Step 1 Common Questions

January 26, 2022 is the effective date of the change. All Step 1 exams taken on or before January 25, 2022 will receive a numeric score and pass/fail outcome. All Step 1 exams taken on or after January 26, 2022 will receive a pass/fail outcome only.

All USMLE transcripts, including those submitted through the Electronic Residency Application Service® (ERAS®), will include the same information. A Step 1 exam taken on or after January 26, 2022 will appear on transcripts as a pass/fail outcome only, without a numeric score. A Step 1 exam taken on or before January 25, 2022 will appear on transcripts as a numeric score and a pass/fail.

All scores for Step 1 exams taken on or before January 25, 2022 will continue to be reported as a numeric score and pass/fail outcome on all USMLE transcripts. If a Step 1 exam on a transcript was taken on or after January 26, 2022, only a pass/fail outcome will be reported.

All USMLE transcripts, including those submitted through the Electronic Residency Application Service® (ERAS®), will include the same information. A Step 1 exam taken on or after January 26, 2022 will appear on transcripts as a pass/fail outcome only, without a numeric score. A Step 1 exam taken on or before January 25, 2022 will appear on transcripts as a numeric score and a pass/fail.

All scores for Step 1 exams taken prior to the date of the policy change will continue to be reported using the three-digit numeric score on all USMLE transcripts.

The primary purpose of USMLE is for licensure. The USMLE co-sponsors recognize that there are other uses for USMLE, such as residency selection, but an ideal system for evaluating candidates should be holistic. This system should feature various assessments of a candidate’s competencies and unique characteristics. In such a system, USMLE would serve as one objective measure and be weighted appropriately.

Carefully review the options available to you---whether a numeric and pass/fail outcome or pass/fail only score is preferred. After you are confident in your selection, book your appointment through Prometric as early as possible in your eligibility period. If you want a numeric score and pass/fail outcome for your Step 1 exam, take the exam on or before January 25, 2022. If you want a pass/fail only outcome for your Step 1 exam, take the exam on or after January 26 ,2022.

No new content was assessed in Step 1 exams administered after the exam was updated in October 2020. Examinees testing after the October 2020 update saw an increase in the number of items that assess knowledge of Communication and Interpersonal Skills; this content has been included on the Step 1 exam for many years.

You can see a representative Step 1 item assessing knowledge of Communication and Interpersonal Skills here.

Step 1 pharmacology items continue to focus on examinees’ understanding of drug mechanisms rather than on pharmacotherapy. Step 1 examinees are not required to identify specific medications; Step 2 CK examinees, however, are asked to do this. See example Step 1 pharmacology item here.