Step 1 Common Questions

Step 1

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1. When will the policy change of reporting Step 1 as pass/fail only occur?

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.

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2. What information will appear on USMLE transcripts after the transition to Step 1 pass/fail?

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.

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3. I am taking Step 1 before January 26, 2022. What information will appear on my paper and/or ERAS transcripts after the transition to Step 1 pass/fail score reporting?

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.

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4. What information will appear on USMLE transcripts after the transition to Step 1 pass/fail?

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.

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5. If I received a 3-digit score on my Step 1 examination, will my 3-digit score be visible on paper and ERAS transcripts after Step 1 outcomes are reported as 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.

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6. How can I compete with others who have a numeric score when I have pass/fail?

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.

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7. When should I schedule my exam if I want a numeric score and pass/fail outcome or if I want a pass/fail outcome only?

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.

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8. What new content appeared on Step 1 exams administered after the exam was updated in October 2020?

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.

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9. What kinds of pharmacology items are on the Step 1 exam following the October 2020 updates?

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.