Exciting news was released in regards to the USMLE Step Exams on February of both 2020 and 2021, and about COMLEX on December 2020 and March 2021. Key changes are coming into play, from scoring report, the amount of attempts for each exam, to exam prerequisites. 

To start, the USMLE Step 1 scoring report will be changed from a three-digit numeric score to a Pass/Fail in February 2020, effective no earlier than January 1, 2022. Soon after, NBOME announced its decision to eliminate numeric scoring of its COMLEX Level 1 exam starting May 1, 2022. The objective for these monumental changes were to ideally reduce the overemphasis on USMLE and COMLEX scores when being evaluated for a PGY1 position. Taking the 2020 NRMP Director Survey into account, which was published immediately prior to the Pass/Fail grading policy change of USMLE Step 1 and COMLEX Level, 90% of all program directors who responded considered Step 1 as the #1 most popular (and an importance of 4.0/5; 56% and 3.9 for COMLEX Level 1) when it came to using scores when offering interviews. The 2020 Program Director survey also shows a 4% drop in USMLE Step 1 popularity and a drop of 0.1 in importance when compared to the 2018 Program Director Survey.

Although Step 2 Clinical Knowledge (CK) remain numerically scored, both USMLE Step 2 Clinical Skills and COMLEX Level 2 Clinical Evaluation have been postponed indefinitely.  USMLE cosponsoring organizations Federal State of Medical Boards (FSMB), and National Board of Medical Examiners® (NBME®) believe that the USMLE Step 1 changes, alongside the original score reporting of USMLE Step 2 CK, will force residency programs to make a more holistic view of a residency application, without negatively affecting the overall educational and licensing environment.

To further analyze the current most up to date NRMP Director Survey, and with the limitations imposed on the medical education community by the COVID-19 Pandemic, we can then expect an increased significance in applicant’s letter of recommendations in the specialty they are applying to, Medical Student Performance Evaluation (MSPE), USMLE Step 2 CK (or COMLEX Level 2 PE), Personal Statements and so forth in the 2022 Match, as we witnessed in the 2021 Match. With the initial news just settling, there is still much to be anticipated on just how residency programs, admission committees, and program directors will adjust to said changes.

Below, we will continue to update this post with questions asked by residency candidates. Please click each to read our responses:

Reporting Step 1 Results

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. 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. Click here for more details.

Reporting Step 2 CS Results

As a medical licensing examination, the USMLE program has the responsibility to produce transcripts that report to state medical boards a complete exam history for each examinee. Accordingly, all Step 2 CS results will continue to be reported on the USMLE transcript. To facilitate the interpretation of transcripts with either Step 2 CS fails or no Step 2 CS attempts, the following statement will be included on all transcripts:

“The USMLE Step 2 CS examination was suspended on March 16, 2020 and formally discontinued on January 26, 2021. Due to the exam’s discontinuation, examinees with a failing Step 2 CS outcome may not have had an opportunity to retest and remediate their performance. The USMLE defines successful completion of its examination sequence as passing Step 1, Step 2 CK, and Step 3.”