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From when is USMLE becoming pass/fail only scoring? Will it impact IMGs?

Asked by Beiruti

USMLE Step 1 score reporting will transition from a numeric score and pass/fail outcome to pass/fail only for exams taken on or after January 26, 2022.

This is likely to have two implications for IMGs:

1. AMGs are always advantageous in comparison to the IMGs. Since, IMGs have less chances to showcase their knowledge in Step 1, they may have to resort to building stronger resume with more research, volunteering, leadership, a strong personal statement and a stronger recommendation.

2. The universities may shift their focus to a scored Step 2 CK as a screening tool which seems to be more relevant than relying on Step 1 scores. May be they want doctors with better clinical knowledge and skills. But we are not sure if the Step 2 is eventually transitioning to pass/fail or not.

References: 

1. USMLE Pass/Fail Implications for IMGs | MedSchoolCoach

2. Step 1 Becomes Pass/Fail: What are the Impacts? • SDN (studentdoctor.net)


  1. Most Program Directors/PDs (78.1%) disagreed with the scoring change. Only 19.6% believe this change will improve medical student well-being. For 63.5% of PDs, medical school pedigree will become more important, and 52.7% believe it will place international medical graduates at a disadvantage. Only 6.2% believe Step 2 CK should also be pass/fail, while 88.7% will increase the weight of Step 2 CK and 88.4% will now require Step 2 CK score submission with the electronic residency application service.

    Pontell ME, Makhoul AT, Ganesh Kumar N, Drolet BC. The Change of USMLE Step 1 to Pass/Fail: Perspectives of the Surgery Program Director. J Surg Educ. 2021 Jan-Feb;78(1):91-98. doi: 10.1016/j.jsurg.2020.06.034. Epub 2020 Jul 10. PMID: 32654997; PMCID: PMC7347473.

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