Changes to Step 3 examination beginning in mid-February 2012 / Updated Step 3 practice materials available
Changes to both the Multiple-Choice Question (MCQ) and the Computer-based Case Simulation (CCS) sections of the Step 3 examination will occur beginning in mid-February 2012.
Changes to Step 3 MCQs
Items with an associated drug ad or abstract will be introduced into the MCQ section of the USMLE Step 3 examination beginning in mid-February 2012. Each drug ad or abstract will appear as a 2- or 3- item set*; examinees will see no more than 5 of these item sets in their examination. A description of the purpose of these new item formats is provided in the November 2011 Comprehensive Review of USMLE update.
Introduction of these formats has resulted in the following changes to the structure of the MCQ portion of the Step 3 examination:
Because item sets with an associated drug ad or abstract may require more time to answer than other multiple-choice items, exam blocks that include an abstract or drug ad item set will contain fewer items. A screen will appear at the beginning of a block alerting examinees if a block includes a drug ad or abstract item set so that examinees can monitor their time accordingly.
The tutorial provided in Prometric centers on exam day at the beginning of the Step 3 exam has fewer screens and less detailed information than the tutorial available as part of the Step 3 practice materials on the USMLE website. In the exam-day tutorial, the screens describing some of the navigation features of the test delivery software have been consolidated into fewer screens. In advance of testing, examinees should review the longer tutorial available in theStep 3 practice materials.
* An "item set" is a drug ad or abstract and the two or three questions that accompany it.
Updated Step 3 practice materials have been posted to the USMLE website. Instructions for practicing with these new item formats are provided in the tutorial.
Changes to Step 3 CCS
The following changes to the structure of the CCS portion of the Step 3 examination will be introduced beginning in mid-February 2012:
The CCS portion of the Step 3 exam, administered on the second day of testing, currently includes nine 25-minute cases. Examinees who test using the updated materials will see twelve cases: a combination of 20-minute cases and 10-minute cases; 25-minute cases will be eliminated.
To help examinees manage their time, the Start Case screen has been updated to clearly indicate the allotted time for each case. In addition, the maximum allotted case time is displayed at the top of the screen during each case.
In the current version of the software, when ordering a physical examination (PE) for a patient in a case, examinees can order a "Complete PE" or they can select individual physical examination components. The "complete PE" option will no longer be available in the updated version. For a physical examination, examinees will select the desired individual components; multiple components can be selected at one time.
Updated Step 3 practice materials have been posted. The updated materials contain both 20-minute and 10-minute cases. Examinees who will test during the transition period should practice with both sets of CCS practice materials.
November, 2011
Delay in score reporting for Step 3
Starting in mid-February 2012, a transition period will begin in which the number of Multiple-Choice Questions (MCQs) and Computer-based Case Simulation (CCS) cases in current forms of the Step 3 examination will change.
The number of MCQs will decrease from 480 items to 474 items.
The number of CCS cases will increase from 9 cases to 12 cases.
Although the transition will occur quickly at many test centers, there may be some locations where the transition takes slightly longer. The transition period will likely last approximately 4 weeks. Please note that:
Scores on both sets of forms will be comparable.
The length of the examination day will remain unchanged.
For additional information about these changes, see Changes to Step 3 examinations.
Because of the changes, as well as routine modifications to the test item pool, there will be a delay in score reporting for most Step 3 examinations administered from mid-February 2012 through early May 2012. The target date for reporting Step 3 scores for most examinees testing during that interval will be Wednesday, June 6, 2012.
October, 2011
Change in minimum passing requirements for Step 3
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 October 2011 meeting, the USMLE Step 3 Committee conducted a review of the minimum passing requirements for the Step 3 examination. During the meeting, the Step 3 Committee considered information from multiple sources, including:
Results of content-based standard setting exercises conducted in 2011 with three independent groups of physicians;
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;
Trends in examinee performance;
Score precision and its effect on the pass/fail decision.
As a result of its review, the Step 3 Committee decided to raise the three-digit score recommended to pass Step 3 from 187 to 190.
The new minimum passing score will be applied to Step 3 examinations for which the first day of testing is on or after November 1, 2011.
