Pass/Fail Scoring Will Begin January 2022

First, the Step 1 exam has long been considered the most important factor in your residency application. The score you receive from that singular exam has a tremendous impact on the type of physician that you can become, and this has been reiterated by program directors nationwide. The second and third most important aspects of your ERAS application will be your letters of recommendation and personal statement, respectively.

Although the Step 1 score has historically allowed for a “leveling of the playing field” amongst US graduates and International Medical Graduates, it is safe to say that this will no longer be the case. As pass/fail scoring is adopted for Step 1, it will certainly have a greater effect on IMGs as we will be losing our single greatest avenue for demonstrating aptitude. 

As Step 1 importance is phased out, I am hopeful that a more holistic approach will be taken when considering applicants for future residency application Match cycles. I predict that more weight will be granted to our Step 2 CK score, as well as an increased reliance on things such as publications, research, letters of recommendation, and scores from clinical year exams (shelf exams).

While programs adapt to the changes set forth by the USMLE, it is important that you remain focused on building out your CV in every aspect that you can until we know for sure what program directors will consider to be the new most important aspect of the application. Remember that a well-rounded applicant will be viewed more favorably than an applicant who only demonstrates a singular strength.

How do you feel about Step 1 becoming pass/fail? Share your thoughts below.

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