Dear Colleagues: 

The United States Medical Licensing Examination® (USMLE®) program recently announced that it will reduce the number of days the Step exams are offered each year beginning in 2028. We recognize the impact transitioning to a Designated Testing Dates model will have on examinees, medical schools, residency programs, and other stakeholders, and we are committed to listening carefully to feedback that will help inform implementation while minimizing confusion and additional disruption.  

Like other high-stakes assessments, the USMLE program continuously evaluates current and emerging security challenges. The challenges that exist today differ fundamentally from challenges of even less than a decade ago. As technology continues to evolve, assessment organizations around the world are adapting their exam delivery models to address increasingly sophisticated security threats and reduce opportunities for compromise. Universities and colleges are making similar adjustments to academic integrity policies and practices in response to this evolving landscape. Our internal security analysis, reinforced by the experience of other large-scale testing programs, suggests that concentrating testing into designated dates and reducing opportunities for security violations is the best way to proactively ensure exam integrity over time.  

Item harvesting and sharing are currently an issue, and evidence suggests this will increase over time if we continue current testing practices. Shifting to a Designated Testing Dates model will allow the USMLE program to more effectively manage threats such as these that could impact score validity. This approach is consistent with how most high-stakes exams, such as the MCAT and many specialty certification examinations, are administered – often on a limited number of annual testing dates. The transition to Designated Testing Dates supports a system that protects the integrity of licensing decisions made by state medical boards – and ultimately the public – that are based in part upon USMLE outcomes. Importantly, this transition also ensures fairness for all examinees.  

Some of the initial feedback we have received concerns capacity at Prometric sites. We have been working diligently with Prometric to address this issue. On the Designated Testing Dates, all Prometric testing centers available for USMLE testing will be exclusively reserved for the Step exams. This means that USMLE examinees will have exclusive access to these testing centers on Designated Testing Dates. 

With our prior experience in medical school administrations, we recognize that schools and training programs may have complex and varied curricular and other requirements linked to USMLE examination outcomes, and we acknowledge that this transition may require adjustments to institutional policies and practices; thus, the 18-month advance notice that we have provided so that any changes deemed necessary by those institutions can be made. We appreciate the work needed to make these changes and are committed to supporting the medical education community throughout the transition.   

The USMLE program will continue to provide updates and support as planning for implementation continues. We welcome questions and input from schools, training programs, and individual examinees as we move forward with these changes, and we encourage you to contact the USMLE program with any concerns or suggestions. We also encourage registration for the next community engagement sessions scheduled for July 22 and August 4. 

For the latest information, including calendars, FAQs, and implementation resources, please refer to the USMLE Designated Testing Dates Information Hub, which will be updated regularly as additional details become available. 

Peter Katsufrakis, MD, MBA President and CEO NBME				Humayun “Hank” Chaudhry, DO, MS, MACP, FRCP  President and CEO Federation of State Medical Boards