September, 2011
New attempt limit for USMLE examinations
The USMLE Program is introducing a limit on the total number of times an examinee can take the same Step or Step Component. When this limit takes effect, an examinee will be ineligible to take a Step or Step Component if the examinee has made six or more prior attempts to pass that Step or Step Component, including incomplete attempts.
The effective date for the six-attempt limit depends upon whether an examinee has taken any Step or Step Component (including incomplete attempts) before January 1, 2012.
Examinees who have NOT taken any Step or Step Component before January 1, 2012
If you have not taken any Step or Step Component before January 1, 2012, the six-attempt limit will go into effect for all exam applications that you submit on or after January 1, 2012.
Example 1: On January 15, 2012, Examinee A submits his application for his first attempt at any Step or Step Component. The six-attempt limit will be effective at that time for all Steps and Step Components and Examinee A will be allowed to take each Step or Step Component no more than six times, including incomplete attempts.
Examinees who have taken any Step or Step Component before January 1, 2012
If you have taken any Step or Step Component (including incomplete attempts) before January 1, 2012, the six-attempt limit will go into effect for all exam applications that you submit on or after January 1, 2013. After that date, all attempts at a Step or Step Component will be counted toward the limit, regardless of when the exams were taken.
Example 2: Examinee B's application for a seventh attempt at a particular Step or Step Component is received on December 15, 2012. For this examinee, the six-attempt limit will not prevent the seventh attempt, since the application was submitted before January 1, 2013. However, if Examinee B fails the exam, he will not be eligible to submit an application after January 1, 2013 to retake that Step or Step Component.
Example 3: Examinee C attempts to submit an application for a seventh attempt at a particular Step or Step Component on or after January 1, 2013. The application will not be processed, since all exam applications submitted on or after January 1, 2013 will be subject to the six-attempt limit.
August, 2011
New rules on repeating USMLE examinations: time between examination attempts
The USMLE Program sets rules on how quickly examinees can repeat the same Step or Step Component. These rules will change for exam applications submitted on or after January 1, 2012.
For exam applications submitted before January 1, 2012, the current rules apply. The current rules are:
For the computer-based examinations (Step 1, Step 2 CK, and Step 3), you may take the examination no more than four times within a 12-month period.
For Step 2 CS, you may take the examination no more than three times within a 12-month period.
For exam applications submitted on or after January 1, 2012, the following rules apply to all Steps and Step Components. You may take the same examination no more than three times within a 12-month period. Your fourth and subsequent attempts must be at least 12 months after your first attempt at that exam and at least six months after your most recent attempt at that exam. Attempts at that examination (complete and incomplete) prior to January 1, 2012 will be counted in determining whether these rules apply.
When you reapply, your exam eligibility period will be adjusted, if necessary, to comply with these rules.
Example: An examinee takes and fails her first attempt at Step 1 on January 15, 2011, her second attempt at Step 1 on April 15, 2011, and her third attempt at Step 1 on September 15, 2011. In January 2012, the examinee submits an application for a fourth attempt at Step 1, requesting the March-April-May eligibility period. The earliest date that is both 12 months after her first attempt on January 15, 2011 and six months after her most recent attempt on September 15, 2011 is March 15, 2012. Since the March-April-May eligibility period requested by the applicant begins before this date, the applicant is assigned the next eligibility period that begins after March 15, 2012, April-May-June.
USMLE takes action against individuals found to have engaged in irregular behavior
The USMLE Committee on Irregular Behavior (CIB) meets periodically throughout each year to review cases involving allegations of irregular behavior by applicants and/or examinees. At its June meeting, the CIB heard multiple cases involving the following:
falsified information, including misrepresentation of educational status
dissemination of test content, including reconstruction of questions from memory and communication of test material to other examinees
solicitation of test content, through internet posting and otherwise
disruptive behavior, e.g., failure to follow proctor's instructions
Actions taken by the CIB at its recent meeting included annotating the individual's USMLE record with a finding of irregular behavior, barring access to USMLE for periods ranging from 1-3 years, and reporting the finding of irregular behavior to the disciplinary data bank of the Federation of State Medical Boards. (State medical boards routinely query this data bank as part of their licensing processes.)
