The USMLE Step 1 Examination: Can Pass/Fail Make the Grade?

On February 12, 2020, the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) announced that the United States Medical Licensing Examination (USMLE) Step 1 will transition to pass/fail results reporting in 2022. This examination is one of several tests from the USMLE that must be passed to practice medicine in the United States. Performance on Step 1 is one of many factors considered in the selection of candidates for residency programs and is heavily weighted in many medical specialties.1 The FSMB and the NBME, co-sponsors of the examination, view this change in reporting test performance as “an important first step toward facilitating broader, system-wide changes to improve the transition from undergraduate to graduate medical education.”2 Understandably, such a significant decision has sparked a robust debate about its merits among many stakeholders in medical education, including students, medical school leaders, residency program directors, licensing organizations, and members of the international community. As the editors of Academic Medicine, we see an important opportunity to support and encourage ongoing dialogue among stakeholders. To begin this process, we asked thought leaders in our community to provide their perspectives on the change in Step 1 results reporting.