Field Trial for USMLE

The NBME plans to conduct a February 2008 field trial to ensure the stability and production-readiness of new exam software and to assure seamless integration with Prometric systems. This field trial will serve as a full "dress-rehearsal" prior to the new software delivery of USMLE exams beginning in August 2008. Participants will be selected on December 10, and the testing window will run from February 11 to March 1, 2008. As with the July field trial, Step 2 and Step 3 exam formats will be offered. There will be 38 domestic and 23 international testing locations for the 650 selected participants who must be eligible to take USMLE Step 2 or Step 3.

Breastfeeding During the USMLE

The FSMB's partner in USMLE, the National Board of Medical Examiners, has developed a Q&A about USMLE policies and circumstances that may affect women who wish to express milk during the administration of a USMLE Step.

Change in Limit on Attempts for Computer-Based Steps

As stated in the 2007 USMLE(tm) Bulletin of Information, the USMLE program has allowed no more than three attempts at the same Step or Step Component within any 12-month period.

Effective immediately, the limit on attempts for computer-based examinations has been increased. Examinees are now permitted up to four attempts at the same computer-based examination (Step 1, Step 2 CK and Step 3) in any 12-month period.

For Step 2 CS only, the limit on attempts will remain at no more than three attempts in any 12-month period.

Upcoming Changes to Candidate Identification Number Screen Prompt

During computer-based USMLE Step Examinations, examinees are required to enter their Candidate Identification Number to launch the examination and to re-enter the examination after a break. Beginning in late August, the examinee's name, as well as the digital photograph of the examinee taken at the Prometric test center will appear on this screen. This update to the test delivery software will be phased in over several weeks.

Reporting of USMLE Results Available On-Line

Beginning in August 2007, examinees will be able to view, download and print their score reports via the Internet. Using password protection, examinees will log onto the web site of their registration entity and obtain examination results. Results will be accessible for approximately 120 days, after which examination results will be made available only in the form of an official paper USMLE transcript. Paper USMLE score reports will be phased out during August 2007. During the transition in August 2007, some examinees will receive the paper score report and others will not. If an examinee's scores are scheduled for on-line release, the examinee will be notified via email when his or her score is available on-line. Examinees will follow instructions on the web site of their registration entity to view, download and print their score reports.

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 2 Clinical Knowledge and Clinical Skills

At its June 2007 meeting, the Step 2 Committee conducted such a review for both USMLE Step 2 Clinical Knowledge (CK) and Clinical Skills (CS). During the meeting, the Step 2 Committee considered information from multiple sources, including: 1) recommendations from independent groups of physicians who have participated in content-based standard-setting activities in 2007; 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 results of the review are listed below. Because there are no reported scores for Step 2 CS, the decisions of the Step 2 Committee for that component of Step 2 are reflected in terms of potential impact on examinees using data from recent administrations.

Step 2 CK

The Step 2 Committee decided to raise the three-digit score recommended to pass Step 2 CK from 182 to 184. The new minimum passing score will be applied to Step 2 CK examinations for which the first day of testing is on or after July 1, 2007.

Step 2 CS

The Step 2 Committee decided to increase the performance levels required to receive a passing outcome on two of the three Step 2 CS subcomponents: Communication and Interpersonal Skills (CIS) and Spoken English Proficiency (SEP). There will be no change to minimum passing requirements for the Integrated Clinical Encounter (ICE) subcomponent of Step 2 CS. If these increases in the performance levels required to pass were applied to a recent group of first-time examinees, the overall passing rate for examinees from US schools would have decreased less than one percent and the overall passing rate for examinees from international medical schools would have decreased approximately eight percent. The new passing requirements will be applied to Step 2 CS examinations for which the first day of testing is on or after July 15, 2007.

Online Scheduling Now Available for USMLE Step 3

Scheduling a testing date for the United States Medical Licensing Examination (USMLE) Step 3 has become even easier with an online option through Prometric. The two-day Step 3 examination can be scheduled, confirmed, rescheduled, and cancelled at www.prometric.com. This service is available 7 days a week, 24 hours a day and represents an expansion of the same services previously available only through calling the Prometric Contact Center via telephone.

Step 2 CK Examination to include Items with Associated Audio and Video beginning in August 2007

A small number of multiple-choice items with associated audio and/or video clips will be introduced into the USMLE Step 2 CK Examination beginning in early August 2007. No more than 5 items with associated media clips will appear in a single examination. The 2007 USMLE Orientation Materials include a small number of multiple-choice items that contain exhibits involving audio and/or video clips. Instructions for practicing with items with associated media clips on Step 1, Step 2 CK, and Step 3 are provided in the Tutorials for each Step examination in the orientation materials.