As evidenced by the sanctions listed above, a finding of irregular behavior carries significant potential impact. USMLE applicants and examinees are reminded to carefully read the USMLE Bulletin of Information, follow the rules of conduct during testing and refrain from any pre- or post-examination conduct that might constitute irregular behavior. Specific examples of conduct deemed to be irregular behavior can be found in the Bulletin.
The USMLE is committed to maintaining the integrity of its examination so that state medical boards may continue to rely upon it as an integral part of their decision-making process for licensure. Applicants and examinees are advised to observe all USMLE policies and procedures to avoid the potentially significant implications arising from a finding of irregular behavior.
July 2011
Owners of Optima University Indicted
As announced on its website, the United States Attorney's Office, District of New Jersey, reported that a grand jury has indicted Eihab Suliman and Egija Kuka on one count of conspiracy to commit mail and wire fraud; two counts of wire fraud; and three counts of mail fraud in connection with the activities of Optima University, a provider of USMLE prep courses. The National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB), sponsors of the USMLE program, are cooperating fully with federal authorities in this matter.
As announced previously on USMLE, the NBME and FSMB have also filed suit in U.S. District Court for the Western District of Tennessee, alleging copyright infringement by Optima University. On February 24, 2009 a U.S. Marshal executed a court order to obtain the Optima prep materials from Optima's offices in McKenzie, Tennessee. In their filing, the NBME and the FSMB allege that Optima was unlawfully using USMLE test questions that they own and have copyrighted.
The USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care. USMLE test questions are developed by a "National Faculty of Medicine," i.e., experts from the academic, practice, and regulatory communities, and undergo rigorous validation and quality assurance processes to ensure fairness to all examinees as well as to provide medical licensing authorities with valid information on a physician's readiness to practice.
The USMLE is copyrighted, and USMLE examinees agree not to disclose secure test questions at any time. Providers of legitimate review courses create their own test prep materials. (See USMLE announcement on selecting review courses.) Under U.S. copyright laws, test prep companies have no right to use USMLE test items. Unauthorized access to secure test materials, whether intentional or inadvertent, may raise questions about the validity of a test-taker's score.
Medicine is a profession that has the privilege of self-regulation. The public expects that the profession, with its commitment to helping and healing, can be trusted to establish its own standards in education, training, licensure, and practice and that physicians themselves are best suited to define and uphold these standards. Thus, the profession and the individuals who belong to it are obligated to ensure that practitioners (and future practitioners) meet minimum standards of knowledge and skills necessary for the safe and effective practice of medicine. The public must be assured that physicians value professionalism and integrity. Memorization, reproduction or dissemination of USMLE content by test takers is a violation of professional ethical standards and will not be tolerated.
The sponsoring organizations of the USMLE program will use every legal means available to protect USMLE copyrighted materials and secure redress against those who violate copyright law.
Carol Thomson
Steege/Thomson Communications
Office: 215-747-7700
Cell: 215-439-6531
E-mail: cthomson@steegethomson.com
Review of USMLE 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 USMLE Step Committees are responsible for establishing and monitoring these 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 the Step Committees are asked to complete an in-depth review of standards.
The Step 3 Committee is scheduled to review the minimum passing score for the USMLE Step 3 examination at its meeting on October 18-19, 2011.
In this review, information from multiple sources will be considered, including:
Results of content-based standard setting exercises conducted with three independent groups of physicians in 2011;
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;
Trends in examinee performance;
Score precision and its effect on the pass/fail outcome.
The decision of the Step 3 Committee will be posted at the USMLE website. If the Committee determines that a change to the minimum passing score is appropriate, the new recommended minimum passing score will become effective for all examinees who take a Step 3 examination on or after November 1, 2011.
June 2011
Updated Step 3 CCS orientation and practice materials available
Practice materials for the Step 3 Computer-based Case Simulation (CCS) examination have been updated.
The new materials include six practice cases, including three new cases. The practice cases, as well as feedback on diagnostic and management steps, can be downloaded from the Practice Materials page.
