The United States Medical Licensing (USMLE) program has announced that, come January 2022, its Step 1 exam scoring will be evaluated by pass/fail rather than a 3-digit number. This news has not been taken lightly by students and physicians, as they are shocked by what is a rather significant reform. Medscape Medical News covers the full story here. 

Some exams will still be scored numerically, such as the Step 2 Clinical Knowledge exam as well as Step 3. This change addresses the significant problem of students spending too much time revising for Step 1 while neglecting their medical education, because Step 1 is weighed too heavily in the process of becoming a certified physician. The numerical scoring of Step 1 required the student to memorize a plethora of science details that might or might not be relevant for their desired field. Getting the highest score possible on an exam is not necessarily a good measure of how a student can apply basic medical knowledge to a practical setting. This new scoring change will hopefully take the pressure off students and allow them to focus on important experiential work. 

However, some are wary that this new scoring means that the pressure will shift from high scores to other personal advantages when being selected for residency programs. Those with better letters of recommendation from more prestigious universities and more money to spend on applications may have an advantage. The question is whether the medical community is risking an even deeper disparity in privilege when it comes to residency programs. 

There are now questions about whether the Step 2 Clinical Knowledge exam is next to switch to a pass/fail system, as anxiety may shift from Step 1 to Step 2 after the Step 1 pass/fail reform. Some physicians have noticed that over the past 10 or 15 years, exams like Step 1 and Step 2 have turned into an absolute measure of someone’s eligibility for specific residency programs rather than a supplement to their well-rounded experience. Caps on the number of applications students can send out would encourage students to apply to programs that truly interest them and allow program directors to give more comprehensive evaluations. It seems as though the Step 1 pass/fail change is a great place to start, but there is still more progress to be made in the fair academic evaluation of prospective physicians. 

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This post was written by McKenzie Cline