USMLE Fees Adopted for 2007 Test Cycle

The United State Medical Licensure Examination (USMLE) Budget Committee adopted the following fees for the 2008 test cycle at its April 16, 2007 meeting : Step 1, $480; Step 2CK, $480; Step 2CS $1025 and Step 3, $670. (Note: Some variation in fees may occur based on the registering entity and the location where the USMLE is administered.) The $670 cost for Step 3 falls within the previously established $690 fee ceiling as communicated to member boards in a memorandum dated April 11, 2006. The committee also voted to establish a $700 fee ceiling for the Step 3 for the 2009 test cycle.

The fee ceiling alerts examinees and state boards of the possible maximum fee for the next test cycle. The fee schedule will be published in USMLE application materials as well as available on this site. For more information, please contact FSMB's Examination Services department at (817) 868-4041 or by e-mail at usmle@fsmb.org.

Elimination of the 60-Day Waiting Period to Retake a Failed Step or Step Component

Current USMLE policy states that if you fail or do not complete a Step or Step Component and wish to retake it, you may do so no sooner than 60 days after your previous test date.

At its recent meeting, the USMLE Composite Committee reviewed this policy and determined that the 60-day waiting period would be discontinued. Therefore, effective May 1, 2007, the 60-day waiting period between attempts at the same USMLE Step or Step Component will be eliminated.

Other than the 60-day rule change, all other requirements to retake a Step or Step Component remain the same; this includes the restriction that you may take a Step or Step Component no more than three times in any 12-month period. Please refer to the USMLE Bulletin of Information for complete information on retaking USMLE Steps.

Field Trial for Test Delivery Software

The National Board of Medical Examiners® (NBME®) is developing new software for delivery of its examination programs, including the United States Medical Licensing Examination™ (USMLE™), which is jointly owned by the Federation of State Medical Boards (FSMB).

A field trial of this software is planned for July 16 to August 4, 2007, at selected test centers of Thomson Prometric, a division of Thomson Learning, Inc. This trial is primarily a test of software functionality, but will resemble USMLE Step 3 in content and format. Those who anticipate taking USMLE Step 3 may find this field trial useful.

Step 3 - Revision to the Organization of Multiple-Choice Question Blocks

The multiple-choice question (MCQ) portions of the Step 3 examination are organized into blocks that correspond to the clinical settings for the patient encounters. Each setting is described at the beginning of the block. The settings have been organized according to three types: (1) office/health center; (2) inpatient facilities; and (3) emergency department.

Beginning mid-to-late March 2007, items in the inpatient facilities and emergency department settings will appear together in the same block. This is a change in the way items are grouped within each block -- there is NO change to the types of items that will be encountered.

There will also be NO change to the total number of MCQ blocks (seven on Day 1 and 4 on Day 2) or to the total number of items per block (48 items per block on Day 1 and 36 items per block on Day 2).

The introductory screen for the emergency department and inpatient facilities settings appears below:

Emergency Department and Inpatient Facilities
You encounter patients in the emergency department and inpatient facilities, including the hospital, the adjacent nursing home/extended-care facility, and detoxification unit. Most patients in the emergency department are new to you and are seeking urgent care, but occasionally, you arrange to meet there with a known patient who has telephoned you. You have general admitting privileges to the hospital, including to the children's and women's services. On occasion you see patients in the critical care unit. Postoperative patients are usually seen in their rooms unless the recovery room is specified. You may also be called to see patients in the psychiatric unit. There is a short-stay unit where you may see patients undergoing same-day operations or being held for observation. Also available to you are a full range of social services, including rape crisis intervention, family support, and security assistance backed up by local police.

USMLE Offers Electronic Scheduling Permits

In December 2006, the USMLE program began producing scheduling permits in an electronic format. This e-permit allows examinees to move forward quickly in accessing the necessary information for scheduling their Step 1, Step 2 Clinical Knowledge (CK) or Step 3 administrations. The e-permit is posted to the USMLE candidate website currently available to all Step examinees for monitoring the status of their application. This service replaces the prior practice of generating and mailing a scheduling permit to applicants via first class mail. With the e-permit, applicants can more quickly access and print the scheduling permit and then schedule their examination. Additionally, misplaced or destroyed scheduling permits are no longer problematic to applicants as the e-permit remains posted to the Candidate website until a score is reported for that Step administration. Note: Examinees are required to print and present a copy of the scheduling permit to proctoring staff in order to sit their Step examination.

Preparations are underway to offer electronic scheduling permits for the USMLE practice exam with April 2007 as the tentative target date for this service. Additionally, the USMLE Composite Committee has approved reporting the results of individual test administrations electronically to the same candidate website. Additional details-including target implementation dates-will be posted as they become available.