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What Does Step 1 Being Pass/Fail Mean for Me?

Activity Forums USMLE Step 1 Forum What Does Step 1 Being Pass/Fail Mean for Me?

This topic contains 2 replies, has 3 voices, and was last updated by Dr. David Delnegro MST USMLE Tutor Dr. David Delnegro MST USMLE Tutor 1 year, 7 months ago.

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    As many of you may already know, the USMLE Step 1 Exam will be transitioning to pass/fail as early as January 1, 2022. This has traditionally been an incredibly important factor in the residency application process (and even that is probably an understatement), to the point of, at times, negatively impacting the mental health and wellness of medical students. The goal of this change is to shift the focus of the application to a more holistic application process, and hopefully help improve wellness during medical school. This will mean a lot of things for future medical students – and hopefully we can address some of those questions here!

    – As early as January 1, 2022: Any tests taken BEFORE this date will be reported normally, even if you are applying to residencies AFTER 1/1/22. Reports will not be retroactively modified.
    – May not happen 1/1/22! Plan as though it is, but this is all subject to change pending announcements from the USMLE. If not 1/1/22, I would imagine shortly thereafter (aka within weeks)
    – Step 2 CK and Step 3: No changes at this time

    We could discuss the pros and cons of this decision in a whole *separate* post, but the main purpose of this post is to help figure out what this will realistically mean for you. If you are a current first year medical student, your test will likely be pass/fail. If you are a current second year medical student, it will depend on your medical school. Some schools take Step 1 after second year, in which case, you will have a normal score. Some take it after third year, in which case you will be pass/fail.

    Preparation for this exam will *STILL* be incredibly important and challenging. The content on this exam is difficult and extensive, and all of the same resources (UWorld, FA, Pathoma, BnB, the list goes on…) will still be necessary. What this may change is your focus on some of the small details and memorization of factoids – the difference between a 240 and 250 will be rendered obsolete. But the fundamentals from your first preclinical years will be incredibly important in mastering to pass the exam, to be a strong third year clerk, and to ultimately being a good resident and physician!

    Dan S., MST USMLE Tutor
    Reputation: 30
    USMLE ExpertMD or DOContributor

    Great points, Sana! Step 2 also might take on new importance, for better or worse, and while Step 1 prep isn’t always directly translatable to Step 2 prep, I would also say they aren’t entirely unconnected, and really getting a good handle on pathophysiology during Step 1 studying can help with Step 2.


    To piggyback off the prior posts, in some ways this is a good thing because some clinically unimportant details (sorry esoterics) will become traded for stuff that will determine your ability to manage patients. If you’re looking for a pass versus an actual number, you’ll focus on what’s truly clinically important because CK will be the end goal, and CK looks more like real life.

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