• Notice of Change in Step 3 Eligibility Requirements for Graduates of LCME- and AOA-Accredited Medical Schools

The USMLE Bulletin of Information (available at www.usmle.org) describes the eligibility criteria for taking USMLE Step examinations. With respect to the requirement that Step 2 Clinical Skills (CS) must be taken and passed in order to be eligible for Step 3, the current examination requirements are as follows:

In order to be eligible to register for USMLE Step 3, the examination requirements for students and graduates of LCME-accredited medical school programs or AOA-accredited medical schools include passing Step 1 and Step 2. Such individuals must pass Step 2 CS as part of the examination requirements for Step 3 if they: (a) have medical school graduation dates in 2005 or later, or (b) graduated from medical school prior to 2005 but did not pass the CK component of Step 2 taken on or before June 30, 2005.

The USMLE Composite Committee has determined that after June 30, 2012, all graduates of LCME- and AOA-approved medical schools/programs will be required to take and pass Step 2 CS in order to be eligible for Step 3. This requirement will apply to individuals who graduated from medical school in 2004 or earlier and who passed Step 2 Clinical Knowledge (CK) on or before June 30, 2005.

• Soft Foam Earplugs May Now Be Used During Computer-based Examinations

USMLE has decided, effective immediately, to begin allowing examinees to bring and use soft-foam earplugs during the Step 1, 2 CK, and 3 under the following conditions:

We are aware that many examinees prefer using earplugs to block out the distraction of ambient noise while taking examinations. Although USMLE prohibits the possession of personal items in the testing room, primarily because of the challenge that particular items can present to the maintenance of security, USMLE has decided, effective immediately, to begin allowing examinees to bring and use soft-foam earplugs during the Step 1, 2 CK, and 3 under the following conditions:

• The soft foam earplugs must be out of the packaging and ready for inspection by test center staff during check in.
• Earplugs must be left at the workstation during all breaks.

Examinees who bring earplugs to these USMLE examinations must realize that if they violate the conditions stated above, then they will be denied use of the earplugs. Further, if based upon inspection, the test center staff have any concerns about the earplugs, then the test center staff may prevent the examinee from using the earplugs during testing.

• A new version of the software used to deliver the computer-based USMLE Step examinations is scheduled to be introduced in mid-August 2008 

A new version of the software used to deliver the computer-based USMLE Step examinations is scheduled to be introduced in mid-August 2008. Migration to the new version will occur first in the Step 2 Clinical Knowledge (CK) examination. The migration is expected to begin at a small number of test centers on August 14, and will then be phased in at remaining test centers throughout the remainder of August and into September. If you plan to take the Step 2 CK examination in mid-August 2008 or later, you should familiarize yourself with both the current test delivery software and the new version.

Orientation and practice materials using both the current and new versions of the software are available for downloading by clicking here.

The change to the test delivery software will be accounted for in scoring the examination results, so that scores will be comparable to those of exams using the older software. Because of this change, as well as routine modifications to the test item pool, it will be necessary to delay the reporting of scores for some examinees. The normal turnaround time for reporting scores to Step 2 CK examinees is 3 to 4 weeks. However, during this transition, turnaround time may be as long as 6 to 8 weeks.

Note to Step 1 and Step 3 examinees: Migration of Step 1 and Step 3 to the new test delivery software will occur in 2009. Please monitor the USMLE website announcements section to check for changes in test delivery software, and to access orientation and practice materials.

• USMLE Fees Adopted for 2009 Test Cycle   

The United States Medical Licensure Examination (USMLE) Budget Committee adopted the following fees for the 2009 test cycle at its April 23, 2008 meeting : Step 1, $495; Step 2CK, $495; Step 2CS $1055 and Step 3, $690. (Note: Some variation in fees may occur based on the registering entity and the location where the USMLE is administered.) For more information, please contact FSMB's Examination Services department at (817) 868-4041 or by e-mail at usmle@fsmb.org.

• Change in Minimum Passing Requirements for Step 3
   Posted April 16, 2008

As stated in the USMLE Bulletin of Information and as explained in a previous posting to the USMLE website, the level of proficiency required to meet the recommended minimum passing level for each USMLE Step examination is reviewed periodically and may be adjusted at any time. Notice of such review and any adjustments are posted at the USMLE website.

At its April 2008 meeting, the Step 3 Committee conducted such a review. The Committee considered information from multiple sources, including: 1) recommendations from independent groups of physicians who participated in content-based standard-setting activities in 2008; 2) results of surveys of various groups (e.g., state licensing representatives, medical school faculty, samples of examinees) concerning the appropriateness of current pass/fail standards for Step examinations; 3) trends in examinee performance; and 4) score precision and its effect on the pass/fail decision.