USE CAUTION IN SELECTING REVIEW COURSES: Orientation, Practice, and Self-Assessment Materials Available through USMLE, NBME, and Third Parties
The United States Medical Licensing Examination® (USMLE®) program recognizes the importance of providing all examinees the opportunity to learn about the design and content of its examinations and to have some exposure, before examination day, to samples of testing formats and materials. USMLE provides orientation and practice materials for all USMLE Steps and Step Components. These materials, which are available at no cost on the USMLE website at www.usmle.org, include:
Informational materials on the overall USMLE program and content descriptions for each of the USMLE examinations,
Tutorials that illustrate the USMLE Step 1, Step 2 Clinical Knowledge (CK), Step 3 multiple-choice question software and the Step 3 computer-based case simulation (Primum® CCS) software,
Sample multiple-choice test questions with answer keys for each Step,
Sample Step 3 Primum cases with feedback, and
Orientation materials for Step 2 Clinical Skills (CS).
In addition, the National Board of Medical Examiners® (NBME®) provides, for a fee, self-assessment services to help the examinee evaluate his or her readiness to take USMLE. These services help individuals become familiar with questions like those that have appeared on USMLE and provide performance feedback on the individual's areas of relative strength and weakness. See www.nbme.org to obtain additional information and to purchase self-assessment services.
Beyond these USMLE and NBME services, there are a variety of commercial test preparation materials and courses that claim to prepare examinees for USMLE examinations. Examinees who are considering using such services should fully understand the nature of these services, the sources of any content being used, and the basis for any claims being made. None of these third-party materials or courses are affiliated with or sanctioned by the USMLE program and information on such materials and courses is not available from the Educational Commission for Foreign Medical Graduates (ECFMG), the Federation of State Medical Boards (FSMB), NBME, USMLE Secretariat, or medical licensing authorities.
Please note that it is unlawful for any test preparation program or any individual to use, disclose, distribute, or provide access to questions or answers from actual USMLE exams. An examinee who is involved with any enterprise that disseminates USMLE content should be aware of the consequences, which include the possible cancellation of USMLE registration and/or testing, the withholding or cancellation of scores, and the imposition of additional sanctions.
April 2011
Change to USMLE Procedure for Reporting Scores
Starting July 1, 2011, USMLE transcripts reported through the Electronic Residency Application Service (ERAS) reporting system will no longer include score results on the two-digit score scale. USMLE transcripts reported through ERAS will be exclusively on the three-digit scale. State medical boards and examinees will continue to receive both the two-digit and three-digit scores on USMLE transcripts. Further information may be found at http://www.usmle.org/General_Information/announcements.aspx.
Please note fees for providing an official transcript will remain the same. Please see official transcript information at www.fsmb.org.
USMLE Fees Adopted for the 2012 Test Cycle
The United States Medical Licensure Examination (USMLE) Budget Committee adopted the following fees for the 2012 test cycle at its April 18, 2010 meeting: Step 1, $535; Step 2CK, $535; Step 2CS $1,140 and Step 3, $745. (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.
March 2011
Comprehensive Review of USMLE (CRU)
The Composite Committee of the USMLE initiated a process to undertake a comprehensive review of the USMLE Examination in 2004. The Composite Committee establishes policy for the USMLE and is comprised of members of the Federation of State Medical Boards (FSMB), National Board of Medical Examiners (NBME), and the Educational Commission for Foreign Medical Graduates (ECFMG).
This multi-year project to review and revise the USMLE sequence is called the Comprehensive Review of USMLE (CRU). A progress summary appears and more detailed information can be found by clicking here. Additional information in the form of frequently asked questions (FAQs) concerning CRU is also available.
January 2011
Delay in Step 3 Score Reporting
Most score reporting of Step 3 results occurs within four weeks of testing. However, because of routine modifications to the test item pool, as well as an update to PRIMUM software announced on December 16, 2010, there will be a delay in reporting for most examinees testing beginning in mid-February 2011.
The target date for reporting scores for Step 3 examinees testing from mid- February through early April is Wednesday, April 27, 2011. It is possible that scores will be available earlier than this date; please check this website for updates.
