What Changed?
USMLE Step 1 scores are reported as “pass” or “fail.” To pass, students need a score of 196, but exact scores are no longer provided unless you fail.
Why the Change?
The change aims to reduce the stress on students over numeric scores and shift the focus to learning and clinical skills.
Initial Impact
Pass Rates Drop
The pass rates dropped in the first year after the change:
- MD Students: 96% (2021) to 93% (2022)
- DO Students: 94% (2021) to 89% (2022)
- IMGs: 82% (2021) to 74% (2022)
A new 3-point increase in the passing score also contributed to this drop.
Reduced Study Time
Students report studying less for Step 1, which may be another reason for the lower pass rates.
Student Concerns
Stress Delayed, Not Removed
The main goal was to reduce stress, but now students face anxiety later, especially for Step 2 CK, which is now the key metric for residency applications.
Impact on Residency Applications
Students must excel in Step 2 CK and focus on other areas like research, extracurriculars, and clerkship grades. This shift may delay stress due to a busier time in medical education.
Perspectives
Medical Student Views
Some students feel the stress has just moved to a different time. They and their peers are unsure how to stand out in residency applications without a Step 1 score. Others believe the change is positive, reducing the focus on memorizing details and advising students to focus on learning and personal growth.
Concerns for Under-Represented Communities
The shift to non-standardized metrics may disadvantage students from less resource-rich programs, potentially increasing inequities in medical education.
Advice for Students
- Plan Ahead: Create a 4-year plan for extracurriculars and exams.
- Study Hard for Step 1: Understand the exam thoroughly.
- Step 2 Study Plan: Prepare well for Step 2 CK, which is now crucial.
- Consider a Gap Year: Only if necessary for competitive specialties.
FAQs
Can you fail Step 1 and still match? Yes, but it will be more challenging. You’ll need to excel in Step 2 CK and other application areas.
If you fail, you can retake Step 1 up to 6 times, but more than twice significantly lowers your chances for competitive specialties.
What is the minimum passing score for Step 1? 196.
How long does it take to get results? 2-8 weeks after your test date.
Final Thoughts
The shift to pass/fail for Step 1 has changed the landscape of medical education. While it aims to reduce stress, it also focuses on other areas of a student’s application. The full impact will become clearer with more data from upcoming residency matches