The Committee decided to raise the three-digit score recommended to pass Step 3 from 184 to 187. The new minimum passing score will be applied to Step 3 examinations for which the first day of testing is on or after May 1, 2008.

• Update on Delay in USMLE Step 3 Score Reporting

On February 4, 2008, USMLE posted an announcement concerning a delay in reporting for some examinees testing in March 2008. This is an update to that announcement.

The target date for reporting Step 3 scores for most examinees testing from early March through early April will be Wednesday, April 30, 2008.

• USMLE Statement on the Fifth Pathway Program and Step 3 Eligibility

Currently, for international medical graduates who wish to take USMLE Step 3, the USMLE program accepts either a valid Standard ECFMG Certificate or a valid Fifth Pathway certificate for purposes of meeting Step 3 eligibility requirements. In November 2007, the American Medical Association (AMA) determined that it would withdraw its support of the Fifth Pathway program. Per the AMA, the last Fifth Pathway program class to be supported will be the January 2009 entering class, which will be supported until its completion in December 2009.

The governing committee of the USMLE program and the USMLE parent organizations (the Federation of State Medical Boards and the National Board of Medical Examiners) have determined that the USMLE program will cease acceptance of Fifth Pathway certificates for the purpose of meeting Step 3 eligibility requirements. The effective date for this policy change will be reviewed by USMLE governance over the next few months. It is anticipated that, consistent with the action taken by the AMA, USMLE will not accept Fifth Pathway certificates issued after December 31, 2009.

For valid Fifth Pathway certificates issued through December 31, 2009, the USMLE program has not yet determined whether they will be accepted indefinitely for purposes of meeting Step 3 eligibility criteria or whether a cut-off date will be imposed. The USMLE program will work closely with the Accreditation Council for Graduate Medical Education (ACGME) and the AMA in an effort to ensure that policies relating to Fifth Pathway certificates issued through December 31, 2009 are consistent among these organizations.

Individuals holding Fifth Pathway certificates that are not accepted by the USMLE program for purposes of meeting Step 3 eligibility will be required to obtain ECFMG certification in order to be eligible for Step 3.

Information and updates about the Fifth Pathway program and USMLE will be posted to the USMLE website.

• Delay in USMLE Step 3 Score Reporting

Most score reporting of Step 3 results occurs within four weeks of testing. However, because of necessary modifications to the test item pool, there will be a delay in reporting for some examinees testing in March 2008. The target date for reporting Step 3 scores for most examinees testing from early March through early April will be Wednesday, April 23, 2008. It is possible that scores will be available earlier than this date; please check this website for updates.

Update on the Comprehensive Review of USMLE

The Committee to Evaluate the USMLE Program (CEUP) has completed its review of information gathering during the early phase of the comprehensive review of USMLE and set a target date of mid-March 2008 for completing its final recommendations. For a complete update, including themes expected to be reflected in the committee’s final report and next steps in the process, please visit http://www.usmle.org/General_Information/review.html

Review of Step 3 Minimum Passing Performance

The USMLE program recommends a minimum passing level for each Step. Medical licensing authorities may accept the recommended pass/fail result, or they may establish their own minimum passing requirements. The recommended requirements to pass USMLE Step 1, Step 2 Clinical Knowledge, and Step 3 were originally identified in the early 1990s, and the Step 2 Clinical Skills standards were first identified in November 2004.

The USMLE Step Committees are responsible for the design and development of the Step examinations, as well as establishing and monitoring standards. These committees are made up of physicians and scientists who bring educational, licensing, and practice perspectives to this process. Every three to four years a Step Committee is asked to complete an in-depth review of standards.

The Step 3 Committee is scheduled to assess the minimum passing score for USMLE Step 3 at its meeting on April 14, 2008. In its review of the minimum passing score, the Step 3 Committee will consider information from multiple sources, including: 1) recommendations from independent groups of physicians who participated in content-based standard-setting activities in 2008; 2) results of surveys of various groups (e.g., state licensing representatives, medical school faculty, samples of examinees) concerning the appropriateness of current pass/fail standards for Step examinations; 3) trends in examinee performance; and 4) score precision and its effect on the pass/fail decision.

The decision of the Step 3 Committee will be posted at the USMLE website at http://www.usmle.org/general_information/announcements.html. If the Committee determines that a change is appropriate for Step 3, the new recommended minimum passing score will become effective for all examinees who begin their Step 3 examination on or after May 1, 2008.